Healthcare Analytics Business Consultant, SQL​/Python

• Write robust, efficient SQL and Python code to extract, manipulate, and analyze large healthcare datasets
• Design, develop, and maintain complex data analyses supporting investigations of potential fraud, waste, and abuse in healthcare claims and provider activity
• Prepare timely and accurate operational and customer-facing reports according to prescribed guidelines and standards
• Communicate data-analysis findings through easy-to-understand visualizations and related documents for diverse audiences
• Collaborate with SIU investigators, leadership, program integrity managers, and compliance teams to understand business processes and translate them into actionable data requirements
• Develop and participate in presentations and consultations with business partners on data, capabilities, and performance results
• Identify data-quality issues, perform root-cause analysis, and recommend improvements to reporting accuracy and data integrity
• Document data logic and methodology to ensure reproducibility and transparency
• Stay informed about policy, workflow, and FWA-detection changes to maintain compliance

• 3+ years of experience in data analytics or data science, preferably in healthcare, health insurance, or Medicaid/Medicare programs
• Ability to distill complex data into meaningful insights and present findings to non-technical audiences
• Solid understanding and experience interpreting medical claim data
• Advanced experience in SQL coding sourcing from a data warehouse
• 3+ years of data interpretation and analysis experience
• 3+ years of project leadership experience
• Strong business and systems knowledge
• Excellent problem-solving, critical thinking, and written communication skills
• Advanced experience in Excel
• Bachelor's degree or equivalent experience
• Preferred:
  Experience in healthcare fraud, waste, and abuse
• Preferred:
  Proficiency in Python for data analysis (Pandas, Num Py)
• Preferred:
  Knowledge of healthcare claims, adjudication and reporting
• Preferred:
  Experience with data visualization tools such as Tableau and Power BI
• Preferred:
  Familiarity with Big Query and Jupyter Notebook
• Ability to support standard East Coast business hours

Demonstrates expertise in SQL and Python for data extraction and analysis, with a strong focus on healthcare datasets. Capable of translating complex data into actionable insights and effective visualizations for diverse audiences.

• SQL Coding
• Python Proficiency
• Data Analysis
• Healthcare Fraud Detection
• Data Visualization

• SQL
• Python
• Data Analysis
• Data Interpretation
• Data Quality Assessment
• Root-Cause Analysis
• Excel
• Healthcare Claims Analysis
• Data Manipulation
• Data Reporting

• Problem-Solving
• Critical Thinking
• Written Communication
• Collaboration
• Presentation Skills

• Healthcare
• Fraud Waste Abuse
• Medicaid
• Medicare
• Data Warehouse

• Tableau
• Power BI
• Big Query
• Jupyter Notebook