Data Scientist

About the Role

Key Responsibilities

• Work with a team of Data Scientists, Data Scientists, Business Intelligence Analysts, and FWA Subject Matter Experts in a remote, distributed environment.
• Develop and execute FWA models and algorithms in multi-payer environments by creating, reviewing, and maintaining statistical analysis plans, providing data interpretation, and generating reports to support research questions.
• Engage with the Data Science team’s collaboration with FWA Subject Matter Experts, Business Intelligence Developers, and clients to develop meaningful analyses for FWA modeling results and provide predictive analytic statistical support.
• Assist in the innovation, design, and maintenance of automated data pipelines in collaboration with data engineers and Business Intelligence Developers, feeding analytic outputs to a server environment for partner interaction.
• Deliver presentations to clients, stakeholders, and effectively communicate key insights and value propositions of the TTP analytic outputs.
• Work as a developer/coder and engage in quality review of analytic output to ensure consistency with protocol and methodological objectives, and compliance with access standards.
• Document processes, best practices, and strategies for existing and future FWA models and algorithms to optimize business efficiencies.

Requirements

• Master's Degree in Statistics or related field or an equivalent combination of education and experience.
• 5-8 years of experience in statistical and computer-science related fields.
• Experience using SQL and Python for healthcare Fraud, Waste, and Abuse datamining and statistical modeling.
• Experience with client relation activities, synthesizing customer requirements, and communicating complex healthcare analytic outcomes.
• Experience presenting FWA analytic outcomes to clients, stakeholders, and conferences.
• Expertise in medical terminology and healthcare coding systems (e.g., ICD-10, CPT, HCPCS, DRG).
• Experience datamining for healthcare fraud, waste, and abuse in large, multi-payer databases including private plans and public programs like Medicare and Medicaid.
• Experience interpreting and applying payer medical policies and industry claim edits.
• Prior experience managing multi-person healthcare data analytics teams with leadership or mentorship skills.
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
• Must currently be working on the CMS HFPP TTP program.

Nice to Have

• Experience in Amazon Web Services (AWS) cloud and/or Snowflake data warehouse environments.
• Ability to communicate technical outcomes clearly to both technical and non-technical audiences.
• Exceptional problem-solving skills, accuracy, organizational skills, and attention to detail.
• Excellent written and verbal communication skills, especially in data presentation.
• Ability to work in a fast-paced, team-oriented environment with minimal supervision.

Qualifications

• Educational background: Master's Degree in Statistics or related field, or equivalent experience.
• Experience: 5+ years in statistical and computer science fields.
• Technical skills: SQL, Python, healthcare coding systems, healthcare data mining.
• Leadership: Experience managing healthcare data analytics teams.

Benefits & Perks

• Competitive pay and benefits.
• Flexible work schedule.
• Collaborative inter-disciplinary environment.
• Health, dental, vision plans, and 401(k) plan with company match.
• Paid time off including vacation, sick, personal days, holidays, and paid parental, military, bereavement, and jury duty leave.
• Paid Family Leave providing up to 160 hours of paid leave annually.
• Short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness, and business travel insurance.