Data Analyst - Medicare Part C Claims

April 2

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LivantaLLC

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Livanta LLC is a technology-enabled organization dedicated to advancing healthcare quality through innovation. It specializes in providing services to patients, caregivers, healthcare providers, and payers, focusing on improving health outcomes, navigating healthcare systems, and ensuring payment accuracy. Livanta is recognized as the largest Medicare Quality Improvement Organization and offers a range of services including quality oversight, auditing, advocacy, and data analytics to enhance patient care and safety while managing healthcare costs effectively.

Information Technology • Data Analysis • Health Information Technology and Healthcare Consulting • Performance Measurement and Data Analytics • Strategic Communications

201 - 500 employees

Founded 2004

⚕️ Healthcare Insurance

📚 Education

📋 Description

• DATA ANALYST Job Summary: We are seeking a detail-oriented and analytical Data Analyst with experience in Medicare Part C data to join our team. • The successful candidate will be responsible for collecting, processing, and analyzing healthcare data to support the Centers for Medicare & Medicaid Services (CMS) in detecting and preventing fraud, waste, and abuse (FWA) within the Medicare Advantage (Part C) program. • Key Responsibilities : • Data Collection and Management : • Collects, manages, and analyzes data from various sources, including pharmacies, dispensers, and manufacturers, to identify trends and potential compliance issues. • Gather and organize data from various sources, including Medicare Part C claims, provider records, and beneficiary information. • Ensure data quality and integrity through rigorous validation and cleaning processes. • Data Analysis : • Perform detailed data analysis to identify trends, patterns, and insights related to Medicare Part C. • Use statistical methods and data visualization tools to interpret and present findings. • Develop and implement algorithms and models to detect potential FWA activities. • Reporting and Documentation : • Develops data models, dashboards, and reports that summarize key findings and support decision-making for program leadership. • Develop comprehensive reports and dashboards to communicate data insights to stakeholders. • Document methodologies, processes, and findings in a clear and concise manner. • Collaboration and Support : • Work closely with cross-functional teams, including data scientists, policy analysts, and healthcare professionals, to support data-driven decision-making. • Provide technical support and training to team members on data analysis tools and techniques. • Compliance and Security : • Ensures data integrity and accuracy throughout all program-related analysis, including during audits and investigations. • Ensure compliance with all relevant data privacy and security regulations, including HIPAA. • Implement best practices for data governance and management.

🎯 Requirements

• Education : • Bachelor’s degree in Data Science, Statistics, Computer Science, Public Health, or a related field. • Experience : • Minimum of 2 years of experience in data analysis, preferably in the healthcare sector. • Experience in supporting data analysis within the context of fraud, waste, abuse, and investigations. • Proven experience working with Medicare Part C data. • Familiarity with CMS data systems and regulatory requirements. • Experience working with large datasets. • Technical Skills : • Proficiency in data analysis tools and programming languages such as SQL, Python, R, and Excel. • Experience with data visualization tools like Tableau, Power BI, or similar. • Knowledge of statistical analysis and modeling techniques. • Soft Skills : • Strong analytical and problem-solving skills. • Excellent communication and presentation skills. • Ability to work independently and collaboratively in a team environment. • Attention to detail and a commitment to data accuracy.