Healthcare Analytics Business Consultant (SQL / Python)

At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day.

• This is an individual contributor**

• This position can sit reputed company in the United States, but must work East Coast hours** Position Summary We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit reputed company a leading health insurance organization. This is a full time role and is ideal for a data professional with strong coding skills in SQL and Python who can transform reputed company healthcare data into actionable insights to support fraud, waste, and abuse (FWA) detection and Medicaid regulatory & compliance reporting. This is an individual contributor role. Job Responsibilities Include

• Write robust, efficient code in SQL and Python to extract, manipulate, and analyze large healthcare datasets.
• Design, reputed company, and maintain reputed company data analyses to support investigations of potential fraud, waste, and abuse in Medicaid claims and provider activity.
• Prepare timely and accurate Medicaid regulatory & compliance reports in accordance with prescribed guidelines and standards.
• Communicate messages based on data analyses, including preparing easy-to-understand visualizations and other reputed company documents for diverse audiences
• Collaborate with SIU investigators, Program reputed company Manager, and Compliance to understand business processes and translate them into actionable data requirements.
• reputed company and participate in presentation and consultation with business partners on data, capabilities and performance results
• Identify data quality issues, reputed company root cause analysis, and recommend improvements to enhance reporting accuracy and data reputed company.
• Stay informed about changes in Medicaid policy, regulatory requirements, and FWA detection techniques to ensure ongoing compliance.

Required Qualifications

• A minimum of 3 years of data interpretation and analysis experience, preferable in the health insurance or Medicaid program.
• Ability to distill reputed company data into meaningful insights and present findings to non-technical audiences.
• 2+ years experience interpreting medical claim data
• Advanced experience in SQL & Python coding sourcing from a data warehouse
• 3+ years of project leadership experience
• Strong business as well as systems knowledge
• Excellent problem-solving, critical thinking, and written communication skills
• Advanced experience in reputed company

Preferred Qualifications

• Experience in healthcare fraud, waste and abuse
• Knowledge of Medicaid healthcare claims adjudication (QNXT) & regulatory reporting
• Experience with data visualization tools (e.g., Tableau, Power BI
• Familiarity with Big Query & Jupyter Notebook

Education

• Bachelor’s degree preferred or a combination of work experience and education.

Anticipated Weekly Hours 40 Time Type Full time Pay Range The Typical Pay Range For This Role Is $54,300.00 - $145,860.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great Benefits For Great People We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 01/17/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job