Director, Federal Health Program Integrity & AI Analytics

Analytica; EE. UU.; A distancia; USD 180.000 - 240.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Bonuses

Employer-paid health care

Training funds

401k match

Descripción de la vacante

Analytica is seeking a Director, Federal Healthcare Program Integrity & Advanced Analytics to lead data-driven solutions that prevent, detect, investigate, and mitigate fraud, waste, abuse, and improper payments across federal health programs.

The role requires expertise in healthcare data domains, AI-driven insights, and translating findings into actionable recommendations for CMS, DHA, VA, and other federal entities.

Formación

• Master's degree or doctorate in a relevant quantitative, healthcare, economics, public policy, informatics, or technology discipline.
• Direct experience supporting federal healthcare program integrity, fraud prevention, investigation, payment integrity, oversight, or enforcement (CMS, DHA, MHS/TRICARE, HHS OIG, DOJ healthcare fraud initiatives, or Medicaid).
• Deep experience with federal healthcare domains (Medicaid/Medicare/TRICARE).
• Experience supporting healthcare fraud investigations or developing fraud indicators and risk models.
• Experience evaluating program-integrity interventions and translating analytics into actionable decisions.
• Experience with modern analytics environments and AI platforms (Python/SAS/R/SQL/Databricks/Snowflake).
• Experience applying NLP, LLMs, OCR, semantic analysis, network/link analysis to healthcare/investigative data.
• Familiarity with responsible AI, model validation, privacy, and data governance.
• Experience contributing to federal solution development, capture, proposals, client engagement.

Responsabilidades

• Lead development of advanced analytics and investigative capabilities for federal health programs.
• Translate analytical findings into actionable recommendations for clients and stakeholders.
• Oversee cross-functional teams including investigators, clinicians, auditors, and data scientists.
• Support business growth, capture efforts, and proposal initiatives through analytical leadership.

Conocimientos

Leadership

Client-facing

Communication

Data-driven decision making

Healthcare program integrity

Advanced analytics

AI/ML concepts

Educación

Master's degree or doctorate in a quantitative/healthcare/policy field

Herramientas

Python

SAS

R

SQL

Databricks/Snowflake

Descripción del empleo

Analytica is seeking a Director, Federal Healthcare Program Integrity & Advanced Analytics to lead data-driven solutions that prevent, detect, investigate, and mitigate fraud, waste, abuse, and improper payments across federal health programs.

The role requires expertise in healthcare data domains, AI-driven insights, and translating findings into actionable recommendations for CMS, DHA, VA, and other federal entities.