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.
- Data Analysis and Interpretation:
- 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.
- Data Management:
- Collect, clean, and preprocess data from various sources to ensure data quality and integrity.
- Maintain and update databases and data systems as necessary.
- Reporting and Visualization:
- Create detailed reports and visualizations to communicate findings to stakeholders, including technical and non-technical audiences.
- Present data insights and recommendations to CMS leadership and other relevant parties.
- Collaboration and Support:
- Work closely with cross-functional teams, including policy analysts, healthcare professionals, and IT specialists, to support data-driven decision-making.
- Provide technical assistance and training to team members on data analysis tools and methodologies.
- Compliance and Security:
- Ensure compliance with all relevant data privacy and security regulations, including HIPAA.
- Implement best practices for data governance and management.
- 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.
- Experience with Medicare Advantage (Part C) risk adjustment and payment model.
- Knowledge of healthcare policy and regulatory environments.
- Certification in data science or related fields.
- Familiarity with CMS data systems and regulatory requirements.
- Proficiency in programming languages such as Python, R, and SQL.
- Experience with data visualization tools like Tableau, Power BI, or similar.
- Knowledge of machine learning techniques and statistical modeling.
- Familiarity with big data technologies such as Hadoop, Spark, and cloud platforms (e.g., AWS, Azure).
- Strong analytical and problem-solving skills.
- Excellent communication and presentation skills.
- Ability to work independently and as part of a team.
- Attention to detail and a commitment to data accuracy.
Essential Skills:
- Excellent written and verbal communication skills required. Strong statistical and data analytical ability and problem-solving skills required.
- Ability to manage others and work as a team member by maintaining good working relationships with co-workers, management, and customers is a must.
Organizational “Fit” Considerations:
Ability to meet deadlines as assigned is crucial. Night and weekend work may be required to accomplish tasks in timeframes assigned
Livanta LLC is an equal employment opportunity employer. All personnel processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military and veteran status or any other characteristic protected by applicable law.
If you need assistance or an accommodation due to a disability, you may contact us at 757-306-4920 or hr@livanta.com.