Python CPT Agile Testing Background Consultant (Jobs in Windsor Mill, MD)   Requirement id 114351 Job title Consultant Job location in WINDSOR MILL, MD Skills required Python, CPT, Agile, Testing Background Open Date 23-Feb-2021 Close Date Job type Contract Duration 6 Months Compensation DOE Status requirement not found Job interview type ---    Email Recruiter: coolsoft Job Description Consultant: Python, CPT, Agile, Testing Background We should submit only GC,GC - EAD, L2-EAD,H4-EAD and Citizens. Job Description Client has an immediate need for a Predictive Modeling Lead supporting a Leading Government Integrator in Woodlawn, MD. The qualified applicant will become part of a major healthcare fraud prevention project, supporting a leading Government Healthcare organization. The qualified applicant will drive development of predictive models to prioritize evaluation of possible fraudulent providers and claims. The lead will interact with the Gov Agency and other stakeholders to develop a project development plan, build / manage predictive analytics team, and develop an innovative, efficient and effective technique to detect claims fraud. Location: Woodlawn, MD (Remote during COVID) Duration: Temp to Perm Compensation: Competitive based on education & years of relevant experience Clearance: Able to obtain & maintain a positions of Public Trust Responsibilities: Analyze claims data and develop requirements for sustainable predictive analytic models and edits Working with the team and client to understand data and client needs Detect potential weakness and vulnerabilities susceptible to fraud Lead working groups with customers, investigators, and other contractors to elicit and evaluate vulnerabilities Prevent FWA using system edits, policy recommendations, and customer/user education Train Gov Agency staff and partner contractors on proactive data analysis, investigations, internet research, etc. Assist with the analysis of vulnerabilities and data anomalies Monitor claims and suspicious activities utilizing proven investigating techniques Reporting and communicating regarding the effectiveness of fraud prevention activities Build and provide oversight to predictive analytics team. Communicates with internal and external sources related to potentially fraudulent activity Provides input on new ways of identifying fraud as well as improving existing fraud models Works with technical staff to test fraud models Participates in meetings and events representing the customer and employer Requirements: Bachelor Degree or Higher in related field of study, and 8+ years of Data Analytics / Predictive Modeling experience for enterprise-level systems. 5+ years of experience in fraud prevention related field(s), including fraud detection, investigation, forensic accounting, judiciary, and law enforcement Must have direct experience with Medicare & Medicaid claims coding, processing systems, healthcare enrollment/eligibility data, as well as healthcare claims data including CPT, ICD 9 and ICD 10 codes Expertise in one or more of the following areas: Predictive analytics/modeling Data mining Machine Learning SPSS, R, Python Practical knowledge of insurance laws and industry regulations, Medicare program rules and regulations, as well as federal, state & local laws and ordinances pertaining to medical services and professions. Knowledge of anti-fraud principles, Healthcare policy, & Legislation Knowledge of the Medicare FFS programs (coverage, payment rules and regulation and claims process). Experience with Agile project methodologies (preferably SAFe) Exceptional communication skills both verbal & written, with end clients & key stakeholders Preferred: Doctor of Philosophy (PhD) and 7 years of related experience. Experience with SPSS to R transformation efforts Experience with Cloud environments such as AWS or Azure Experience with Databricks Experience working with customers to understand data and decision needs.   Call 502-379-4456 Ext 100 for more details. Please provide Requirement id: 114351 while calling.   Other jobs in MD: Annapolis (1), Baltimore (34), Baltimore Maryland (1), Beltsville (3), Downtown Baltimore (1), Elkridge (1), Frederick (2), Hanover (1), North Baltimore (2), Owings Mills (1), Rockville (1), Sparks (2), Timonium (4), Woodlawn (7), Python job openings in WINDSOR MILL, MD Jobs List Data Scientist - 53693 Create date: 07-Oct-2019 We should submit only GC, GC EAD, L2 EAD, H4 EAD and Citizens. Notes : Must be able to come for a F2F in Maryland Description of Work: Identifying data needs and proper methods for data gathering, integration, preparation, data quality and data governance Performing exploratory an.... 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