Job Description
POSITION : DATA SCIENTIST / PREDICTIVE ANALYST LOCATION : 100% REMOTE/ WOODLAWN, MD DURATION: LONG TERM CONTRACT/PERMANENT
STATUS- MUST BE GREEN CARD OR US CITIZEN Data science/SAS Programmer/Data modeler type of people with a STRONG FOCUS ON R
RESPONSIBILITIES: • Analyze claims data and assist in the validation/development of requirements for sustainable predictive analytic models and edits • Works with technical staff to test fraud models & validate proper setup for production • Working with the team and client to understand data and client needs • Detect potential weakness and vulnerabilities susceptible to fraud • Attend working groups with customers, investigators, and other contractors to elicit and evaluate vulnerabilities • Prevent FWA using system edits, policy recommendations, and customer/user education • Assist with the analysis of vulnerabilities and data anomalies • Monitor claims and suspicious activities utilizing proven investigating techniques • Reporting and communicating regarding the effectiveness of fraud prevention activities • Communicate with internal and external sources related to potentially fraudulent activity • Provide input on new ways of identifying fraud as well as improving existing fraud models Requirements: • Bachelors’ Degree in related field of study, and 3-5 years of Data Analytics / Predictive Modeling experience for enterprise-level systems. • Must have hands on experience in the following areas: o Predictive analytics / modeling o Data mining o Machine Learning o SPSS, R, Python o Validation / Unit Testing for Models • Hands on experience with / knowledge of Machine Learning techniques & application • Experience with Agile project methodologies (preferably SAFe) • Knowledge of Medicare & Medicaid claims coding, processing systems, healthcare enrollment/eligibility data, as well as healthcare claims data including CPT, ICD 9 and ICD 10 codes • Goal-oriented, eager to learn, and ability to get things done with a proactive approach • Exceptional communication skills both verbal & written, with end clients & key stakeholders Preferred: • Experience with SPSS to R transformation efforts • Experience with Cloud environments such as AWS or Azure • Experience with Databricks • Knowledge of anti-fraud principles, Healthcare policy, & Legislation • Experience in fraud prevention related field(s), including fraud detection, investigation, forensic accounting, judiciary, and law enforcement • Knowledge of the Medicare FFS programs (coverage, payment rules and regulation and claims process). • Experience working with customers to understand data and decision needs. • Familiarity with one or more data analysis tools, data mining tools, and/or statistical packages.
Company Description
Intellisoft is providing staffing and team augmentation services to Fortune 500 direct clients in USA, CANADA and INDIA. With operations in USA and INDIA Intellisoft is currently engaged with leading technology, networking, telecommunication, companies to provide software consulting, team augmentation and key business process outsourcing services. Please visit our website www.intellisofttech.com for more information on us and our clients.