Data Analyst - Medicaid Job at Peraton in Reston

Data Analyst - Medicaid

Job Locations

US

Requisition ID

2024-152760

Position Category

Audit

Clearance

No Clearance Required

Responsibilities

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

We are seeking a Data Analyst to be part of our team of professionals. You will be part of the Southeastern Unified Program Integrity Contract (SE UPIC) audit team. The SE UPIC is responsible for audits/investigations in eight States and two Territories. The Data Analyst under our Medicaid Team will focus on the data analytics of the Medicaid Managed Care Plan's (MCP) and evaluate whether their activities are safeguarding the Medicaid program and providing appropriate services to beneficiaries. This includes comprehensive Managed Care Organizations (MCOs), as well as Pre-Paid Inpatient Health Plans (PIHPs) and Pre-Paid Ambulatory Health Plans (PAHPs).

What you'll do:

The Data Analyst requires the individual to conduct research on Medicaid Managed Care Plan claims data and other sources of information to identify Medicaid program integrity issues.

Analyze data to identify and compare norms, trends and patterns.
• Present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government.
• Conduct self-directed research to uncover problems in Medicare payments made to a variety of provider types including physicians, suppliers, hospital, rehabilitation facilities, Skilled Nursing Facilities, Rural Health Care Facilities, and other healthcare professionals as well as Home Health Agencies and Hospices.
• Organize case files, research violations and accurately and thoroughly document all steps taken in project development.
• Support investigations teams by providing additional data as requested.

• Attend meetings, training and conferences; overnight travel required in some instances.
• Telework available from contiguous United States.

Qualifications

Basic Qualifications:

• Bachelors degree with 5 years; Masters with 3 years or PhD with 0 years experience.
• Proven Ability to work with a variety of systems, sources of data and analytic tools.
• This position may require the incumbent to appear in court to testify about work findings.
• Carry out data analysis to identify and compare norms, trends and patterns.
• Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government.
• Ability to report work activity on a timely basis.
• Ability to handle confidential material.
• Ability to work independently and as a member of a team to deliver high quality work.
• US Citizenship required.

Desirable Qualifications:

• Strong computer skills including experience in relational data base design, extract, and reporting, Excel, and the Internet.
• Strong proven analytical ability and basic knowledge of statistics and sampling techniques.
• Strong communication and organization skills.
• Ability to organize a case file, research violations and accurately and thoroughly document all steps taken in project development.

Peraton Overview

Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can't be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we're keeping people around the world safe and secure.

Target Salary Range

$66,000 - $106,000. This represents the typical salary range for this position based on experience and other factors.