The Predictive Modeling Senior Consultant will drive the development of predictive models to prioritize evaluation of possible fraudulent Medicare providers and claims. The Predictive Modeling Senior Consultant will interact with clients and other task leads to develop a model development plan, manage the predictive analytics team, and develop innovative, efficient and effective techniques to detect Medicare fraud.
In addition, the Predictive Modeling Senior Consultant will coordinate Modeler activities and ensure Modeler tasks are completed on time; review modeling results with client; provide technical direction to Modelers on effective techniques to detect Medicare fraud; monitor and maintain the quality of predictive modeling efforts; work with the Project Manager to contribute to project planning, management and project status.
Consultants will be located in an IBM office in the metropolitan area or at an IBM client site.
Generally projects and clients are within the Metro area and require very limited travel outside of the local area. However, some projects do require up to 100% travel for an extended period of time that is generally less than 1 year. Consultants are required to be flexible with their ability to travel and cannot refuse projects due to travel.
- Bachelor's Degree
- At least 2 years experience in healthcare programs, especially Medicare
- At least 2 years experience in predictive analytics/modeling and/or data mining
- At least 2 years experience in fraud detection techniques
- At least 2 years experience in Medicare claims coding and processing systems, healthcare enrollment/eligibility data, healthcare claims data.
- At least 2 years experience in working with customers to understand data and decision needs.
- At least 2 years experience in SAS
- Readiness to travel Up to 5 days a week (home on weekends-based on project requirements)
- U.S. citizenship required
- English: Basic knowledge
- Doctorate Degree
- At least 2 years experience in complex data systems
- English : Intermediate
IBM is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
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