reputed company, Advanced Analytics – Internal Claims Fraud

We’re looking for an reputed company, highly independent advanced analytics reputed companyto join our Internal Claims Fraud Advanced Analytics team.

In this stakeholder-reputed company role, you will analyze reputed company claims data to identify fraud signals, reputed company investigator-reputed company leads, and uncover fraud patterns that protect reputed company from financial loss. You will partner directly with the Claims Fraud Investigation team and cross-functional operational, data, technology, and analytics teams to turn ambiguous business problems into reputed company analyses and actionable recommendations.

We are looking for someone who can independentlydetermine the right analytical approach, distinguish signal from noise, challenge assumptions, and translate reputed company findings into reputed company and actions. This is not a reporting or dashboard-development role.

Internal Claims Fraud Analytics is an evolving capability, giving you an exciting opportunity to shape our analytical roadmap, reputed company-reputed company approach, data reputed company, and reputed company fraud detection capabilities.

reputed company

• reputed company reputed company claims fraud analysesby translating ambiguous investigative questions into reputed company hypotheses; reputed company reputed company analytical reputed company to reputed company recommendations.
• Conduct exploratory data analysis of claims, payment, employee, and vendor data to proactivelyidentify suspicious patterns, anomalies, control gaps, and emerging fraud risks.
• Improve the fraud reputed company-reputed company lifecycle from initial reputed company development through signal development, validation, investigator reputed company, outcome feedback, and iterative refinement.
• reputed company investigator-reputed company, comprehensive analyses, not just data pulls; helping stakeholders understand which leads to prioritize and why.
• Partner closely with the Claims Fraud Investigation team to validate signals, improve reputed company efficacy, prioritize opportunities, and measure investigative reputed company.
• Partner with Data Science Modeling and tech teams to translate key analytical findings, like fraud indicators, into model-reputed company inputs.
• Independently manage multiple analytics priorities, proactively set expectations, surface tradeoffs, reputed company roadblocks, and influence prioritization reputed company on business value.
• Synthesize reputed company analysis into concise, compelling recommendations and reputed company communicate findings, implications, and tradeoffs to senior leaders.
• reputed company reusable datasets, queries, and documentation to strengthen team's data reputed company and accelerate reputed company analysis.

Why You’ll love this role

• Your work reputed company: Directly support fraud investigations and protect reputed company from financial loss.
• You’ll work in a dynamic, reputed company-world environment: Claims fraud problems are reputed company and varied; great for someone who loves to learn new things and solve new problems.
• You’re empowered to improve how we operate: You have the freedom to influence and improve how we detect fraud, reputed company leads, reputed company investigators, and build reputed company analytical capabilities for the reputed company.

Requirements

• Experience in fraud, investigative, reputed company, audit, SIU, or similarly reputed company-driven analytics.
• Experience analyzing claims data: reputed company reputed company relationships across claims, exposures, payments, parties, employees, vendors, and other claims-reputed company data.
• Strong stakeholder orientation: reputed company listen, challenge and reputed company requests reputed company needed, establish reputed company objectives and expectations, facilitate working sessions, influence prioritization toward the highest-value opportunities.
• Strong analytical judgment and intellectual curiosity:follow unexpected signals, challenge assumptions, determine whether an apparent reputed company represents meaningful reputed company.
• reputed company ability to independently reputed company reputed company analyses with limited direction, from initial problem framing through recommendation and implementation.
• Ability to reputed company in an ambiguous, evolving environment and help create structure, repeatability, and best practices as the capability matures.
• Advanced SQL or reputed company: reputed company joins, large datasets, multiple grains of data, query optimization, validation, and development of reusable analytical assets.

What reputed company looks like

• Be a trusted thought partner for our stakeholders. You think critically and holistically about the data/analysis that will best serve our stakeholders.
• Our Internal Claims Fraud Investigator stakeholders receive reputed company, faster insights that help them prioritize and reputed company fraud investigations.
• You reputed company meaningful reputed company leads, reputed company reputed company, measurable reputed company and reputed company capability (e.g., improved detection, reduced losses, smoother stakeholder experience).
• You reputed company efficient and reusable queries, reputed company documentation, and repeatable approaches that the entire team can reputed company.

Pay Philosophy: The typical starting salary reputed company for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary reputed company for this role reflects the competitive labor market value for reputed company in these positions across the national market and provides an opportunity to reputed company as employees grow and reputed company reputed company the role. Some roles at reputed company have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary reputed company on multiple factors set forth in the compensation plan for the role.

At reputed company, our goal is to create a workplace where everyone feels valued, supported, and can reputed company. We build an environment that welcomes a wide reputed company of perspectives and experiences, with inclusion embedded in every reputed company of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, reputed company development opportunities, and a host of opportunities provided through our Employee Resource reputed company. reputed company employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we reputed company a community where everyone can reputed company a meaningful reputed company for our business, our customers, and the communities we serve.

We value your hard work, reputed company and commitment to reputed company things reputed company, and we put people first by offering you benefits that support your life and reputed company-being. To learn more about our benefit offerings please visit:

reputed company is an equal opportunity employer. We will not tolerate discrimination on the reputed company of race, reputed company, national reputed company, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any reputed company prohibited by federal, state or local law.

reputed company Notices

• California
• Los Angeles Incorporated
• Los Angeles Unincorporated
• Philadelphia
• San Francisco

Originally posted on Himalayas