Note: The job is a remote job and is open to candidates in USA. Zachary Piper Solutions is seeking a Data Analyst (Healthcare Fraud) to support a federal healthcare fraud, waste, and abuse initiative for the Department of Veterans Affairs Veterans Health Administration. The role analyzes healthcare data, develops fraud detection workflows, and generates leads and analytics to support government review and fraud prevention.
Responsibilities
- Develop and maintain fraud detection business rules, algorithms, and analytical workflows to identify healthcare fraud, waste, and abuse
- Analyze healthcare claims, provider, enrollment, and exclusion datasets to support provider risk scoring and case prioritization
- Build and support data pipelines, transformations, and analytics workflows within the Palantir platform
- Perform anomaly detection, network analysis, and trend analysis to identify suspicious billing patterns and coordinated fraud schemes
- Create dashboards, reports, and executive-level analytics supporting fraud prevention, payment integrity, and improper payment reduction initiatives
Skills
- Bachelor's degree in Data Science, Statistics, Computer Science, Health Informatics, Information Technology, or a related field
- 2-5 years of experience supporting federal healthcare analytics, including Medicare, Medicaid, VHA, or related healthcare programs
- Experience developing analytical business rules for fraud detection, payment integrity, healthcare claims analytics, or related use cases
- Strong experience with SQL and Python
- Knowledge of healthcare claims data, including CPT, HCPCS, ICD-10, NPI, provider, and beneficiary data
- Experience with data pipelines, data transformations, dashboards, and analytics platforms
- Ability to pass a Tier 2 / Moderate Background Investigation (MBI) and obtain a VA PIV card
- Legal authorization to work in the United States
- Ability to handle PHI in accordance with HIPAA and VA security requirements
- Experience with PySpark or R is highly desired
Benefits
- Medical
- Dental
- Vision
- 401(k)
- PTO
- Sick Leave (where applicable)
- Paid Holidays
- 100% Remote Work Arrangement within the Continental United States
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