Program Analyst (Data Analytics)

Offices, Boards and Divisions • Washington, DC • 1h ago

Summary This position is located in the Criminal Division, Fraud Section, Health Care Fraud Unit. The incumbent serves as a Program Analyst (Data Analytics) and is responsible for analyzing health care claims data, identifying anomalous billing patterns, supporting investigations, and providing subject matter expertise to prosecutors and investigative partners. Additional selections may be made from this vacancy announcement to fill vacancies that occur subsequent to this announcement. Responsibilities Conduct independent data analysis to identify potential new fraud investigations; complete and fulfill data analysis and information requests for law enforcement health care fraud investigations; and support and provide investigative leads. Apply knowledge of federal healthcare program rules, coding/claims processing systems (CPT, HCPCS, ICD), reimbursement structures, and provider and beneficiary enrollments to identify abnormalities and emerging fraud schemes. Design and employ appropriate algorithms to discover patterns in data sets. Identify patterns in claim volume, utilization, geographic distribution, or sudden changes in billing behavior that may indicate fraudulent conduct. Validate analytic findings using comparative analysis, sampling, and other rigorous methodologies. Provide expertise on program policies, claims systems, and health care benefit structures. Prepare written reports, presentations, and visualizations summarizing analytical results for prosecutors, management, and investigative partners. Provide training to DOJ staff, U.S. Attorney's Offices, and partner agencies on health care claims data, fraud typologies, and analytic methods. Requirements Conditions of Employment Qualifications To qualify at the GS-12 level, applicants must have one year of specialized experience at, or equivalent to, the GS-11 Federal grade level. Examples of specialized experience include: analyzing and interpreting data; identifying trends or patterns in data sets; validating data accuracy; and developing reports that support areas of study or investigations. To qualify at the GS-13 level, applicants must have one year of specialized experience at, or equivalent to, the GS-12 Federal grade level. Examples of specialized experience include: conducting complex data analysis by identifying and interpreting patterns, trends and outliers in large data sets; validating analytical findings by comparing appropriate samples; leveraging data to support areas of study or investigations; and summarizing large volumes of data into clear reports for decision makers. Education There is no education requirement for this position. Additional Information Additional selections may be made from this vacancy announcement to fill vacancies that occur subsequent to this announcement. EEO Statement: The United States government does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service or other non-merit factor. To learn more, please visit the U.S. Equal Employment Opportunity Commission. Career Transition Programs (CTAP or ICTAP): These programs apply to Federal and/or DOJ employees who meet the definition of surplus or displaced from a position in the competitive service. To receive selection priority for this position, you must: Meet CTAP or ICTAP eligibility criteria; Be rated well-qualified for the position with a score in the highly qualified category or above based on the competencies listed above; and Submit the appropriate documentation to support your CTAP or ICTAP eligibility. For more information visit: USAJOBS Career Transition Programs. USA Hire Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended and the Americans with Disabilities Act of 1990 as amended, that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request an RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments. To determine if you need an RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments here: https://support-usahire.opm.gov/hc/en-us/articles/45424542500371-How-to-request-a-reasonable-accommodation.

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