Healthcare Fraud Data Analyst (Remote)

Openkrill; United States; Hybrid; USD 90,000 - 140,000; Full time

Job summary

Arlo Solutions is seeking a Data Analyst (Healthcare Fraud) to join the VHA War Room initiative. The role focuses on analyzing VHA data, building rules in Palantir Foundry, and surfacing prioritized leads for government review.

You will work on data extraction, anomaly detection, and dashboarding to support fraud risk assessments and annual reporting. Remote with on-site requirements, candidates must obtain Public Trust clearance.

Qualifications

• Must be legally eligible to work in the United States.
• Able to pass Tier 2 / Moderate Background Investigation (MBI) and VA PIV card.
• Bachelor's degree in information technology, Computer Science or a related field (such as data science, statistics or health informatics).
• 2-5 years of federal healthcare data analytics experience, such as with Medicare, Medicaid or VHA data; experience writing healthcare data analytics business rules.
• Strong coding skills in SQL and Python (or PySpark/R).
• Proficiency with analytics platforms, including data pipelines, transformations and dashboards.
• Working knowledge of healthcare claims data, such as claim types, CPT/HCPCS and ICD-10 codes, NPIs and provider and beneficiary data.
• Able to handle PHI and sensitive information under HIPAA and VA privacy requirements, and to complete the required VA TMS trainings.

Responsibilities

• FWA Rule & Algorithm Development: Write, test and document business rules and algorithm logic mapped to FWA schemes.
• Platform Development: Support configuration, code development and deployment on VA's Palantir platform, including data pipelines and system integration.
• Provider 360 & Anomaly Detection: Help combine claims, enrollment and exclusion data into a single Provider 360 view.
• Weekly Analytic Runs: Run the weekly analytics that feed War Room decision packages and the recurring prioritized lead lists.
• Data Extraction & Analysis: Extract, clean and analyze federal healthcare data for FWA identification.
• Quality Assurance & Back-Testing: Back-test rules, track rule precision and support QA and corrective action plans.
• Benchmarking: Support federal benchmarking and alignment of VHA data analysis with CMS data and methods.
• Dashboards & Reporting: Build dashboards, visualizations and data for quarterly fraud trend and improper payment reduction reports.
• Documentation & Knowledge Transfer: Document rule specifications, acceptance criteria and analytic methods; train VA staff.

Skills

SQL

Python

Data analysis

Healthcare data

Education

Bachelor's degree in IT/CS/related

Tools

Palantir Foundry

Power BI

Tableau

PySpark

Job description

Arlo Solutions is seeking a Data Analyst (Healthcare Fraud) to join the VHA War Room initiative. The role focuses on analyzing VHA data, building rules in Palantir Foundry, and surfacing prioritized leads for government review.

You will work on data extraction, anomaly detection, and dashboarding to support fraud risk assessments and annual reporting. Remote with on-site requirements, candidates must obtain Public Trust clearance.