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Senior Fraud, Waste, and Abuse (FWA) Data Analyst
United States
Full Remote
AI Summary
HHAeXchange is seeking a Senior Fraud, Waste, and Abuse (FWA) Data Analyst to analyze Medicaid claims and billing datasets to identify suspicious patterns and anomalies. The ideal candidate will have 5-7 years of experience in healthcare analytics and a strong understanding of Medicaid regulatory requirements. The role will involve working closely with product, engineering, and payer stakeholders to develop and refine detection tools and methodologies.
Key Highlights
Analyze Medicaid claims and billing datasets
Identify suspicious patterns and anomalies
Develop and refine detection tools and methodologies
Key Responsibilities
Analyze Medicaid claims, visit, and billing datasets using SQL and other analytical tools
Identify patterns and anomalies that may indicate fraud, waste, or abuse
Develop and refine detection queries and analytical logic that can be applied across datasets at scale
Conduct proactive data analysis to identify emerging fraud patterns and program integrity risks
Apply knowledge of the end-to-end revenue cycle to contextualize billing anomalies and assess their integrity implications
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Technical Skills Required
Benefits & Perks
Competitive health plans
Paid time-off
Company paid holidays
401K retirement program with company match
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Nice to Have
Experience with a payment integrity organization, healthcare analytics company, managed care plan, or state Medicaid agency
Experience with Python, R, or advanced analytics and data visualization tools
Experience with electronic visit verification (EVV) data and familiarity with EVV mandates under the 21st Century Cures Act
Job Description
HHAeXchange is the leading technology platform for home and community-based care. Founded in 2008, HHAeXchange was born out of an idea to create a fully comprehensive end-to-end homecare solution to help people who are aging or have disabilities thrive in their homes and communities. Our employees are passionate about transforming the healthcare space by building the only homecare ecosystem that fully connects patients, personal care providers, managed care organizations, and states.
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