Data Analysis Project Manager III

Overview

Data Analysis Project Manager III - REMOTE

The Data Analysis Project Manager III is  responsible for overseeing data projects and collaborating with various stakeholders to detect fraud, waste, and abuse in Medicare and Medicaid. Coordinate with other internal teams to facilitate data-related training and algorithm development to meet the needs of Program Integrity,  Medical Review, and Data Analysis or other teams, as necessary. Develop reports to provide a comprehensive overview of ongoing projects, data analysis activities, and outcomes.

In assuming this position, you will be a critical contributor to meeting CoventBridge Group's objective:  To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud, waste and abuse. 

The Data Analysis Project Manager III will report to the Data Manager and will work in our Grove City, OH office, or if not local, remotely from a home office.

Responsibilities/ Requirements

 Essential Duties and Responsibilities:

• Provide oversight to the Data Analysis supervisors to ensure that internal metrics are met. Conduct root cause analysis and initiate appropriate changes/processes if metrics are not met.
• Lead data analysis projects from planning and execution to monitoring and closure, ensuring timely delivery and alignment with CMS and organizational goals.
• Develop detailed project plans including objectives, metrics, milestones, and resource allocation to ensure successful project execution.
• Oversee the design and implementation of data mining, trend analysis, predictive modeling, and machine learning to identify anomalies and potential fraud.
• Organize and lead regular project update meetings and status updates.  Maintain clear and consistent communication with all project stakeholders to address any issues promptly.
• Work closely with CMS, state Medicaid representatives, and subcontractors to ensure the quality and format of the Medicaid data is sufficient to meet operational needs. This includes suggesting changes to the data structure to meet changing goals or contract requirements.
• Produce and submit reports as directed by the Data Manager.
• Oversee development and revision of orientation for new Data Analysis team members and ongoing training for current Data Analysis team members.
• Coordinate data-related training for internal and external partners.
• Work collaboratively with cross-functional teams including Medical Review, Program Integrity, and IT teams to define project requirements and data needs.
• Ensure compliance with Medicare Program Integrity Manual guidelines and CMS direction concerning data analysis and data management.

Competencies:

• Proficient in Python, R, SQL, and/or SAS, and data visualization tools such as Power BI or Tableau.
• Strong knowledge of Medicare, Medicaid, and fraud detection methodologies.
• Knowledge and skills to plan, conduct, and supervise work according to UPIC contract requirements.
• Strong leadership, organizational, planning, and presentation skills.
• Excellent analytical, problem-solving, critical thinking, and negotiation skills required.
• Ability to manage multiple and conflicting priorities.
• High attention to detail and a commitment to maintaining data integrity.
• Microsoft Office proficiency required.

Educational/Experience Qualifications:

• Bachelor’s Degree in Data Science, Statistics, Mathematics, Computer Science, Business Analytics, or a related field.  Master’s degree is preferred.
• Minimum of three years of prior experience in program integrity or fraud investigations as a data analyst, data scientist, or supervisor.  Prior experience at a UPIC is preferred.
• Minimum of three years of proven project management experience with a strong focus on data analytics projects.
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• Minimum of three years’ experience with Medicare/Medicaid claims data

Benefits

• Medical, Dental, Vision plans
• Life, LTD and STD paid by the employer
• 401(k) with company match up to 4%
• Paid Time Off and company paid holidays
• Tuition assistance after 1 year of service

The salary range for this role is $95,000 to $115,000 annually.  This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future.  An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.  

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

About Us:

CoventBridge Group is the global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs.  The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.

CoventBridge is an equal opportunity employer.  We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.

CoventBridge is committed to the full inclusion of all qualified individuals.  As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com.

UPIC