Job Description

Industry: Health Insurance

Day rate: negotiable

Period: 3 months + possible extension

The Consultant will work within the team of Payment Integrity which focuses on the identification, prevention and recuperation of medical or third party liability claims; and reduction of unwarranted claims expenditure by controlling fraud, waste and abuse. The main focus of activity for the Consultant will be to further build upon internal capability in network link analysis and graphical models that can help proactively identify connections and interdependencies between players in the healthcare system (e.g. providers, brokers, members) that could indicate fraud. This network analysis will enable effective big data analytics, integrating and leveraging data sets of differing quality, source and completeness in a meaningful way; which is not possible with traditional statistical models.

Job Categories: Consultant. Job Types: Freelance. Job Tags: big data, Fraud, and network link analysis.

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