Our work depends on a Data Scientist Manager joining our team to support the Centers for Medicare & Medicaid Services (CMS) anti‑fraud activities. As a Data Scientist Manager supporting the Healthcare Fraud Prevention Partnership (HFPP), you will lead a team of Data Scientists engaged in Fraud, Waste, and Abuse (FWA) analytics. You will collaborate with FWA Subject Matter Experts and Business Intelligence Developers to develop models and algorithms that detect and describe actionable FWA leads for the HFPP.

The Data Scientist Manager directs the Data Science team in using tools such as SAS and Python to analyze healthcare claims across Medicare, Medicaid, and private payers within a multi‑billion‑record database representing a large public‑private payer partnership.

HOW A DATA SCIENTIST MANAGER WILL MAKE AN IMPACT:

• Manage a team of Data Scientists working within a multidisciplinary organization of Data Scientists, Business Intelligence Analysts, and FWA Subject Matter Experts.
• Plan, direct, and oversee the development and execution of FWA models and algorithms in multi-payer environments. This includes creating, reviewing, and maintaining statistical analysis plans; interpreting data; and generating reports to address research questions.
• Facilitate collaboration between the Data Science team, FWA SMEs, Business Intelligence Developers, and clients to develop meaningful analyses and provide predictive analytic support.
• Direct the design and maintenance of automated data pipelines, in partnership with data engineers and Business Intelligence Developers, feeding analytic outputs to the server environment for HFPP partner access.
• Deliver strong, compelling presentations to clients and stakeholders, effectively communicating insights and value propositions from TTP analytic outputs.
• Split responsibilities between management (40%) and hands‑on development/coding (60%).
• Oversee quality reviews of analytic outputs to ensure methodological integrity, adherence to protocol, and compliance with applicable access standards.
• Document processes, best practices, and strategies for current and future FWA models and algorithms, optimizing business efficiencies and process improvements.
• Manage a team of 5–8 Data Scientists.

WHAT YOU'LL NEED TO SUCCEED:

• Master’s degree in Statistics or a related field, or an equivalent combination of education and experience.
• 7+ years of experience in statistical and computer science–related fields.
• Experience using SQL and Python for healthcare FWA data mining and statistical modeling.
• Experience managing client interactions, gathering and synthesizing requirements, and communicating complex analytic outcomes clearly.
• Proven experience presenting FWA analytic outcomes to clients, stakeholders, or conferences.
• Expertise in medical terminology and healthcare coding systems (ICD‑10, CPT, HCPCS, DRG, etc.).
• Experience conducting FWA data mining in large, multi-payer databases spanning commercial insurance and public plans (Medicare and Medicaid).
• Experience researching, interpreting, and applying payer medical policies (LCDs, NCDs, private carrier policies) and industry claim edits (NCCI).
• Prior experience managing analytics teams, with strong supervisory and mentorship capabilities.
• Proficiency with the Microsoft Office Suite, including Word, Excel, and PowerPoint (portfolio samples or practicum assignments may be requested).

DESIRED QUALIFICATIONS:

• Experience with AWS and/or Snowflake environments.
• Ability to communicate technical outcomes in detailed, precise terms to technical audiences, while also explaining them in accessible ways for non‑technical audiences.
• Strong problem‑solving skills, accuracy, organizational skills, attention to detail, and the ability to multitask under deadlines.
• Excellent written and verbal communication skills, especially the ability to convey data clearly to clients.
• Ability to work in a fast‑paced, team‑oriented environment with minimal supervision.

SECURITY CLEARANCE REQUIREMENTS:

• Must be eligible to obtain a public trust clearance, requiring U.S. residency for 3 of the last 5 years.

WHAT GDIT CAN OFFER YOU:

The GDIT HFPP TTP is the only data warehouse of its kind, containing billions of healthcare claims from dozens of public and private payers. This environment exists exclusively to perform FWA analytics.

The TTP identifies overpayments, fraud leads, and insights into abusive billing behaviors through a cross‑payer lens. The HFPP is a public‑private partnership dedicated to combating fraud, waste, and abuse in healthcare.

We offer competitive pay and benefits, a flexible schedule, and a collaborative, interdisciplinary environment where innovation thrives.

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