FWA Payment Integrity Data Analyst III

Job description

Job Summary: The FWA Payment Integrity Data Analyst III is responsible for developing, implementing, managing and presenting in-depth analyses that meet the information needs associated with Fraud, Waste and Abuse. Essential Functions: - Lead and implement data analytic Ideation and R&D activities and strategy to support decision-making across multiple lines of business and clients to enable FWA growth. - Validate Program Integrity vendor deliverables, results and collaborate with PI vendors to understand and drive CareSource FWA analytic needs and results, function as consultant to propose business solutions, and communicate results of data analytics outcomes against goals and strategic plan. - Participate in analytical, experimental, investigative, and other fact-finding work in support of concept development and in conjunction with vendors. - Monitor emerging internal and external FWAE data vulnerabilities and trends which may impact CareSource and create solutions to mitigate risk. - Identify trends and patterns using standard corporate, processes, tools, reports, and databases as well as leveraging other processes and data sources - Research policies, coding guidelines, and re...