State of Tennessee · 1 day ago
DATA ANALYTICS SPECIALIST - SR - 74522
Tennessee, United States
Full-time
Hybrid
Mid, Senior Level
$6,544/mo - $10,363/mo
2+ years expThe State of Tennessee is seeking a Senior Data Analytics Specialist for the Medicaid Fraud Control Division. This role involves using advanced data mining techniques to detect healthcare fraud and patient abuse, providing actionable insights to support investigations and enhance compliance.
AgricultureChildrenEducationGovernmentHealth Care
Responsibilities
Extract, clean, and analyze large datasets from Medicaid claims, provider records, and other sources to identify anomalies and trends indicative of fraud or abuse
Develop predictive models and algorithms to detect high-risk providers and fraudulent billing practices
Translate complex data findings into actionable intelligence for special agents and attorneys
Collaborate with investigative teams to prioritize cases and support evidence development for criminal and civil prosecutions
Create clear, concise reports and dashboards to communicate findings to internal teams and leadership
Present data insights in formats that support legal proceedings and investigations
Ensure data integrity, accuracy, and compliance with federal and state regulations
Maintain secure databases and documentation for ongoing investigations and audits
Qualification
Required
a Bachelor's degree in a quantitative or related discipline AND 2 or more years of relevant professional work experience
A Master's degree in a quantitative or related discipline
6 or more years of relevant professional work experience
Preferred
Certification as a Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), or an equivalent credential
prior experience in custom data analysis for investigative work and data mining techniques
Company
State of Tennessee
State government is the largest employer in Tennessee, with approximately 43,500 employees in the three branches of government.
10001+ employees
H1B Sponsorship
State of Tennessee has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Hugh Hale
Chief Information Officer, TennCare
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