Senior Manager, Program Integrity Data Science
CareSource(1 month ago)
About this role
Senior Manager, Program Integrity Data Science leads the Program Integrity Data Science team at CareSource, accountable for the analytic strategy to ensure claim payment accuracy and reduce fraud, waste, and abuse across health plans. The role synthesizes complex healthcare data and predictive insights to support legal, audit, and program integrity decision-making. It partners with cross-functional leaders and presents findings to senior leadership.
Required Skills
- Python
- R
- Statistical Modeling
- Machine Learning
- Predictive Modeling
- Feature Engineering
- Data Analysis
- Claims Data
- EHR
- Cloud Services
+5 more
Qualifications
- Bachelor's Degree
- Master's Degree (Preferred)
- AAPC Certified Professional Coder (CPC)
- Certified Fraud Examiner (CFE) (Preferred)
- AHIP Certification (Preferred)
- HCAFA or MHP (Preferred)
- Accredited Health Care Fraud Investigator (AHFI) (Preferred)
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