Texas Health and Human Services

The Fraud Analytics unit within the Fraud Analytics and Data Operations (FADO) Division of the Office of Inspector General (OIG) is seeking a Senior Fraud Data Analyst (Data Analyst IV). The Fraud Analytics unit is responsible for performing innovative and advanced data analytics that increase the identification of fraud, waste and abuse in state health and human services programs such as Medicaid (including Managed Care), CHIP, SNAP and TANF by supporting data-driven investigations, reviews, audits, and inspections. The Senior Fraud Data Analyst will gain valuable experience with complex healthcare data, analytical and statistical methods, rules-based methods, and descriptive and predictive analytics. The Senior Fraud Data Analyst performs complex (journey-level) data analytics, data research, and data reporting. This position reports to the Director of Fraud Analytics and works under general supervision, with moderate latitude for the use of initiative and independent judgment. This position works closely with Fraud Analytics team members, internal OIG units, and external entities and may provide guidance to others. The Senior Fraud Data Analyst is responsible for performing intermediate/advanced level programming to clean, prepare, and query large, complex health and human services related datasets and to develop and code algorithms and models that identify data trends, patterns, and anomalies. This position prepares written methodology documents; communicates data analytics findings through data visualizations and presentations; and tests and evaluates new tools, methods, and techniques. *** This position can telework 100% from locations within Texas consistent with HHS telework policies. *** Essential Job Functions: Attends work on a regular and predictable schedule in accordance with agency leave policy and performs duties as assigned: 1. Plans and conducts data analytics on large, complex datasets using SAS, SQL, and other programming languages, including Python and R. Interprets and explains identified data trends, patterns, and anomalies. Develops, implements, and assesses the validity of existing and emerging analytical and statistical tools, methods, and techniques. Applies advanced analytical and statistical methods and techniques to known and new data sources. 2. Effectively communicates data analytics findings and related recommendations to stakeholders both verbally and in writing, including written methodology documents and detailed reporting of findings through data packages, data visualizations, and presentations. 3. Peer reviews algorithms and programs/scripts for logic and syntax errors. Peer reviews analytical and statistical methods for accuracy and applicability. Develops and conducts training for internal OIG units and external stakeholders. 4. Engages in collaboration and communication across internal OIG units and with external entities, including but not limited to: OIG program area customers, the OIG executive team, contractors/vendors, and team members. 5. Performs other duties necessary to achieve the mission of the Office of Inspector General. Statewide travel of about 5% may be required. Knowledge Skills Abilities: 1. Knowledge of analytical and statistical tools, methods, and techniques; of data models and querying relational databases; of data wrangling, data mining and data visualization techniques; and of record keeping, including security procedures for handling, protecting, and distributing confidential data. 2. Intermediate/advanced programming skill in SAS, SQL, Python or R, or other data science programming languages (SAS and SQL preferred). Skill in Excel and PowerPoint. 3. Skill in cleaning, preparing, querying, and analyzing large, complex datasets to discover trends and patterns and deliver meaningful insights. 4. Skill in data visualization to present data analytics results and findings. 5. Skill in critical thinking, analyzing problems, and devising effective solutions. 6. Skill in verbal and written communication skills essential to effectively interacting with OIG customers, leadership, and team members 7. Ability to compile, review, analyze, manage, and manipulate large, complex data sets. 8. Ability to effectively communicate complex data findings and analytical methodologies, both verbally and in writing, to non-technical audiences. 9. Ability to work in teams that may cross departments and/or agencies 10. Ability to work independently, exercise independent judgment, prioritize tasks, and manage multiple projects/assignments/responsibilities in a fast-paced environment under time constraints. 11. Ability to provide guidance to others and supervise the work of others. Registration or Licensure Requirements: None. Initial Selection Criteria: Experience in SAS, SQL, Python, R, or other data science programming languages/tools appropriate for large scale data preparation and analysis. (1 – 3 years) Experience in data analytics, data science, data research, and data reporting work. (1 – 3 years). Experience in the healthcare domain preferred. Graduation from an accredited four-year college or university with major coursework in data science, business analytics, healthcare analytics, computer science, computer information systems, management information systems, accounting, finance, mathematics, statistics, economics, or a related field. Advanced degree (Master's or Ph.D.) in related field may substitute for experience. Additional Information: A copy of college transcript will be required. Selected candidate must be able to pass a background check. The OIG is responsible for preventing, detecting, auditing, inspecting, reviewing, and investigating fraud, waste, and abuse in the provision of HHS in Medicaid and other HHS programs. Potential employees of OIG are subject to criminal background checks in accordance with the HHS Human Resources policy. Selected applicants must submit to a name-based, or in some instances a fingerprint based, criminal background check through Texas Department of Public Safety (DPS) to determine if an applicant has a conviction for a Class A misdemeanor within the last five years or a felony that constitutes a bar to employment. OIG will request that all applicants considered for an interview provide responses to essay questions. Failure to respond to the request could disqualify an applicant from the interview process. Any employment offer is contingent upon available budgeted funds. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual. HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work. In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888—894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.