Data Analyst Fraud Waste & Abuse

Description –

The Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You will be working with a State Government Product and Data Mining team. Your primary responsibility will be to assist in the development and deployment of algorithms designed to support program integrity across various platforms and states plus support our fraud and abuse detection product and services.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Qualifications

Required Qualifications:

3+ years experience writing intermediate SQL queries

3+ years fraud, waste and abuse data mining experience

2+ year data analysis experience working with database structures

2+ years of healthcare claims experience

Preferred Qualifications:

• Industry certifications: Certified Professional Coder (CPC) or Certified Fraud Examiner (CFE)
• Experience with statistical analysis of data
• Knowledge of Medicaid policy and real-life fraud, waste, abuse schemes
• Knowledge of healthcare claim adjudication systems
• Experience with Rally

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy