Director, Data Analytics and Systems Group

Full-time

Remote

Deadline

June 27, 2024

About the organization

CMS

Centers for Medicare & Medicaid Services

Organization type

Government

In A Nutshell

Location

Remote Anywhere in USA

Salary

$147,649-$221,900

Job Type

Full-time

Experience Level

Senior-level

Visa Sponsorship

Not Available

Deadline to apply

June 27, 2024

Provide executive leadership, direction, and coordination for comprehensive analytics strategies, including providing statistical and data analysis for Program Integrity (PI) issues, as well as identifying emerging fraud trends through data mining and other analytical techniques.

Responsibilities

  • Promotes integrity in Medicare and Medicaid Programs by developing a national fraud prevention program for payments and provider enrollment, integrating predictive modeling into CMS’ claims processing and provider enrollment system.
  • Serves as an effective change agent to achieve quality improvement within PI by using data to quickly identify vulnerabilities and areas for action/improvement and planning and re-measuring to ensure effective improvement actions.
  • Achieves quality improvement within PI by utilizing technology to analyze datasets to identify patterns and networks that represent a high risk of fraudulent activity and analyzing processes to determine the root cause of such vulnerabilities.
  • Oversees the development and maintenance of IT platforms and data access methodologies for detection of fraud and abuse.
  • Develops and manages ROI methodologies to report savings associated with fraud prevention systems.
  • Develops and maintains Information Technology platforms and data access methodologies for detection of fraud and abuse.
  • Exercises executive leadership in the development, vision, strategy, oversight, and implementation of the Agency’s major fraud fighting tools.
  • Provides oversight of the development of clinical and data-driven algorithms that run in the IT systems used to detect fraud.

Skillset

  • Demonstrated experience in a senior leadership position, dealing and negotiating with a wide range of senior-level information technology (IT) officials in various government agencies, law enforcement organizations, or public and private organizations regarding complex and controversial issues concerning federal programs and the protection of the integrity of these programs.
  • Demonstrated experience in the development and implementation of Program Integrity (PI) prevention and detection initiatives into large-scale IT platforms for the identification of major fraud, waste, and abuse trends.
  • Demonstrated experience in developing and implementing a national fraud prevention IT system that integrates predictive analytics.
  • Demonstrated experience building high-performing teams of IT professionals.
  • Demonstrated experience developing and implementing an organizational-wide IT workforce strategy that attracts, develops, and retains top IT, digital, and cybersecurity talent to continuously analyze and adopt modern technologies, solutions, and processes that drive enhanced business value.

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