Data

Company :

Highmark Health

Job Description :

The Graduate Intern - Data Analytics will work closely with Senior Data Scientists to support Highmark's Fraud, Waste, and Abuse identification efforts. Daily responsibilities will involve the in-depth analysis of complex healthcare claims data utilizing advanced analytical techniques to detect anomalous provider billing patterns.

SUMMARY OF JOB RESPONSIBILITIES

This job has the goal of providing the opportunity to acquire practical experience through direct exposure to the related business line(s) and to develop the next generation of diverse business professionals. To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business.

• Collaborate with senior team members on Fraud, Waste, and Abuse identification initiatives to develop and execute analytical strategies.

• Develop and optimize SQL queries to extract data from healthcare claims databases.

• Analyze large datasets of healthcare claims to identify patterns, trends, and anomalies indicative of potential fraud, waste, or abuse.

• Utilize statistical methods, data mining techniques, and machine learning algorithms to detect suspicious provider billing behaviors.

• Assist in the development and refinement of analytical models to improve the efficiency and accuracy of fraud detection efforts.

• Prepare and present findings, insights, and recommendations to team members and other relevant stakeholders.

REQUIRED QUALIFICATIONS

• Bachelor's degree.

• Pursuance of a graduate degree full or part-time in an accredited college or university.

PREFERRED QUALIFICATIONS

• Experience analyzing large datasets

ESSENTIAL JOB FUNCTIONS

Communicate effectively. This position displays effective communication skills while interacting directly with colleagues, clientele, and/or other internal or external constituencies in the planning of assignments and the resolution of day-to-day operational problems.

Under supervision, provide professional services as appropriate to the day-to-day operating objectives of the area. Receives guidance, training, and mentoring from senior personnel in planning and carrying out activities and assignments.

Undertake and/or participate in projects and programs designed to develop professional skills and expertise appropriate to the needs of the organization.

Participate in the planning and implementation of unit projects and initiatives within area of expertise and ability.

As specifically requested by management, conducts research and reporting inclusive of recommendations or alternative proposals for action.

Undertake related studies or enrichment programs as appropriate to the specific objectives of the operating unit.

Perform miscellaneous job-related duties as assigned.

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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For accommodation requests, please contact HR Services Online at [email protected]

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Req ID: J270605