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Data Analysis and Fraud Detection:
- Analyze Medicaid claims, visit, and billing datasets using SQL and other analytical tools.
- Identify patterns and anomalies that may indicate fraud, waste, or abuse.
- Develop and refine detection queries and analytical logic that can be applied across datasets at scale.
AI & Advanced Analytics:
- Apply machine learning and AI techniques to fraud detection.
- Collaborate with data science teams on feature engineering, model validation, and the operationalization of AI-driven detection logic.
- Leverage generative AI and LLM-based tools to support investigation summarization, pattern narrative development, and analytical workflow acceleration.
Product & Engineering Collaboration:
- Translate analytical findings into clear, actionable requirements for product and engineering teams.
- Contribute to the design of fraud detection dashboards, alerting systems, and investigation workflows.
- Support the development of automated detection tools and AI-driven fraud identification capabilities.
HHAeXchange
HHAeXchange is the leading technology platform for home and community-based care. Founded in 2008, it helps people who are aging or have disabilities thrive in their homes and communities. Our employees are passionate about transforming the healthcare space by building the only homecare ecosystem that fully connects patients, personal care providers, managed care organizations, and states.