Data Scientist - Medicare Part C - Remote

Overview

We are seeking a highly skilled and motivated Data Scientist with expertise in Medicare Part C data to join our team. The successful candidate will play a critical role in analyzing and interpreting complex healthcare data to support the Centers for Medicare & Medicaid Services (CMS) in detecting and preventing fraud, waste, and abuse (FWA) within the Medicare Advantage (Part C) program.

In Short

• Analyze large datasets related to Medicare Part C to identify trends, patterns, and anomalies indicative of FWA.
• Conduct statistical analyses and develop predictive models to support investigations and enhance program integrity.
• Utilize machine learning techniques to detect and prevent fraudulent activities.
• Collect, clean, and preprocess data from various sources to ensure data quality and integrity.
• Create detailed reports and visualizations to communicate findings to stakeholders.
• Work closely with cross-functional teams to support data-driven decision-making.
• Ensure compliance with all relevant data privacy and security regulations, including HIPAA.
• Provide technical assistance and training to team members on data analysis tools.
• Maintain and update databases and data systems as necessary.
• Present data insights and recommendations to CMS leadership.

Requirements

• Minimum of 3 years of experience in data science, with a focus on healthcare data analysis.
• Bachelor’s degree in Data Science, Statistics, Computer Science, Applied Mathematics, or a related field. Master’s degree preferred.
• Experience in supporting data analysis within the context of fraud, waste, abuse, and investigations.
• Proven experience working with Medicare Part C data.
• Knowledge of healthcare policy and regulatory environments.
• Proficiency in programming languages such as Python, R, and SQL.
• Experience with data visualization tools like Tableau, Power BI, or similar.
• Strong analytical and problem-solving skills.
• Excellent communication and presentation skills.
• Attention to detail and a commitment to data accuracy.

Benefits

• Equal employment opportunity employer.
• Supportive work environment.
• Opportunities for professional development.
• Flexible working hours.
• Remote work options.