Location(s): Remote (Continental United States) | East Coast Hours | Occasional Travel to Washington, DC
Responsibilities of the Data Analyst (Healthcare Fraud) include:
- Develop and maintain fraud detection business rules, algorithms, and analytical workflows to identify healthcare fraud, waste, and abuse
- Analyze healthcare claims, provider, enrollment, and exclusion datasets to support provider risk scoring and case prioritization
- Build and support data pipelines, transformations, and analytics workflows within the Palantir platform
- Perform anomaly detection, network analysis, and trend analysis to identify suspicious billing patterns and coordinated fraud schemes
- Create dashboards, reports, and executive-level analytics supporting fraud prevention, payment integrity, and improper payment reduction initiatives
- Bachelor's degree in Data Science, Statistics, Computer Science, Health Informatics, Information Technology, or a related field
- 2-5 years of experience supporting federal healthcare analytics, including Medicare, Medicaid, VHA, or related healthcare programs
- Experience developing analytical business rules for fraud detection, payment integrity, healthcare claims analytics, or related use cases
- Strong experience with SQL and Python; experience with PySpark or R is highly desired
- Knowledge of healthcare claims data, including CPT, HCPCS, ICD-10, NPI, provider, and beneficiary data
- Experience with data pipelines, data transformations, dashboards, and analytics platforms
- Ability to pass a Tier 2 / Moderate Background Investigation (MBI) and obtain a VA PIV card
- Legal authorization to work in the United States and ability to handle PHI in accordance with HIPAA and VA security requirements
- Salary Range: $100,000 - $110,000 depending on experience
- Comprehensive Benefits: Medical, Dental, Vision, 401(k), PTO, Sick Leave (where applicable), and Paid Holidays
- 100% Remote Work Arrangement within the Continental United States
This job opens for applications on October 9, 2026. Applications for this job will be accepted for at least 30 days from the posting date.
