Compliance Data Scientist

Job Overview

The Compliance Data Scientist is responsible for developing, designing, producing, and Compliance interpreting complex data sets within the compliance department and implementing advanced analytical models to identify compliance risks, ensure regulatory adherence, detect and prevent fraud, waste, and abuse, and support risk-based strategic decision-making within the compliance department.

Qualifications

• Bachelor's degree in Data Science, Statistics, Computer Science, or a related field; Master's degree preferred.
• Minimum five (5) years of healthcare-related work experience with reporting and analytics, including data extraction, manipulation, statistical modeling, and data visualization.
• Proven experience in advanced analytics, data visualization, data modeling, and statistical analysis.
• Strong understanding of compliance regulations and risk management.
• Proficiency in analytical tools, machine learning, data visualization, data reconciliation, and data management including SQL and Microsoft Power BI.
• Excellent problem-solving skills and attention to detail.
• Strong communication skills with the ability to present complex data insights to nontechnical stakeholders.
• Expert proficiency in Excel, including creating pivot tables.
• Ability to use various tools to create visualizations of analysis results.
• Familiarity with Federal and NYS Regulations.
• Experience working with electronic medical record (EMR) systems and healthcare data including patient records and claims data.
• Experience in designing and preparing reports for the Compliance Committee and/or Board of Directors.
• Experience and familiarity with Fraud, Waste, and Abuse (FWA), Centers for Medicare & Medicaid Services (CMS), Drug Enforcement Agency (DEA), Food and Drug Administration (FDA), Office of Civil Rights (OCR) and Health Insurance Portability and Accountability Act (HIPAA).