Intelligence Analyst - Medicare

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

Since 1999, SGS has prevented nearly $10 billion in inappropriate payments, consisting of more than $6.1 billion in pro-actively Prevented Dollars (including Savings from Revocations) and nearly $3.9 billion in Recovered Overpayment Dollars. Our experience with fraud and abuse analytics has resulted in the referral of thousands of cases to law enforcement and resulted in successful criminal and civil prosecution and civil monetary penalties.

• You will be required to prepare and direct complex proactive project plans in response to findings of analysis.
• You will require employee to travel to law enforcement and healthcare fraud workgroup meetings.
• Collaborate with law nfeorcement with investigations and coordinate meetings with law enforcement.
• You will be expected to direct the project plan through resolution while tracking and reporting results.
• Must be able to identify fraudulent billing schemes and develop proactive project plans sufficient to investigate these schemes from a small to a large scale.

Telework available from all states except Hawaii

• Experience in relational data base design, extract, and reporting
• This position may require the incumbent to appear in court to testify about work findings.
• Ability to organize a case file, research violations, and accurately and thoroughly document all steps taken in project development.
• Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government.
• Bachelors degree and 8-10 years experience or Masters degree and 6-8 years experience or PhD and 3-5 years experience
• Use of intelligence databases
• Ability to work independently and as a member of a team to deliver high quality work.
• Ability to report work activity on a timely basis.
• Ability to develop and execute complex data and investigative plans.
• Ability to attend meetings, training and conferences, overnight travel required in some instances.
• Ability to handle confidential material.
• Ability to conduct self-directed research to uncover problems in Medicare and Medicaid payments made to providers enrolled in the Medicare and Medicaid Program.
• Proven ability to work with a variety of systems, sources of data and analytic tools, such as but not limited to:
  • Use of intelligence databases
  • Use of link analysis software
• Use of link analysis software
• Ability to analyze data to identify and compare norms, trends, and patterns.
• Ability to communicate effectively, internally, and externally.

• 3+ years of experience working with intelligence databases
• Preferred candidates will have the following areas of concentration for work experience:
  • 5+ years of law enforcement experience
  • 3+ years of experience conducting program integrity type investigations
  • 3+ years of experience working with intelligence databases
• 3+ years of experience conducting program integrity type investigations
• Strong computer skills including Microsoft Excel, SQL, Outlook, and PowerPoint.
• Strong communication and organization skills
• 5+ years of law enforcement experience
• Strong proven analytical ability and basic knowledge of modelling, statistics, and sampling techniques