Data Analyst Fraud Waste & Abuse
RIT Solutions
Data Analyst Fraud Waste & AbuseThe Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You will be working with a State Government Product and Data Mining team. Your primary responsibility will be to assist in the development and deployment of algorithms designed to support program integrity across various platforms and states plus support our fraud and abuse detection product and services. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:3+ years experience writing intermediate SQL queries3+ years fraud, waste and abuse data mining experience2+ year data analysis experience working with database structures2+ years of healthcare claims experiencePreferred Qualifications:Industry certifications: Certified Professional Coder (CPC) or Certified Fraud Examiner (CFE)Experience with statistical analysis of dataKnowledge of Medicaid policy and real-life fraud, waste, abuse schemesKnowledge of healthcare claim adjudication systemsExperience with Rally
$110.7k - $218.3k
...organization. Join our team and use advanced data, AI, and emerging technologies with... ...with a cross disciplinary team to deploy a fraud detection accelerator for a large... ...programs identifying and mitigating fraud, waste, or abuse. Ability to travel 5-25%, on average, based...FraudLocal area$91.7k - $163.7k
...Insight is improving the flow of health data and information to create a more connected... ...Justice background and/or certified Fraud Investigation experienceDemonstrated solid... ...to interpret dataExperience with Fraud Waste & Abuse or Payment IntegrityPrevious CMS experience...FraudMinimum wageFull timeWork experience placementLocal areaRemote work$91.7k - $163.7k
...United StatesSalary: $91,700 - $163,700/yearJob Area: Business & Data AnalyticsCompany: UnitedHealth GroupAt UnitedHealthcare, we're... ...where Medicare Advantage product data is needed.The Sr Product Data Analyst is a business-facing position that will specialize in managing...SuggestedMinimum wageFull timeWork experience placementWork at officeLocal areaRemote work$112.7k - $193.2k
...GroupOptum Insight is improving the flow of health data and information to create a more connected... ...of Optum Payment Integrity's Intelligent Fraud Detection products. This role offers the... ...5+ years of experience in fraud and abuse domains within payment integrity 3+ years...FraudMinimum wageFull timeWork experience placementWork at officeLocal areaRemote workShift work- ...UnitedHealth Group's UnitedHealthcare team seeks a Sr Product Data Analyst to manage eligibility and benefit data for Medicare Advantage, collaborating with vendors and internal stakeholders to ensure CMS-compliant, accurate data. This role supports data exchanges, validates...SuggestedRemote work
$24 - $43 per hour
...people with the care, pharmacy benefits, data and resources they need to feel their... ...together. The C&S Coding Clinical Analyst is required to determine the accuracy... ...billing patterns and trends, evidence of fraud, waste or abuse, and recommends providers to be flagged...FraudHourly payMinimum wageFull timeContract workWork experience placementLocal areaRemote work$96.9k - $121.1k
...place in the Twin Cities to build a career. Job Purpose: As a Data Analyst III, you will design and deliver analytics solutions that support... ...recruitment experience for our applicants. Recruitment fraud is a growing concern for job seekers, so please be aware that...FraudFull timeSummer workCasual workWork at officeWork visaFlexible hoursWeekend work1 day per week$91.7k - $163.7k
...United StatesSalary: $91,700 - $163,700/yearJob Area: Business & Data AnalyticsCompany: UnitedHealth GroupAt UnitedHealthcare, we're... ...while supporting a positive member experience.This Senior Data Analyst role is s business-facing data analyst role responsible for developing...Minimum wageFull timeWork experience placementLocal areaRemote work$200.4k - $343.5k
...make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative... ...payment integrity, claims editing/coding, clinical validation, or Fraud, Waste, and Abuse (FWA) systemsHands-on familiarity with healthcare data and...FraudMinimum wageFull timeWork experience placementWork at officeLocal areaRemote work- ...5:00 PM CST - Hybrid Schedule 2-3 days in the office. Cargill's Data Function is transforming their data platform and analytics foundation... ..., and standards. We are looking for a Data Platform Governance Analyst to play a significant role in the implementation and operations...Contract workWork at officeMonday to Friday
- ...Job PostingProject Notes:Team:Messaging AnalyticsUHC ops – shared service analytics team – several pillars – Group does OMNI Channel Data and Analytics; calls, chat, etc. COO’s come to them for data and analytical needsLooking for resources that can really work...
