Healthcare Statistician

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

We are looking to add a Healthcare Statistician to our SGS team of talented professionals.

What you'll do:

• Develop sampling designs to support compliance and fraud case development.
• Collaborate with Investigations, Audits, and Medical Review staff to develop projection methodologies consistent with the client policy manuals, e.g. IOM 100-08 or IOM 100-15.
• Extract data from multiple systems, using various statistical tools, neural network and machine learning techniques for sampling, projections and analysis to detect potentially fraudulent behaviors and build designs to support fraud case development.
• Will present results of statistical work to non-statistical audiences, including investigators and law enforcement people at all levels.
• Telework available from anywhere in the continental U.S.

Basic Qualifications:

• Bachelor's Degree with 5 years of experience or Master’s degree with 3 years in statistics or in a related field (e.g., psychometrics, biostatistics, econometrics, mathematics etc)
• Working knowledge of Python and SAS
• Significant coursework in sampling and estimation methodologies and experience in interpreting results
• Ability to communicate effectively, internally and externally
• Excellent analytic and quantitative skills
• Good interpersonal skills
• Extract, transform, and load data from various sources to support the sampling process
• Perform statistical sampling and extrapolations to support program integrity investigations
• Produce and submit required deliverables according to established time guidelines
• Must be a US citizen 

The most competitive candidates will have:

• Prior work experience in the health insurance industry, a utilization review firm, or another health care claims processing organization in a role that involved extrapolations and related activities
• High proficiency with Microsoft Office applications, especially Word, Excel, PowerPoint and Access
• Experience with Business Objects or equivalent
• Knowledge of Medicare and Medicaid programs, rules and regulations preferred
• Experience working with healthcare claims data and familiarity with CPT/HCPC, Procedure codes, Diagnosis codes.
• Ability to organize work and systematically pursue a hypothesis through statistical techniques including regression models and interaction with subcontractors on sophisticated predictive software
• Ability to conduct self-directed research to uncover potentially fraudulent or abusive billing using a variety of data sources and analytic tools
• Perform self-directed research and utilize data analysis tools and techniques to detect any issues with Medicare/Medicaid claims data
• Perform statistical sampling and extrapolations to support program integrity investigations