Remote opportunity at
Arlo Solutions(765) Data Analyst (Healthcare Fraud)
Arlo Solutions is an information technology consulting firm that provides technology solutions designed to reduce costs, enhance business processes, and accelerate response times. The organization is…
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About This Role
Arlo Solutions is an information technology consulting firm that provides technology solutions designed to reduce costs, enhance business processes, and accelerate response times. The organization is currently supporting the Department of Veterans Affairs Veterans Health Administration Office of Integrity and Compliance by establishing and operating the VHA Fraud Rapid Response Center, known as the VA War Room. This initiative utilizes data analytics, fraud risk assessments, and rapid administrative actions to…
Job Description
Arlo Solutions is an information technology consulting firm that provides technology solutions designed to reduce costs, enhance business processes, and accelerate response times. The organization is currently supporting the Department of Veterans Affairs Veterans Health Administration Office of Integrity and Compliance by establishing and operating the VHA Fraud Rapid Response Center, known as the VA War Room. This initiative utilizes data analytics, fraud risk assessments, and rapid administrative actions to safeguard taxpayer funds and support Veterans.
The company is seeking a Data Analyst specializing in Healthcare Fraud to serve as essential personnel on the fraud, waste, and abuse analytics team. In this position, the professional works alongside the Analytics and Technology Program Director and the Senior Data Analyst to examine VHA claims, enrollment, and exclusion data using the platform provided by Palantir. Responsibilities include designing and testing business rules to spot potential overpayments and illicit activities, generating prioritized lead lists, and performing network analysis to uncover coordinated billing schemes. This analytical and advisory function assists government personnel, who retain final decision-making authority.
This opportunity suits data professionals with a background in federal healthcare analytics who possess strong technical capabilities in SQL, Python, or related languages. Ideal candidates are familiar with healthcare claims data, capable of handling sensitive protected health information according to strict privacy standards, and comfortable operating within an on-site environment.
Responsibilities
- Develop, test, and document business rules and algorithms mapped to fraud, waste, and abuse schemes
- Support configuration, code development, and deployment on the Palantir platform including data pipelines
- Combine claims, enrollment, and exclusion data to establish a single Provider 360 view
- Run weekly analytics that feed decision packages and prioritized lead lists for the War Room
- Extract, clean, and analyze federal healthcare data to identify fraud and support claim review workpapers
- Back-test rules, track rule precision, and support quality assurance and corrective action plans
- Align VHA data analysis methods with Centers for Medicare and Medicaid Services data and benchmarks
- Construct dashboards, visualizations, and data for quarterly fraud trend and improper payment reduction reports
- Document rule specifications and train Department of Veterans Affairs staff to run analytics independently
Requirements
- Legally eligible to work in the United States
- Able to pass a Tier 2 Moderate Background Investigation and obtain a Department of Veterans Affairs PIV card
- Hold a bachelor's degree in computer science, information technology, data science, statistics, health informatics, or a related field
- Possess two to five years of federal healthcare data analytics experience involving Medicare, Medicaid, or VHA data
- Demonstrate strong coding skills in SQL and Python, PySpark, or R
- Show proficiency with analytics platforms, data pipelines, transformations, and dashboards
- Have working knowledge of healthcare claims data, CPT, HCPCS, ICD-10 codes, NPIs, and provider data
- Able to handle protected health information and sensitive data under HIPAA and Department of Veterans Affairs privacy rules
Qualifications
- Hands-on experience with Palantir Foundry or Gotham
- Background in healthcare fraud, waste, and abuse or payment integrity analytics
- Experience with Department of Veterans Affairs Community Care data, CMS Integrated Data Repository, or OIG LEIE and SAM exclusion lists
- Familiarity with anomaly detection, machine learning, or network and link analysis
- Experience with rule back-testing and precision measurement including positive predictive value and false-positive analysis
- Proficiency with visualization tools like Power BI or Tableau
- Hold a Certified Fraud Examiner credential or another data or analytics certification
Core Skills
Frequently Asked Questions
What is the employment type for this position?
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What is the remote work policy for this role?
The posting states that the position involves on-site work.
What salary is offered for the Data Analyst role?
The salary is not specified in the job posting.
What security clearance or background check is required?
Candidates must be able to pass a Tier 2 Moderate Background Investigation and obtain a Department of Veterans Affairs PIV card.
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