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Medical Investigation Data Analytics/ 1 day ago

Job Description

Strategic & Managerial Responsibilities:

  • Support the execution of the health insurance cost containment strategy by delivering timely and accurate data insights that align with organizational priorities.
  • Proactively identify opportunities to improve data processes, analytics workflows, and reporting tools to enhance fraud, waste, and abuse (FWA) detection capabilities.
  • Collaborate with cross-functional teams to contribute to the development and refinement of fraud detection methodologies and healthcare cost optimization initiatives.
  • Participate in continuous improvement efforts to elevate data quality and analytical rigor within MIAD Data Analytics.

Core Responsibilities:

  • Develop, maintain, and enhance interactive dashboards and detailed reports using Power BI and other visualization tools to monitor provider, clinician, and member utilization patterns for FWA risks.
  • Execute complex data extraction, transformation, and analysis workflows using SQL, Power BI, and scripting tools to detect abnormal utilization and potential waste.
  • Work closely with senior data scientists to support advanced modelling efforts and ensure data consistency and integrity across analytics projects.
  • Prepare clear, concise business insights and presentations that translate technical findings into actionable recommendations for leadership and operational teams.

Quality & Excellence Management:

  • Monitor data quality and consistency in all reporting outputs, ensuring adherence to internal standards and regulatory requirements.
  • Assist in the development and implementation of quality assurance procedures for data accuracy in reporting and analysis.
  • Optimize and document analytics workflows to improve efficiency and reproducibility of results.
  • Stay current on emerging FWA trends and healthcare data innovations to enhance analytical responsiveness and accuracy.

People Management Responsibilities:

  • Provide guidance and training to business users on data visualization tools and self-service analytics platforms to promote data-driven decision-making.
  • Collaborate with team members and stakeholders to facilitate knowledge sharing and support seamless execution of analytics projects.
  • Assist in mentoring junior analysts or interns, contributing to their professional development and skill enhancement.

Preferred Educational Qualifications and Professional Certifications

  • Bachelor’s degree required; strongly preferred fields are related to Computer Science or Programming, Statistics or Mathematics, Health Economics or Healthcare Management
  • Master’s degree or PhD is preferred

Experience

  • Minimum 3 years of experience in the healthcare industry data management or data analysis/reports/automations
  • Minimum 3 years of experience in applying advanced analytical techniques to decision making in the healthcare/insurance industry incorporating some of the following skills: Data Analytics, Targeting, Optimization, Simulation, Decision Support, Statistics, and/or Mass-Data Analysis. Diversification and depth of subject matter excellence is preferred
  • Experience working with medical coding using CPT4 and ICD10 and one of the following coding systems: UCLS, DRG, MOH, HCPCS or SRVC or similar healthcare methodology experience preferred
  • Experience in FWA highly desired

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Daman National Health Insurance Company

Daman National Health Insurance Company

  • Year founded
    2006
  • Phone
    600532626
  • Website
    https://damanhealth.ae/
  • Address
    United Arab Emirates
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