About this role
Accountabilities: As Senior Data Analyst, you will develop and execute advanced analytical approaches to detect potential fraud, waste, and abuse while supporting high-quality project delivery and collaboration across analytical teams. Develop and implement analytical models and methodologies to support Medicare and Medicaid fraud, waste, and abuse detection initiatives. Apply healthcare data and policy expertise to known fraud schemes, identifying potential patterns and indicators within claims data. Design and execute tests to validate analytical hypotheses and use findings to build and improve fraud detection models. Detect anomalies, investigate unusual activity, and identify outliers or patterns potentially associated with fraud, waste, or abuse. Build advanced analytical models using Python, R, SQL, SAS, and other appropriate tools. Extract, manipulate, merge, and analyze large Medicare, Medicaid, and other healthcare claims datasets stored in cloud environments. Design and conduct targeted analyses and prepare supporting materials aligned with project objectives. Monitor Medicare and Medicaid policy developments, assess their impact on fraud detection methodologies, and update analytical models accordingly. Participate in testing sprints and contribute to related project initiatives. Provide subject matter expertise, technical guidance, and analytical support to Statistical and Data Analysts. Support task execution, conduct peer reviews, and help maintain the quality and accuracy of project deliverables. Prepare detailed analytical reports communicating findings, methodologies, and recommendations. Potentially serve as a Team Lead, coordinating project activities, documenting progress, managing team performance, and acting as a primary client liaison. Requirements The ideal candidate combines strong quantitative and statistical expertise with hands-on experience analyzing complex healthcare claims data and developing analytical solutions for program integrity initiatives. Bachelor's degree in Statistics, Mathematics, Computer Science, or a related field, or at least 6 years of healthcare data analysis experience. At least 6 years of professional experience working with large and complex datasets. Advanced knowledge of analytical, mathematical, and statistical methods. Demonstrated experience working with healthcare claims data, particularly Medicare and Medicaid claims. Experience or working knowledge of ICD-10 codes, HCPCS, and Diagnosis Related Groups (DRGs). Strong SQL and data manipulation skills, including merging disparate datasets, INNER/LEFT/RIGHT joins, and functions such as COALESCE() and CAST(). Familiarity with SAS functions and procedures, including SUBSTR(), LAG(), and PROC SQL. Proficiency in one or more of the following analytical tools: SAS, Python, R, and SQL. Background in a health-related, scientific, public policy, or business discipline, supported by strong quantitative and statistical knowledge. Knowledge of analytical methodologies, program integrity analytics, and relevant principles. Proficiency with Microsoft Office applications, including Excel, Word, PowerPoint, and Outlook. Ability to perform complex mathematical calculations and translate analytical findings into clear conclusions. Strong analytical, organizational, customer service, leadership, and presentation skills. Excellent collaboration and communication abilities, with the capacity to work independently and as part of a multidisciplinary team. Ability to manage multiple assignments, adapt to changing priorities, and consistently meet deadlines. Demonstrated responsiveness, initiative, and a cooperative approach to tasks and requests. Additional Requirements Must successfully pass post-hire background screening checks. Must have reliable wired and/or wireless internet access to work remotely. Must be able to obtain security clearance if required by the client or contract. Benefits Annual salary range of $70,000–$100,000 for U.S.-based remote candidates. Paid vacation and sick leave. Paid holidays. Health, dental, and vision insurance. Short-term and long-term disability coverage. Life insurance. Employee Assistance Program. 401(k) retirement plan. Educational benefits. Fully remote working arrangement. Salary determined by relevant experience, geographic location, skills, internal equity, and applicable contractual requirements. How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1
- LOCATION
- Remote · US, United States
- WORK MODE
- Remote
- JOB TYPE
- Full-time
- POSTED
- Oct 30, 2026
Source: Jobgether Careers