Lead Outpatient Data Analyst

Development InfoStructure LLC., (DEVIS) provides exceptional DevSecOps integration in our agile software development and embedded software solutions, combined with comprehensive IT management and consulting services to our federal, state, and local governments. The outcomes of our research and development, products and universe of services will support the international development community, multiple civilian agencies and the nation’s defense and intelligence communities. Our focused research, services and products include complex DevSecOps solutions to support refugee processing across multiple federal agencies, research and development for Signal Intelligence (SIGINT), Command, Control, Communications, Computers and Intelligence (C4I), Data Analytics, and Intelligence, Surveillance and Reconnaissance (ISR) development and sensor capabilities supporting both the aerospace/defense and intelligence communities, as well as complex HHS comprehensive care coding requirements, and integrated management systems for our countries civilian agencies (FAA, FDIC, HOR, etc.).

Our primary mission is to best serve the needs of our clients by solutioning with our stakeholder teams to ensure that the goals and objectives of our customers are proactively solutioned, such that opportunities to invest our time in developing long-term solutions and assets are abundant and move our clients forward efficiently.

At DEVIS, we are enthusiastic about our research, our work and embracing an environment where all are supported in the mission, while maintaining a healthy work-life balance.

Overview

The Lead Outpatient Data Analyst is responsible for analyzing outpatient Medicare claims and payment error data to identify patterns of over-utilization and potential payment errors. This role supports the development of Comparative Billing Reports (CBR) and Programs to Evaluate Payment Patterns Electronic Reports (PEPPER). The Lead Outpatient Data Analyst ensures all analyses are precise, thorough, and align with CMS standards.  This role is contingent upon contract award.

Responsibilities

Data Analysis:

• Conduct detailed analysis of outpatient Medicare claims and payment error data.
• Identify and report on patterns of over-utilization and potential fraud or abuse.
• Develop and refine metrics for CBR and PEPPER reports.

Report Generation:

• Create accurate and detailed reports based on data analysis.
• Ensure reports include clear and understandable metrics, comparisons, and trends.
• Collaborate with the Program Director and other team members to ensure timely report delivery.

Quality Assurance:

• Implement rigorous testing and quality assurance processes for all data analyses and reports.
• Maintain documentation of quality control reviews and outcomes.
• Ensure the accuracy and integrity of all data used in reports.

Stakeholder Support:

• Provide data and analysis support to CMS, providers, and other stakeholders.
• Participate in training and educational sessions to explain report findings and methodologies.
• Respond to inquiries related to outpatient data and report methodologies.

Collaboration:

• Work closely with the Lead Inpatient Data Analyst and other team members to ensure consistency and accuracy across all reports.
• Contribute to project planning and methodology development.
• Participate in biweekly meetings with CMS and other relevant stakeholders.

Required Qualifications:

• Minimum of seven years of professional experience, including at least three years of experience analyzing Medicare claims data.
• Expertise in data analysis and interpretation, particularly in the healthcare sector.
• Proficiency in statistical analysis tools and software.
• Excellent attention to detail and accuracy.

Preferred Qualifications:

• Extensive experience analyzing Medicare claims data.
• In-depth experience in arraying, analyzing, and reporting medical claims outlier data.

Educational Requirements:

• Bachelor’s degree from an accredited institution.
• Licensed Registered Nurse (RN) or equivalent or higher degree and licensure in the medical field (e.g., Medical Doctor, Physician Assistant, Nurse Practitioner).
• Certified or credentialed professional coder and/or a strong educational background in Statistics or Data Analytics.

Location:  Remote

Devis is an AA/EOE/M/F/Disabled/VET Employer committed to providing equal employment opportunity without regard to an individual’s race, color, religion, age, gender, sexual orientation, veteran status, national origin or disability.