Jobs in the United States

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Added 5 mins ago
PKI Systems Administrator
Agil3 Technology Solutions (A3T)
Mechanicsburg, PA
…access control management, system configuration management, database maintenance, software upgrades, compromise reporting, and for performing…
Added 9 mins ago
Senior Business Analyst Medical Group Clinical Services
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United States
Must have excellent analytical and organizational skills and the ability to manage multiple priorities with changing needs and deadlines
Added 9 mins ago
EVS Assistant
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United States
Enjoy a flat rate $1/hour weekend shift differential and an 18%-night shift differential when applicable · Must possess knowledge obtained through two years previous experience in customer service
Added 10 mins ago
Java Web Developer
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Participate in database modeling and design activities
Added 10 mins ago
Court Researcher- Bullitt & Nelson Counties, KY
First Advantage Background Services
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Must have (or be willing to obtain) a valid Driver's license and must be willing to travel to the courthouse(s) daily
Added 11 mins ago
T
Solution Architect
TEKsystems
Hanover, MD
- $125,000 to $190,000 USD / year
Added 11 mins ago
T
Sr. Oracle Cloud DBA
TEKsystems
Minneapolis, MN
- $120,000 to $150,000 USD / year
DescriptionJob SummaryThe Cloud Database Engineer provides operational database services across both cloud (AWS) and on-premises environments, ensuring seamless data flow by designing and…
Added 11 mins ago
UG
Associate Patient Care Coordinator
UnitedHealth Group
Glendale, CA
- $16 to $29 USD / hour
Follows “downtime” procedures by manually entering patient information; identifying patient’s MRN in the MPI database, assigning a financial number; and, accurately entering all information…
Added 12 mins ago
NY
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Workday Finance Reporting Senior Associate (Location Flexible)
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United States
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Registered Nurse Surgery Center
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Added 15 mins ago
Intern - Development
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Orlando, FL
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Postgres and MySQL database administration, troubleshooting, and performance tuning
Added 19 mins ago
Director of Supply Chain
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Provide governance, guidance, and support for the MRP database(s) and their users at both facilities.
Added 22 mins ago
Solution Architect
DynatraceLLC
Boston
Considered an expert in a combination of database and platform application services is a plus
Added 25 mins ago
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- $39.26 to $58.04 USD / hour
Tracks the assignment of TCP/IP networks and individual addresses using certificate system and domain name database.
Added 25 mins ago
Master Data Analyst
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Basic SQL, query development, or database reporting experience.
Added 26 mins ago
Data Scientist
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San Francisco, CA
Manages database of research data for projects.
Added 26 mins ago
Senior Software Engineer (United States)
Karat
Remote, United States
Experience with system architecture, database design, cloud infrastructure, and deployment technologies (AWS, GCP, or Azure)
Added 26 mins ago
Pre-Clerkship Curriculum Manager
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CA
Proficiency with common office, learning management, database, scheduling, and web-based technologies used to administer educational programs.
Added 27 mins ago
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Added 28 mins ago
Research Senior Data Scientist - Ajami Lab - Department of Neurology (Remote)
Cedars-Sinai Medical Center
Remote, United States
Creates database-to-deployment pipelines for models using necessary programming languages (primarily R, Python, SQL, neo4j).

CareSource Management Services LLC

FWA Payment Integrity Data Analyst III (Health Plan & SQL exp required)

Remote, United States

Apply on caresource.wd1.myworkdayjobs.com About employer

Applications open in a new tab.

Job details

Pay: $83,000.00 - $132,800.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level.
Posting language: English
Posted: Nov 10, 2026

Original job description

Job Summary:

The FWA Payment Integrity Data Analyst III is responsible for developing, implementing, managing and presenting in-depth analyses that meet the information needs associated with Fraud, Waste and Abuse.

