Analytica is seeking a Senior Data Scientist with Medicaid policy experience to engage in developing algorithms to identify aberrant provider billing and utilization patterns. This role supports the Centers for Medicare & Medicaid Services (CMS) in strengthening oversight of Medicaid and CHIP programs through advanced analytics, data modeling, and risk-based insights. The mission of PIMAS is to identify, analyze, and prioritize program integrity risks across Medicaid and CHIP by leveraging large-scale claims and enrollment data. The project focuses on developing and refining analytic models, dashboards, and decision-support tools that help CMS detect fraud, waste, abuse, and emerging vulnerabilities, and translate complex data into actionable intelligence for federal and state stakeholders.
Analytica has been recognized by Inc. Magazine as one of the fastest-growing 250 businesses in the US for three consecutive years. We support U.S. government clients in health, civilian, and national security missions to build better solutions that impact Americans’ day-to-day lives. The company offers competitive compensation with opportunities for bonuses, employer-paid healthcare, training and development funds, and a 401k match.
Responsibilities include (but are not limited to):
- Designing and enhancing risk-based analytic models to identify high-risk providers, services, and utilization pattern
- Conducting exploratory and targeted data analyses to support CMS program integrity initiatives
- Supporting development of dashboards, visualizations, and reporting products for CMS leadership and technical staff
- Collaborating with the prime contractor and CMS to refine analytic methodologies, assumptions, and outputs
- Translating analytic results into clear findings, documentation, and recommendations usable by non-technical audiences
The PIMAS technical environment is data-intensive and collaborative, typically involving:
- Large Medicaid and CHIP datasets (e.g., claims, provider, and enrollment data)
- Analytic tools and languages such as SQL, Python, R, and related data science libraries
- Data visualization and dashboard platforms (e.g., Tableau or similar tools)
- Secure federal data environments with strict data governance, privacy, and compliance requirements
- Version control, documentation, and collaboration tools to support distributed teams
- Candidates should be comfortable working in regulated environments and adapting to evolving analytic requirements.
Team members work closely with other subcontractors and prime contractor analytics teams. Client engagement on PIMAS is frequent and collaborative. Team members regularly participate in meetings and working sessions with CMS staff. They also present findings, walk through methodologies, and support refinement of results. This project is well-suited for professionals who enjoy direct client interaction, translating technical analysis into policy-relevant insights, and working in a mission-driven federal environment.
Basic Qualifications:
- Bachelor’s or Master’s degree (Masters preferred) with a concentration on data analytics, statistics, health policy, or public health
- Python, SQL, and SAS programming skills.
- Healthcare and/or program integrity background preferred
- Woking knowledge of statistical programming concepts and best practices is required
- Experience with MLFlow, MLOps, and AI/ML programming techniques is required
- Experience with Databricks and/or Snowflake or other notebook development environment is required
- Experience with ESRI or other geospatial mapping and analytics tool is a plus·
- Experience with Tableau and data visualization techniques is a plus
- Ability to adapt effectively to a remote work environment.
- U.S. citizenship, Green Card, or valid work authorization (H1B).
About Analytica: Analytica is a leading consulting and information technology solutions provider to public sector organizations supporting health, civilian, and national security missions. The company is an award-winning SBA certified 8(a) small business that has been recognized by Inc. Magazine each of the past three years as one of the 250 fastest-growing companies in the U.S. Analytica specializes in providing software and systems engineering, information management, analytics & visualization, agile project management, and management consulting services. The company is appraised by the Software Engineering Institute (SEI) at CMMI® Maturity Level 3 and is an ISO 9001:2008 certified provider.
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What We Do
Analytica is an award-winning consulting and technology services provider that supports public-sector health, civilian, and national security. We specialize in data-driven solutions, which have been recognized by organizations such as NYU’s Governance Lab for driving public sector modernization and innovation. Analytica is an SBA Certified 8(a), HUBZone that has been honored as one of the 250 fastest-growing businesses in the U.S. for three consecutive years by Inc.
For information on the company visit: www.analytica.net
For exciting career opportunities visit: careers.analytica.net
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