Program Integrity Data Analyst (Hybrid)

rhsc; Okemos (MI); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Delta Dental of Michigan, Ohio, and Indiana is seeking a Professional Review Data Researcher in Okemos, MI to transform raw data into actionable information and support program integrity initiatives.

You will design analytics, validate models, maintain dashboards, and collaborate with internal stakeholders to monitor denials, overpayments, and provider patterns in a hybrid work environment.

Qualifications

• Bachelor's degree in computer science, information systems, business administration or a related field and three years of data analytics experience.
• Knowledge of insurance business and claims processing systems; ability to use data extraction and analysis tools.

Responsibilities

• Designs, develops, validates, and deploys data-driven analytics, predictive models, reporting solutions, and end-to-end analytical research.
• Investigates referrals, performs provider research, analyzes billing and patterns to identify fraud, waste, and abuse.
• Develops recommendations on provider status and communicates with stakeholders.
• Creates and maintains dashboards, databases, and automated analytic workflows.
• Collects and cleanses data to ensure analysis-ready datasets and consistent definitions.

Skills

Data analytics

Communication skills

Independent judgment

Education

Bachelor's degree in computer science, information systems, business administration or a related field

Tools

Excel

Access

PowerPoint

Oracle Discoverer

ACL

Job description

Delta Dental of Michigan, Ohio, and Indiana is seeking a Professional Review Data Researcher in Okemos, MI to transform raw data into actionable information and support program integrity initiatives.

You will design analytics, validate models, maintain dashboards, and collaborate with internal stakeholders to monitor denials, overpayments, and provider patterns in a hybrid work environment.