$134.6k - $230.8k
...initiatives, ensuring alignment between business objectives, data strategies, and technology platforms across multiple business... ...adoption.Drive architecture strategy for Payment Integrity, Claims, Fraud, Waste & Abuse (FWA), and Cost Containment programs, incorporating...FraudMinimum wageFull timeWork experience placementLocal areaRemote work$102.1k - $175.1k
.... We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration... ...is the norm and every member feels valued. Medica’s Lead Analyst, Healthcare Analytics provides reporting and analytical support...Work experience placement3 days per week$30 - $60 per hour
...based on your skills and experience — talk with your recruiter to learn more. Base pay range $30.00/hr - $60.00/hr Title: Data Governance Analyst Location: St. Louis Park, MN Employment Type: 6-12 month Contract + Extensions / Conversion Day to Day: Our client is...Contract work$24 - $43 per hour
...people with the care, pharmacy benefits, data and resources they need to feel their... ...supports the identification of suspected Waste & Error of health insurance claims and... ...patterns and trends, evidence of fraud, waste, or abuse, and recommends providers to be flagged...FraudHourly payMinimum wageFull timeContract workWork experience placementLocal areaRemote work- Required Skills : **10+ years experience in Net Programming-C# .Net, .Net Framework, .Net Programming-VB .Net, ASP.NET MVC, .Net Core,SQL, ASP.NET Core . ** AI Agent Framework ** Experience with AI Assisted coding using AI Agentic frameworks Job description/Responsibilities...Remote job
$24 - $43 per hour
...Coding Quality Analyst Optum is a global organization that delivers care, aided by... ...people with the care, pharmacy benefits, data and resources they need to feel their... ...Behavioral Health experience Experience with fraud, waste, abuse, and error Knowledge of CMS 1500 and...FraudRemote jobHourly payMinimum wageFull timeWork experience placementLive inLocal areaMonday to FridayShift work$112.7k - $193.2k
...improving the flow of health data and information to create a more... ...Clinical resources, Business Analysts, and Matrix Partners to... ...Commercial client savings through Fraud, Waste, and Error recoveries, while... ...within the Fraud, Waste, Abuse space ~3+ years of experience...FraudMinimum wageFull timeContract workWork experience placementWork at officeLocal areaRemote work- ...connect, protect, analyze, and act on their data and applications wherever they live, from... ....Job Description:The Product Management Analyst provides financial, pipeline, and... ...applicants with criminal histories.Recruitment Fraud AlertWe have become aware of an increase...FraudFull timeWork experience placementWork at officeLocal areaImmediate startShift work2 days per week
- ...Asset Protection professional to observe and document suspicious activity, conduct interviews, and lead investigations into theft and fraud across stores. You will collect evidence, report findings, and support leadership in maintaining a secure retail environment. The...Fraud
- ...Job Description Job Description Performs data collection, analysis, validation, cleansing, and reporting. Designs, codes, tests, debugs, and documents ETL processes, SQL queries, and stored procedures. Extracts and analyzes data from various sources, including databases...
$165k - $200k
...across global operations. The role will also lead the company's Anti-Fraud Program, including prevention, detection, risk assessment, and... ...and Anti-Fraud programs across businesses and functions. Data Analysis: Uses data, dashboards, and AI tools to identify trends...FraudWork experience placement$24 - $43 per hour
...Clinical Professional Coding Analyst Optum is a global organization that delivers... ...people with the care, pharmacy benefits, data and resources they need to feel their best... ...(PPCV) product within Commercial Fraud, Waste, Abuse, and Error for external commercial clients...FraudRemote jobHourly payMinimum wageFull timeWork experience placementLocal area- Ziegler CAT in Bloomington, MN is seeking a Product Support Data Analyst to analyze operational and financial data and deliver actionable insights to support growth and efficiency. The role emphasizes data mining, reporting, and visualization, working with leadership to...
$165k - $200k
...overseeing adherence to federal and state privacy, security, and fraud, waste, and abuse regulations. Monitor compliance with CMS Conditions of... ...sustainable growth. Influence decision-making through data, risk analysis, and regulatory insight. Qualifications...FraudFor contractorsWork at officeLocal area$91.7k - $163.7k
...United StatesSalary: $91,700 - $163,700/yearJob Area: Business & Data AnalyticsCompany: UnitedHealth GroupAt UnitedHealthcare, we're... ...rigorous evaluations across all Lines of Businesses. The Senior Data Analyst 1) supports the team in analytic dataset creation for...Minimum wageFull timeWork experience placementWork at officeLocal area$78.1k - $128.5k
...tools for researchers to further treat and prevent disease worldwide.Pay Range:$78,100.00 - $128,500.00Position Summary:The Senior Data Analyst, Supply Chain & AI engages in supply chain agility, operational performance, and cost efficiency through data, process...Full timeTemporary workInternshipWork at officeWorldwideFlexible hours- ...UnitedHealthcare is seeking a qualified specialist for the Quality Reporting Operations team to oversee HEDIS data reporting and process improvements across programs. This role supports NCQA/HEDIS reporting requirements and ensures alignment with organizational strategy...Work at officeRemote work
- ...Job Description Job Description Required Qualifications " Strong SQL and data analysis skills. " Experience working with large-scale data warehouses and analytics platforms. " Experience with GCP data environments, including BigQuery. " Strong requirements...
$180k - $190k
...legal issues related to provider health care organizations, including Medicare and Medicaid reimbursement, regulatory compliance, fraud and abuse laws, HIPAA, state privacy laws, and transactional experience involving health care organizations. Key Qualifications...FraudTemporary work
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