About the Company

Zachary Piper Solutions provides technology and professional services supporting government and commercial organizations. For this position, the company is supporting the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), in establishing and operating a Fraud Rapid Response Center focused on detecting healthcare fraud, waste, and abuse.

About the Role

Zachary Piper Solutions is seeking a Data Analyst (Healthcare Fraud) to support the VHA’s Fraud Rapid Response Center. This role focuses on analyzing federal healthcare data, developing fraud detection rules, identifying suspicious billing activity, and producing prioritized leads for government review. The work supports efforts to protect Veterans, reduce improper payments, and safeguard taxpayer dollars. As part of the analytics team, you will work with healthcare claims, provider, and enrollment data to identify potential fraud patterns and support investigative decisions. You will also contribute to analytics workflows within the VA’s Palantir platform, develop provider risk scoring methods, evaluate the accuracy of detection rules, and prepare dashboards and reports for government stakeholders. This is a fully remote position within the continental United States, with East Coast working hours and occasional travel to Washington, DC, for in-person meetings.

Key Responsibilities

Develop, test, and document analytical business rules and algorithm logic to identify healthcare fraud, waste, and abuse schemes. Support provider risk scoring, case prioritization, and fraud detection criteria to help investigators identify high-risk providers and suspicious claims. Support the configuration, development, deployment, and integration of data pipelines and analytics workflows within the VA’s Palantir platform. Combine claims, enrollment, and provider exclusion data to build a comprehensive Provider 360 view of community care providers. Conduct anomaly detection and network analysis to identify unusual billing patterns, relationships, and potential coordinated fraud schemes. Run recurring weekly analytics to generate prioritized lead lists and support Fraud Rapid Response Center decision packages. Extract, clean, transform, and analyze federal healthcare data to identify fraud indicators, improper payments, and overpayments. Develop and maintain analytical workpapers documenting findings and supporting case review activities. Back-test fraud detection rules, measure precision and positive predictive value (PPV), analyze false positives, and support quality assurance and corrective action plans. Support federal benchmarking and align VHA data analysis methods with relevant Centers for Medicare & Medicaid Services (CMS) practices. Create dashboards, visualizations, and analytical reports for fraud trends, improper payment reduction initiatives, risk governance, and executive briefings. Document rule specifications, acceptance criteria, data transformations, and analytical methodologies. Support knowledge transfer and training to help VA staff operate and maintain the analytics workflows independently. Handle protected health information (PHI) and sensitive government data in accordance with HIPAA, VA privacy requirements, and applicable security procedures.

Required Qualifications

Bachelor’s degree in Information Technology, Computer Science, Data Science, Statistics, Health Informatics, or a related field. Two to five years of federal healthcare data analytics experience, including work with Medicare, Medicaid, or VHA data. Experience developing analytical business rules for healthcare data, fraud detection, payment integrity, or related applications. Strong SQL and Python skills, or comparable analytical programming experience with PySpark or R. Proficiency with analytics platforms and data workflows, including data pipelines, transformations, and dashboards. Working knowledge of healthcare claims data, including claim types, CPT/HCPCS and ICD-10 codes, National Provider Identifiers (NPIs), provider data, and beneficiary data. Strong analytical, problem-solving, and documentation skills. Ability to pass a Tier 2 / Moderate Background Investigation (MBI) and obtain a VA Personal Identity Verification (PIV) card. Legal eligibility to work in the United States. Ability to handle PHI and sensitive information in accordance with HIPAA and VA privacy requirements and complete required VA TMS training. Preferred Qualifications / Requirements Hands-on experience with Palantir Foundry or Gotham, particularly in healthcare analytics, fraud detection, or payment integrity. Experience identifying healthcare billing anomalies, including upcoding, unbundling, duplicate billing, impossible days, and billing by excluded providers. Familiarity with VA Community Care data, the CMS Integrated Data Repository (IDR), the HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE), or SAM exclusion lists. Experience with anomaly detection, machine learning, network analysis, or link analysis. Experience back-testing analytical rules, measuring positive predictive value (PPV), and evaluating false-positive rates. Proficiency with Power BI, Tableau, or similar data visualization and reporting tools. Certified Fraud Examiner (CFE) credential or a relevant data analytics certification. Location and Work Arrangement Work arrangement: 100% remote within the continental United States. Working hours: East Coast working hours. Travel: Occasional travel to Washington, DC, for in-person meetings. Salary & Benefits The salary range for this position is $100,000–$110,000, depending on experience. Benefits include medical, dental, and vision insurance, a 401(k) plan, holidays, paid time off (PTO), and sick leave as required by law.