At GDIT, people are our differentiator. Our work depends on a Fraud, Waste and Abuse Data Scientist joining our team to support Centers for Medicare and Medicaid Services anti-fraud activities. As a FWA Data Scientist supporting the Healthcare Fraud Prevention Partnership, you will be trusted to collaborate with Subject Matter Experts and other Data Scientists to create unique fraud detection methodologies within a multi-billion record database made up of a large partnership of public and private healthcare payers. You will be a part of a 12-person team supporting the Trusted Third Party fraud, waste and abuse data analytics.
We are GDIT. The people supporting and securing some of the most complex government, defense, and intelligence projects across the country. We ensure today is safe and tomorrow is smarter. Our work has meaning and impact on the world around us, but also on us, and that’s important.
GDIT is your place. You make it your own by embracing autonomy, seizing opportunity, and being trusted to deliver your best every day.
We think. We act. We deliver. There is no challenge we can’t turn into opportunity.
In this role, a typical day will include:
This position is within a multi-disciplinary team of Data Scientists, Business Intelligence Analysts and FWA Subject Matter Experts. Our team is 100% remote and distributed throughout the country.
This position will be responsible for development and execution activities in multi-payer environments by creating, reviewing, and maintaining statistical analysis plans, providing data interpretation and generating reports in support of proposed research questions.
The FWA Data scientist will develop statistical tests for FWA modeling results and provide predictive analytic statistical support.
This position is responsible for preparing timelines for statistical project management and performs and interprets basic and complex analyses.
The FWA Data Scientist will provides quality review on statistical analysis and programs plan to ensure consistency with protocol and adequacy to meet objectives defined in protocol, by collaborating with other statisticians and programmers to identify potential data problems from analytic queries and to take appropriate action to guide the resolution process.
This position requires documenting analyses, creating summaries and presenting written and verbal results for FWA study reports.
The FWA Data Scientist will effectively communicate statistical and data-related concepts to non-statisticians (managers, researchers in other fields, etc.).
This team member will be called upon to lead or co-lead small project teams as necessary.
Master’s Degree in Statistics or related field.
7+ years of experience in statistical and computer-science related field(s).
5+ years of experience using SAS software for healthcare Fraud, Waste and Abuse data mining and statistical modeling.
5+ years client relation activities, ingesting and synthesizing customer requirements and effectively communicating complex healthcare analytic outcomes to client satisfaction.
5+ years expertise in medical terminology and all healthcare coding systems (e.g., ICD-10, CPT, HCPCS, DRG and the like).
5+ years of experience datamining for healthcare fraud, waste and abuse in large, multi-payer databases with diverse health care benefit structures and claim processing systems, including private plans (commercial insurance) as well as Federal and State public plans (Medicare and Medicaid).
5+ years of experience researching, interpreting and applying payer medical (coverage) policies (e.g., LCDs, NCDs, private carrier medical policies) and common industry claim edits (e.g., NCCI).
2+ years of experience using Tableau, with demonstrable experience communicating and visualizing complex healthcare analytic outcomes
Demonstrated expertise in the complete Microsoft Office Suite including: Word, Excel, and PowerPoint
Competence and experience in the following programming languages and platforms: Linux, SQL, Hadoop, Python and/or R.
Strong supervisory experience leading project teams and/or mentorship ability guiding new analysts.
Ability to communicate technical outcomes with a high degree of detail and precision to technical audiences, while at the same time being able to communicate those outcomes to non-technical audiences in an approachable and understandable manner.
Exceptional problem-solving abilities, accuracy with work, strong organizational skills, attention to detail and the ability to multi-task while meeting deadlines.
Excellent communication skills, both written and verbal, and especially the ability to communicate data clearly to clients.
Ability to work in a fast-paced, team-oriented environment with minimal supervision.
WHAT GDIT CAN OFFER YOU
The GDIT HFPP Trusted Third Party is the only data warehouse of its type anywhere, bringing in many billions of healthcare claims from dozens of healthcare payers, including federal, state and local plans both public and private. We use this data warehouse solely for fraud, waste and abuse analytics.
The TTP is responsible for identifying overpayments, fraud leads, and meaningful insights about abusive billing behaviors through a cross-payer lens. Government and private healthcare. organizations collaborated to form the HFPP as a public-private partnership to combat fraud, waste, and abuse.
Competitive pay and benefits, flexible work schedule, collaborative inter-disciplinary environment where the best idea wins.
General Dynamics Information Technology is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.
We are GDIT. The people supporting some of the most complex government, defense, and intelligence projects across the country. We deliver. Bringing the expertise needed to understand and advance critical missions. We transform. Shifting the ways clients invest in, integrate, and innovate technology solutions. We ensure today is safe and tomorrow is smarter. We are there. On the ground, beside our clients, in the lab, and everywhere in between. Offering the technology transformations, strategy, and mission services needed to get the job done.
GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.