USAJOBS · 23 hours ago
Program Analyst (Data Analytics)
Washington, District of Columbia, USA
Full-time
Onsite
Mid, Senior Level
$102K/yr - $102K/yr
4+ years expUSAJOBS is part of the Department of Justice, specifically the Criminal Division's Fraud Section. The Program Analyst (Data Analytics) is responsible for analyzing health care claims data, identifying anomalous billing patterns, supporting investigations, and providing subject matter expertise to prosecutors and investigative partners.
Telecom & CommunicationsGovernmentConsultingHuman ResourcesInformation TechnologyInternetStaffing Agency
No H1B
U.S. Citizen Only
Responsibilities
Conduct independent data analysis to identify potential new fraud investigations; complete and fulfill data analysis and information requests for law enforcement health care fraud investigations; and support and provide investigative leads
Apply knowledge of federal healthcare program rules, coding/claims processing systems (CPT, HCPCS, ICD), reimbursement structures, and provider and beneficiary enrollments to identify abnormalities and emerging fraud schemes
Design and employ appropriate algorithms to discover patterns in data sets
Identify patterns in claim volume, utilization, geographic distribution, or sudden changes in billing behavior that may indicate fraudulent conduct
Validate analytic findings using comparative analysis, sampling, and other rigorous methodologies
Provide expertise on program policies, claims systems, and health care benefit structures
Prepare written reports, presentations, and visualizations summarizing analytical results for prosecutors, management, and investigative partners
Provide training to DOJ staff, U.S. Attorney’s Offices, and partner agencies on health care claims data, fraud typologies, and analytic methods
Qualification
Required
You must be a U.S. Citizen to qualify for this position
You must complete the online questionnaire and additional assessment(s)
You must undergo a pre-employment security investigation
Selective Service Registration is required, as applicable
You must meet all qualification requirements by the closing date of this announcement
You must meet status eligibility for this announcement
Direct Deposit: All federal employees are required to have federal salary payments made by direct deposit to a financial institution of their choosing
A one-year probationary period may be required
The Criminal Division participates in the Electronic Employment Eligibility Verification Program. E-Verify helps employers to confirm the employment eligibility of all newly hired employees
To qualify at the GS-12 level, applicants must have one year of specialized experience at, or equivalent to, the GS-11 Federal grade level
To qualify at the GS-13 level, applicants must have one year of specialized experience at, or equivalent to, the GS-12 Federal grade level
Federal employees must meet time-in-grade requirements for consideration by the closing date of this announcement
Company
USAJOBS
USAJOBS enables federal job seekers to access job opportunities across hundreds of federal agencies and organizations.
10001+ employees
Funding
Current Stage
Late StageRecent News
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