The Fraud Waste Abuse Analyst is responsible for planning and conducting statistical and epidemiological analysis of health care data in support of the HMS Mission, Vision, Key Quality Strategies, and Values.
Essential Functions: Design and conduct analysis of health care databases using SAS statistical analysis software and other relevant tools for multiple health care projects. Serve as an analytic resource within multi disciplinary project teams. Provide statistical and epidemiologic input to study design, sampling methodology, analysis, and reporting to assure statistical integrity of project. Develop data formatting and cleaning criteria for data from various sources and evaluates relevant data. Prepare reports and presentations documenting analytic methods and results. Conduct ad hoc analyses of data as requested by hospitals, clinicians, and internal customers. Other Functions: Performs other functions as assigned
Knowledge, Skills and Abilities: Ability to use of SAS statistical analysis software required. Ability to communicate both verbally and written in English. Ability to manipulate and analyze large databases. Ability to analyze information, using logic and processes to address work-related issues and problems. Ability to work proficiently with Microsoft Word, Excel, Access, DB2 and SQL preferred. Ability to demonstrate strong time management and project management skills. Ability to work k in a self-guided manner and in an interdisciplinary team environment effectively. Ability to use interpersonal skills with customer-service orientation. Ability to be careful and thorough about detail. Ability to function under pressure and meet deadline oriented project demands as well as manage multiple initiatives. Ability to multi-task and prioritize. Ability to organize well. Ability to perform oral presentations with good quality. Ability to perform well in team environment, with staff at all levels, to achieve business goals. Ability to work independently to meet objectives. Working knowledge of HIPAA privacy and Security rules.
Work Conditions and Physical Demands: Primarily sedentary work in a general office environment Ability to communicate and exchange information Ability to comprehend and interpret documents and data Requires occasional standing, walking, lifting, and moving objects (up to 10 lbs.) Requires manual dexterity to use computer, telephone and peripherals May be required to work extended hours for special business needs May be required to travel at least 10% of time based on business needs
Minimum Education: Bachelors degree in Applied Statistics or equivalent required, or Masters degree with equivalent work experience preferred. Minimum Related Work Experience: > 5 yrs of experience with Bachelors degree or < 1 yr experience with Masters degree
Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
HMS is enterprising healthcare. HMS delivers the broadest range of solutions in the industry to improve financial and health outcomes for at-risk organizations.
Back in 1974, HMS identified the multi-billion-dollar problem with Medicaid coordination of benefits, creating a solution from scratch for providers. We adapted that solution to state agencies and then to Medicaid managed care organizat...ions. Later we pushed beyond coordination of benefits into payment integrity – including Medicare – and data solutions for health plans, state and federal agencies, employers and at-risk providers.
Today we are the most comprehensive solutions provider for at-risk healthcare organizations in America. We’ve even expanded into health management and engagement solutions, including population health and member involvement. Using innovative technology as well as powerful data services and analytics, our solutions cover the care and payment continuum.
Based in Irving, Texas, HMS has more than 2,500 employees in 25-plus offices across the country. We are a wholly owned subsidiary of HMS Holdings Corp., traded on NASDAQ (ticker: HMSY), and certified by HITRUST. Permedion, a wholly owned subsidiary of HMS, is a QIO-like entity, and is URAC-accredited for Independent Review Organization: External Review and Health Utilization Management. With the support of our leadership, we also promote social responsibility.
Most important, we save our customers billions of dollars a year, helping to make the healthcare system better for everyone.
Enterprising is HMS. And HMS is enterprising healthcare.