The Anti-Fraud, Waste & Abuse (FWA) Data Scientist will assist the Director of Anti-FWA Data Science with the development of a comprehensive data science driven anti-fraud, waste, an abuse program for LogistiCare by leveraging the largest data set in the industry to combat FWA. By combatting FWA, you will make contributions not only to the company, but to society by improving the efficiency of how healthcare dollars are spent.
You’ll work with the Director of Anti-FWA data science and a broader team throughout the company, including operations leaders, financial and accounting managers, and data architects to define, feature, and quantify fraudulent behavior. You will employ modern supervised and unsupervised learning algorithms that can be used to identify, predict, and fight FWA with data science.
The ideal candidate will have an interest and aptitude for running algorithms in R/Python/SQL and driving case load to the company’s Special Investigative Unit (SIU) teams of FWA investigators. The ideal candidate will also be very goal oriented and eager to help the company succeed.
- Analytical Skills – Ability to use thinking and reasoning to solve a problem
- Communication, Oral – Ability to communicate effectively with others using the spoken word
- Communication, Written – Ability to communicate in writing clearly and concisely
- Customer Oriented – Ability to take care of the customers’ needs while following company procedures.
- Decision Making – Ability to make critical decisions while following company procedures.
- Interpersonal – Ability to get along well with a variety of personalities and individuals.
- Management Skills – Ability to organize and direct oneself and effectively supervise others.
- Problem Solving — Ability to find a solution for or to deal proactively with work-related problems
- Relationship Building – Ability to effectively build relationships with customers and co-workers
- Working Under Pressure – Ability to complete assigned tasks under stressful situations
- Bachelors’ Degree or higher required or equivalent number of years of experience
The successful candidate must have 2+ years of experience:
- With R or Python
- With excel
- With writing T-SQL commands
- Working with at least one business intelligence tool
- KPI analysis, management, and prioritization
- Experience in a predictive modeling role or
- Experience with statistics
- Good data visualization and communication skills
- Has sharp, driven, strong communication skills
- Is excited by challenges and undeterred by ambiguity
- Is always looking for ways to improve the current process
- Works well with others – you thrive while sharing knowledge and receiving input
- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Entire work time is conducted in an office environment in a controlled atmosphere building.
- The noise level in the work environment is usually moderate.
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