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Data Scientist - Medicaid Fraud Control Unit (NYC)

Attorney General, Office of the – New York, NY

The candidate is required to have the following knowledge and experience:
  • 3+ years demonstrated experience in data analysis and data visualization required;
  • Experience in SQL and a firm understanding of relational databases;
  • Strong interpersonal skills collaborate with people across functions and develop strong relationships;
  • Ability to communicate with both technical and non-technical staff to understand issues and present analytical results;
  • Strong proficiency in MS Excel.

The ideal candidate will have the following additional preferred knowledge and experience:
  • Master s degree in computer science, applied mathematics, (bio) statistics, applied statistics, economics, or other similar field of study;
  • Knowledge of the healthcare industry and medical coding concepts (CPT, ICD-9 / 10, DRGs) and/or experience analyzing healthcare claims data;
  • Strong proficiency in MS Access;
  • Experience with common scripting languages (R, Python) or other open source data analytics tools (KNIME);and
  • Experience leading and growing a team of data analysts preferred.
Duties Description The New York State Office of the Attorney Generals (OAG) Medicaid Fraud Control Unit (MFCU) is seeking a Lead Data Scientist to join its Electronic Investigative Support Group (EISG) based in the New York City office. The mission of MFCU is to investigate, prosecute and obtain criminal and/or civil remedies against individuals and corporate entities responsible for improper or fraudulent Medicaid billing schemes, as well as to investigate and prosecute allegations of abuse and neglect of residents in nursing homes and other residential healthcare facilities, and to make Medicaid program integrity recommendations for New Yorks $70 Billion Medicaid program that serves over 7 million New Yorkers. From inception through disposition, MFCU uses a team based approach where attorneys, analysts, investigators and other professionals work together to uncover complex fraudulent conduct for which MFCU holds offenders accountable through both criminal prosecution and civil litigation. MFCUs EISG manages a statewide network, consisting of eight (8) regional offices, and supports a 20+ terabyte data mart which serves as a primary data source in the investigation and prosecution of healthcare fraud and abuse.
Duties include, but are not limited to:
  • Analyzing healthcare data, Medicaid claims and other data mining resources to identify instances of fraud, waste and abuse;
  • Being an advocate for analytics-driven decision-making within MFCU;
  • Evaluating new open and closed-source software to aid in MFCUs mission;
  • Act as a mentor and grow the technical capabilities and skills of MFCU analytical staff;
  • Collecting, cleansing, and formatting large quantities of data;
  • Conducting exploratory data analysis and drafting potential anomaly metrics;
  • Translating historical patterns of fraud, waste, and abuse into features for modeling; and
  • Collaborating with MFCUs audit and investigative staff to validate potential models and recording requirements for future development.

Additional Comments

OAG employees serve more than 19.85 million state residents through a wide variety of occupations. We offer a comprehensive New York State benefits package, including paid leave, health, dental, vision and retirement benefits, and family-friendly policies. As an employee of the OAG, you will join a team of dedicated individuals who work to serve the people of our State.
Candidates from diverse backgrounds are encouraged to apply. The Office is an equal opportunity employer and is committed to work place diversity.
Salary to be determined commensurate with experience.
PLEASE NOTE: Unless otherwise specified in the Notes on Applying section, the Application Due date associated with this posting is not the last day applications can be submitted. Applications for this position will be accepted by the hiring bureau on a rolling basis until a candidate is selected; recruitment for this position can be closed or suspended at any time. For the most current information on available position vacancies, applicants are advised to review the Office of the New York State Attorney General website (www.ag.ny.gov/job-postings) or contact the Legal Recruitment Bureau via email at [email protected] or phone at 212-416-8080.

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