Essential Functions:

Lead and implement data analytic Ideation and R&D activities and strategy to support decision-making across multiple lines of business and clients to enable FWA growth.
Validate Program Integrity vendor deliverables, results and collaborate with PI vendors to understand and drive CareSource FWA analytic needs and results, function as consultant to propose business solutions, and communicate results of data analytics outcomes against goals and strategic plan.
Participate in analytical, experimental, investigative, and other fact-finding work in support of concept development and in conjunction with vendors.
Monitor emerging internal and external FWAE data vulnerabilities and trends which may impact CareSource and create solutions to mitigate risk.
Identify trends and patterns using standard corporate, processes, tools, reports, and databases as well as leveraging other processes and data sources
Research policies, coding guidelines, and regulations that would support the hypothesis being developed.
Conduct outcome analyses to determine impact and effectiveness of corporate and SIU initiatives.
Collaborate on the examination and explanation of complex data relationships to answer questions identified either within the department or by other departments as it relates to Fraud Waste and Abuse.
Generate graphics that effectively describe, explore, and summarize analysis for communication to appropriate parties.
Manage processes and reporting to ensure that claims associated with investigations are processed appropriately and in a timely manner.
Collaborate with the Legal Department, generating data and analyses to support Legal proceedings.
Perform data analyses in support of both the SIU Program Integrity and Audit Functions.
Incorporate critical thinking skills and judgment in the analysis process to determine best course of action for each inquiry/problem.
Review reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques that will reveal intelligence for identification of any associative or causal relationships pertaining to Fraud Waste and Abuse and Error, providing management level summaries that explain key findings and providing documentation for use during Audits.
Use descriptive statistical techniques to measure impact of various actions/studies, internal and external, develop sampling and hypothesis testing to help the organization determine outcomes.
Performs any other job related duties as requested.

Education and Experience:

Bachelor's degree or equivalent years of relevant work experience in Healthcare Data Analytics required
Seven (7) years of experience in data analysis, FWA Ideation and/or analytic programming required
Seven (7) years Health care delivery and/or payer experience required
Extensive experience with Data Visualization / Dashboard tools (Power BI) required
Extensive experience using SQL for analytics projects, including databases queries required
Three (3) years of experience with Medicare/Medicaid required
Healthcare management experience/exposure required
Clinical experience is preferred

Competencies, Knowledge and Skills:

Proven understanding of database development including: Implementing Database Relationships; Data Integration; Data Manipulation using SQL; Database Object Creation using SQA; Database Normalization; Dimensional Design Concepts
Insight in administering Microsoft SQL Server, Transact-SQL (ANSI-SQL) and Integration Services (SSIS) is required
Insight and understanding of in programming languages such as Microsoft Visual Basic, Python
Strong Knowledge of coding standards, billing rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD10 coding, HCPCS, APC and DRGs)
Proven analytic skills in solving multi-dimensional problems
Advanced level experience in Microsoft Applications: Excel, Access, Word, and PowerPoint
SAS and SQL skills
Graphic development/presentation skills
Knowledge of inferential statistics
Working knowledge of descriptive statistical application and techniques
Data Mapping Skills
Ability to document database design, application design
Ability to maintain documentation of changes and modifications
Critical listening, thinking skills, and verbal and written communication skills
Decision making/critical thinking skills
Ability to work independently and within a team environment
Knowledge of Medicaid, Medicare, and managed care
Ability to lead analytic efforts

Licensure and Certification:

Coding certification through AAPC or AHIMA preferred

Working Conditions:

General office environment; may be required to sit or stand for extended periods of time
Travel is not typically required

Compensation Range:

$83,000.00 - $132,800.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary Organization Level Competencies

Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Brand=CareSource

Apply on caresource.wd1.myworkdayjobs.com About employer

More about this job

Skills

SQL
Decision making
Data analysis
Strategic planning
Create solutions to problems
Research
Communication skills
Improve business processes
Critical thinking
Documentation
Data visualization
Microsoft Power BI
Microsoft SQL Server
Transact-SQL
SQL Server Integration Services
Programming languages
Microsoft Visual Basic
Python
CPT
HCPCS
Microsoft Excel
Microsoft Access
Microsoft Word
Microsoft PowerPoint
SAS
Presentation skills
Statistics
Work independently

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Jobs in the United States