Navitus Health Solutions is seeking a SIU Analyst I to join our team!
The SIU Analyst position is responsible for conducting moderate to complex research using internal and external databases to perform analyses and develop recommendations on suspected fraud, waste, and abuse related to members, prescribers, pharmacies, and clients. In addition, the Analyst is responsible for regular and proactive extraction and evaluation of mined data, scoping data for investigations, and responding with reports and data for audits, universes, and impact assessments. The Analyst will coordinate and support data requests from third parties regarding fraud, waste, and abuse. The Analyst will also process and assess data produced by vendors, health plans, and third parties for analysis and comparison with Navitus claims. The Analyst will remain current on the regulatory environment and trends associated with fraud, waste, and abuse including changes directly or indirectly impacting Navitus Health Solutions, LLC. The Analyst will also assist the Associate Director, Compliance and SIU with duties related to analytic criteria, data tools, metrics calculation, and reporting of results.
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