Data Analyst

Zachary Piper Solutions; Northern (KY); Hybrid; USD 100,000 - 110,000; Full time

Benefits offered by this job

PTO

Paid Holidays

Medical

Dental

Vision

401K

Sick Leave

Job summary

Zachary Piper Solutions is seeking a Data Analyst (Healthcare Fraud) to support federal healthcare fraud prevention and analytics for Veterans programs. This role is 100% remote within the continental United States, with occasional travel to the Washington, DC area as needed.

You will develop fraud detection analytics, analyze claims data, and generate actionable leads to support fraud, waste, and abuse investigations.

Qualifications

• 2–5 years in healthcare data analytics or related federal initiatives.
• Strong SQL, Python and data analytics platforms experience.
• Experience with healthcare claims data and CPT/HCPCS ICD-10.
• Bachelor's degree in IT/CS/Data Science or related field.
• Ability to obtain VA PIV card after Tier 2/MBI.

Responsibilities

• Develop, test, and maintain fraud detection analytics and rules.
• Analyze healthcare claims, enrollment data for suspicious patterns.
• Build data pipelines, dashboards, and reporting solutions.
• Perform anomaly detection and provider risk scoring for investigations.
• Document methodologies and prepare executive briefings.

Skills

SQL

Python

Data analytics

Fraud detection

Dashboard development

Education

Bachelor's degree in Information Technology, Computer Science, Data Science, Statistics, Health Informatics, or a related field

Tools

ETL tools

Visualization tools

Analytics platforms

Job description

Zachary Piper Solutions is seeking a Data Analyst (Healthcare Fraud) to support a company focused on federal healthcare fraud prevention, payment integrity, and healthcare analytics supporting Veterans' healthcare programs. This position is 100% remote within the continental United States, with occasional travel to the Washington, DC area as needed. The Data Analyst (Healthcare Fraud) will develop fraud detection analytics, analyze healthcare claims data, and generate actionable leads to support fraud, waste, and abuse investigations. Join a mission-driven team dedicated to protecting Veterans, reducing improper payments, and strengthening healthcare program integrity through advanced analytics.

Responsibilities for the Data Analyst (Healthcare Fraud) include:

• Develop, test, and maintain analytical business rules and fraud detection algorithms to identify healthcare fraud, waste, and abuse (FWA).
• Analyze healthcare claims, provider, and enrollment data to identify suspicious billing patterns, improper payments, overpayments, and high-risk providers.
• Build and support data pipelines, workflows, dashboards, and reporting solutions using analytics platforms and visualization tools.
• Perform anomaly detection, provider risk scoring, and network analysis to support fraud investigations and case prioritization.
• Document analytical methodologies, support quality assurance efforts, and create executive-level reports, briefings, and recommendations.

Required Qualifications for the Data Analyst (Healthcare Fraud) include:

• 2-5 years of experience supporting healthcare data analytics, fraud detection, payment integrity, healthcare claims analysis, or related federal healthcare initiatives.
• Strong technical experience with SQL, Python, and data analytics platforms, including data pipelines, transformations, and dashboard development.
• Experience analyzing healthcare claims data, provider information, CPT/HCPCS codes, ICD-10 codes, beneficiary data, and fraud detection methodologies.
• Bachelor's degree in Information Technology, Computer Science, Data Science, Statistics, Health Informatics, or a related field.
• Ability to pass a Tier 2 / Moderate Background Investigation (MBI) and obtain a VA Personal Identity Verification (PIV) card.

Compensation for the Data Analyst (Healthcare Fraud) include:

Salary Range: $100,000 - $110,000 depending on experience

Full Benefits Package: PTO, Paid Holidays, Medical, Dental, Vision, 401K, Sick Leave as required by law

Keywords

Data Analyst, Healthcare Fraud Analyst, Fraud Detection Analyst, Healthcare Data Analyst, Healthcare Analytics, Fraud Waste and Abuse, FWA Analyst, Payment Integrity Analyst, Improper Payments Analyst, Federal Healthcare Analytics, Healthcare Claims Analysis, VA Healthcare, Veterans Health Administration, VHA, Medicare Analytics, Medicaid Analytics, Healthcare Fraud Prevention, Provider Risk Scoring, Provider 360, Data Analytics, SQL Developer, Python Develope