Deloitte Program Integrity – Healthcare Investigations and Recovery- Senior Consultant in Houston, Texas
Are you an analytical, data-driven professional? Are youinterested in a role that uses leading edge analytics and offers an opportunityto provide front line support to solve our clients most challenging problemsassociated with health care Payment Integrity / Fraud, Waste and Abusedetection and prevention? If so, the Forensic Analytics practice is the placefor you!
As a data analyst, you will be expected to apply yourspecialized knowledge of data acquisition, management, analysis, andinterpretation directly to Healthcare or dental claims, eligibility, policy, etc., data,providing actionable insights that Deloitte, our clients, decision-makers, andothers can use. It s a great career choice for those who want to applyhealthcare expertise in a novel and innovative way.
Forensic Analytics is a fast-growth practice within Deloitte Riskand Financial Advisory that centers around several of the hottest areas ofbusiness today analytics, forensic analysis, and litigation support and thespecialized skills that make careers in these areas both fascinating and inhigh-demand. Our Analytics team makes extensive use of data, statistical andquantitative analysis, rules-based methods, and explanatory and predictivemodeling to bring insights to client issues. Our work increasingly employsspecialized competencies, such as advanced analytics, visualization, andgeospatial techniques.
Workyou ll do
Provide domain experience in review of Healthcare plan policy
Guide the development and review of new Healthcare rule
Conducting dental recovery analytics to identify potential fraud, waste, abuse, or improper payment.
Performing and interpreting dental billing patterns to identify potential fraud, waste, abuse, or improper payment.
Query and mine large health care related data sets to discover transaction patterns, examine financial data and filter for targeted information
Gather and interpret data from a variety of sources (e.g., claims, eligibility, contract /pricing, cost reports)and critically evaluate it, reconcile conflicts, disseminate high-level information into details and distinguishing user requests from their true needs
Query and mine large data sets to discover transaction patterns, examine financial data and filter for targeted information
Design and develop models and solutions that use predictive analytics, text analytics and cognitive computing, and big data frameworks, in order to find anomalies and hidden patterns
Provide assistance interpreting needs of customers and translating them into the application and operational requirement with the help of product management skill
Assist in preparing and presenting complex written and verbal materials (reports, findings and presentations)
Review deliverables for accuracy and quality
Provide coaching to junior staff
Contribute to new business proposals and proposal development
Manage own personal and professional development; seek opportunities for professional growth and expansion of consulting skills and experience
As a member of ourForensic Analyticspractice in the Senior Consultant role, youwill work on projects that will allow you to collaborate withclients, and other analysts and investigators. As part of these projects,you ll be provided the opportunity to demonstrate your technical, projectmanagement and leadership skills in an environment that provides foroutstanding growth and advancement. Position may necessitate intermittent traveland requires flexibility with the client service projects.
Bachelor s Degree in Economics, Finance, Statistics, Mathematics, Computer Science, Management Information Systems, Engineering, Business Analytics disciplines, or related area
Experience with dental data analytics
3 years of hands-on technical experience miningand analyzing transactional electronic data.
Proficiency in word processing, spreadsheet, and presentation creation tools, as well as Internet research tools
Professional demeanor and strong communication skills, both written and oral
Demonstrated problem solving and troubleshooting skills with experience exercising mature judgment
Ability to work independently and manage multiple projects and responsibilities in a fast-paced environment
Proven experienceeffectively prioritizing workload to meet deadlines and work objectives
Experience working in Payment Integrity / FWA detection and prevention space is a plus
Must be legally authorized to workin the United States without the need for employer sponsorship, now or at anytime in the future.
Previous accounting/audit or analytics experience in a professional services firm
Bachelor s Degree inEconomics, Finance, Statistics, Mathematics, Computer Science, Management Information Systems, Engineeringor a professional affiliation such as CPA, FCPA, CFE, MBA, ASA, and/or CFA
Extensive knowledge of procedure codes, claims processing, and provider relations, as well as the ability to understand the cascading impact of claims processing policy changes on key performance indicators, claim costs, and overall financial health of the organization
Howyou ll grow
AtDeloitte, our professional development plan focuses on helping people at everylevel of their career to identify and use their strengths to do their best workevery day. From entry-level employees to senior leaders, we believe there salways room to learn. We offer opportunities to help sharpen skills in additionto hands-on experience in the global, fast-changing business world. Fromon-the-job learning experiences to formal development programs at DeloitteUniversity, our professionals have a variety of opportunities to continue togrow throughout their career. ExploreDeloitte University, The Leadership Center. at https://zoomforth.com/s/deloitte/du#home
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