Director, Federal Healthcare Analytics & Integrity

Analytica; Bethesda (MD); On-site; USD 180,000 - 230,000; Full time

Benefits offered by this job

Bonuses

Employer-paid health care

Training and development funds

401k match

Job summary

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

The role is senior and client-facing, overseeing AI-driven insights, investigative support, and collaboration with investigators, clinicians, and policy experts to strengthen oversight.

Qualifications

• 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 in CMS/DHA/VA or similar.
• Deep domain experience in Medicaid, Medicare, TRICARE, or related health programs.
• Experience building fraud indicators, risk scores, anomaly/outlier methods, entity resolution, network analysis, provider profiles, or investigative lead-generation models.
• Experience evaluating program-integrity interventions and translating analytical findings into actionable decisions.
• Experience with modern analytics ecosystems (Python, SAS, R, SQL, Databricks, Snowflake, cloud data platforms, ML/AI platforms, graph technologies).
• Experience applying NLP, LLMs, RAG, OCR, semantic analysis, entity resolution, network/link analysis to complex healthcare data.
• Familiarity with responsible AI, model validation and explainability, privacy, security, and data governance.

Responsibilities

• Lead delivery of data-driven solutions for federal healthcare program integrity and advanced analytics.
• Oversee development of AI-driven insights and investigative support capabilities.
• Collaborate with investigators, clinicians, auditors, policy experts, data scientists, and federal stakeholders.
• Translate analytical findings into actionable recommendations and contribute to client relationships and growth.
• Support capture efforts, proposals, and solution development for business growth.

Skills

Python

SAS

R

SQL

Databricks

Snowflake

ML/AI platforms

NLP

LLMs

OCR

Graph technologies

Privacy & security

Education

Master’s or Doctorate in a quantitative/healthcare-related field

Tools

Databricks

Snowflake

Cloud data platforms

Job description

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

The role is senior and client-facing, overseeing AI-driven insights, investigative support, and collaboration with investigators, clinicians, and policy experts to strengthen oversight.