Senior Analyst, Healthcare Fraud, Waste and Abuse

Who We Are

At Lucet, we are industry leaders in behavioral health, dedicated to helping people live healthy, balanced lives. Our purpose is to advocate for and improve the overall well-being of those we serve, through balanced treatment of the mind and body.

When you join Lucet, you become a valued member of our team, serving more than 15 million people across the U.S. Our employees have a passion for helping others - and it shows. From entry-level employees to senior leaders, we are inspired by our members, putting them first in everything we do. From day one, you'll see firsthand the impact you have on our members, knowing you can make a true difference in their lives.

Why Join our Team

At Lucet, we’re committed to creating a workplace where top talent thrives both personally and professionally. We offer a dynamic, mission-driven environment where your work has real impact, your unique background and experience are valued, and no two days are alike. If you’re passionate about meaningful work and delivering impactful results, we encourage you to apply!

We support our team with a competitive compensation and benefits package, including:

• Annual compensation between $97,000 - $110,000, PLUS an annual performance-based, discretionary incentive.
• *Compensation is dependent on non-discriminatory factors including but not limited to an applicant's skills, education/degrees, certifications, prior experience, market data, and other relevant factors.
• Comprehensive health benefit options: Medical, dental, and vision coverage
• 401(k) with competitive employer match
• Company-paid life and disability insurance
• Paid parental leave and wellbeing incentives
• Generous paid time off, including volunteer time
• Flexible spending accounts for healthcare and dependent care
• Professional development opportunities and tuition reimbursement
• Remote work flexibility (role-dependent)
• Opportunity for meaningful growth, both personally and professionally, where your unique background and experience is welcomed and valued.

At Lucet, your work will directly support our mission to improve behavioral, physical, and social health—one member at a time.

What You Will Do - Essential Functions

The Sr Analyst, Healthcare Fraud, Waste and Abuse will be a business consultant to the rest of the organization in providing reports and analysis to support Lucet’s Program Integrity and Fraud, Waste and Abuse prevention. In addition, the analyst is responsible for translating evaluation questions into analytic plans, constructing analytic datasets, producing appropriate data summaries, and conducting valid data comparisons and statistical tests.

• Reporting & Fraud, Waste & Abuse Analytics
• Lead and expand reporting and analytics programs to generate insights and drive actions supporting Program Integrity and Fraud, Waste & Abuse (FWA) prevention.
• Perform detailed claims trend and drill-down analyses to identify actionable FWA risks across member/provider populations and cost categories.
• Population Health & Strategic Analysis
• Partner with clinical strategy teams to define intervention and comparison cohorts, develop valid performance measures, and ensure appropriate use of enterprise data.
• Serve as a population health consultant by profiling member populations, identifying opportunities for new service offerings, and projecting savings through multivariable analysis.
• Cost Management & Financial Impact Assessment
• Identify cost-saving opportunities through analysis of care utilization, practice patterns, negotiations, and contract performance, while recommending improvements to reduce cost of care.
• Evaluate the financial impact of contracts, RFPs/RFIs, and operational initiatives, providing data-driven recommendations and reporting to support management decision-making.

Who You Are

• Required Qualifications

• Bachelor's Degree

• 5+ years of experience in a similar role at healthcare payer or provider organization

• Familiar with common statistical methods including but not limited to regression, propensity matching, and analysis of variance

• Proficiency in database query language (e.g. SQL, SAS). Other experience with the use of software for data analysis, extraction, and manipulation (e.g., Python, R), data visualization (e.g., Tableau, PowerBI) and analytic automation (e.g. scripting, macros)

• Experience with enterprise data warehouse and commercial/Medicare/Medicaid claims data

• Ability to read, analyze and interpret technical materials and financial data

• Must be able to present information in a small group setting with internal and external customers

• Ability to perform complex arithmetic and intermediate algebra to set up spreadsheets and reports

• Creates reports using advance graphical skills which can be quickly understood by the customer

• Ability to pass background check upon hire and throughout employment to include criminal felony & misdemeanor search, SSN validation/trace search (LEIE), education report (highest degree obtained), civil upper and lower search, 7-year employment report, federal criminal search, statewide criminal search, widescreen plus national criminal search, health care sanctions-state med (SAM), national sex offender registry, prohibited parties (OFAC) (terrorist watchlist), and a 10-Panel Drug Screen.
• Someone who embodies our values by:
• Serving everyone with compassion and leading with empathy.
• Stepping up and creating value by taking charge and acting when there is an opportunity.
• Adapting in a changing world by recognizing our responsibility to be agile and respond quickly.
• Nurturing growth and belonging by respecting and celebrating everyone for who they are.
• Competencies
• Practical problem-solving abilities, i.e. the ability to formulate hypotheses, test options and move forward in a fast-paced environment.
• Strong analytic and data management skills
• Strong oral and written communication and presentation skills
• Ability to work both independently and as part of a team is essential
• Ability to work well with individuals at all levels within the institution
• Ability to appropriately scope and execute evaluation and analysis work
• Responsible with a high level of integrity and ethical standards
• Intuitive nature to identify compliance irregularities
• Excellent communication and interpersonal skills, with the ability to collaborate across teams
• Working Conditions:
• High-speed internet service (cable or fiber optic) with minimum download Speed of 20 Mbps, Upload Speed of 5 Mbps, and Maximum Latency of 100 milliseconds (must be installed before starting) required.
• Frequent use of computer and phone systems
• Must be able to constantly remain in a stationary, sitting position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.
• Work is performed from home with company-provided equipment. Sitting for long periods of time is expected and use of fingers and hands for typing is necessary.
• A quiet workspace with minimal background noise for calls.

We encourage applicants from a variety of backgrounds and experiences to apply, especially those who can demonstrate how their unique qualifications and skills align with the requirements of this role and support our mission to improve whole-person health.

This position will accept and review new applications and resumes no less than 5 business days after the original posting date and may remain open an extended period of time with no set end date based on the level of interest.