Essential Responsibilities 

• Work as part of a team developing fraud detection algorithms.
• Demonstrated ability to convey complex ideas in an easily understood manner to guide audience through written or verbal communications.
• Gather and organize data.
• Meet milestone deadlines.
• Provide input into schedule and/or cost management tools.
• Take instructions from client and/or project manager and create clear documents/deliverables based on this guidance.
• Engage in proposal activity as requested.

Required Skills & Experience:

• 7 years prior work experience in the health care industry.
• 3 years of SAS programming experience.
• Formal training or at least 1 year experience in predictive algorithm methodologies, payment integrity and health care IT.
• At least 1 year experience working with Medicare and Medicaid claims data, fraud analytics, predictive analytics methodologies and payment integrity.
• At least 3 years experience in documentation of code and/or processes.
• Ability to gather, synthesize and analyze data.
• Eager attitude to learn new skills and tackle new problems.
• Must possess good communication and organizational skills.
• Must be self-directed, detail-oriented, a team player, have a strong attention to detail.

Preferred Experience:

• Formal training or at least 3 years experience in predictive algorithm methodologies, payment integrity and health care IT.
• At least 3  years experience working with Medicare and Medicaid claims data, fraud analytics, predictive analytics methodologies and payment integrity.

Education/Certifications:

• Bachelor's or Master's Degree in Public Health, Health Administration, Economics, Information Systems, Biostatistics, Applied Mathematics or related field.