Sr Data Scientist Payment Integrity

Point32Health


Job Location:

Canton, OH - USA

Monthly Salary: $ 129565 - 194348
Posted on: 23 hours ago
Vacancies: 1 Vacancy

Job Summary

Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality affordable healthcare. Serving nearly 2 million members Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. Weve had a long-standing commitment to inclusion and equal healthcare access and outcomes regardless of background; its at the core of who we are. We value the rich mix of backgrounds perspectives and experiences of all of our colleagues which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve live and work.

We enjoy the important work we do every day in service to our members partners colleagues and communities. Learn more about who we are at Point32Health.

Job Summary

Position will report into Payment Integritys Sr Manager Provider Audit.
The Sr Data Scientist is responsible for delivering innovative data-driven solutions through the analysis of complex high-dimensional datasets. This role leverages exploratory data analysis advanced statistical techniques and AI-powered technologies to uncover patterns identify opportunities and generate actionable business insights. The Sr Data Scientist translates complex data into strategic recommendations formulates critical business questions and develops advanced analytical and AI-driven products that address key business challenges and drive measurable value.

Job Description

  • Design develop and orchestrate experiments models algorithms and visualizations.
  • Lead multiple and concurrent projects and manage project phases or smaller projects in their entirety. Communicate results and insights in a clear and concise manner to a non-technical audience.
  • Identify define and translate business needs/problems into analytical questions.
  • Apply advanced machine learning natural language processing statistical and computational methodologies to provide actionable insights and identify strategic opportunities that optimize quality consumer experience and healthcare costs.
  • Lead and develop scalable efficient and automated processes for large scale data analyses and model development validation and implementation.
  • Provide supervision and mentorship to junior team members and create/adhere to governance and ethical norms.
  • Other duties and projects as assigned.

Certification and Licensure

  • Relevant certifications are a plus.

Education

  • Masters degree in data science Applied Mathematics Computer science Statistics Epidemiology or equivalent combination of experience and education.

Experience (minimum years required):

  • 8 - 10 years of work experience in a Data Scientist or similar role or equivalent combination of transferrable experience and education
  • 8 - 10 years experience with advanced machine learning statistics and statistical packages (SAS SQL) as well as Excel/PowerPoint skills (including visual graphics and analytics).
  • Experience in information management best practices including information lifecycle management data modeling and carrying out business audits and requirements gathering.

Skill Requirements

  • Advanced knowledge and mastery in Python or other programming languages along with competence in using advanced statistical analysis computational methodologies and techniques.
  • Mastery in developing supervised and unsupervised machine learning algorithms and data structures.
  • Advanced knowledge in model evaluation tuning performance operationalization scalability of scientific techniques and establishing decision strategies.
  • Experience with cloud platforms like Azure AWS or Google Cloud.
  • Proficiency in data analysis cleaning and preparation along with full understanding of data sources and limitations warehousing system and the impact of the data on business decisions.
  • Knowledge of the agile development framework.
  • Excellent written visual and oral communication skills.
  • Lead projects and manage project phases along with ability to delegate and prioritize work independently and meet/exceed deadlines.
  • Think strategically and broadly (end to end process) analyzing complex business problems.
  • Act as a Lean thinker applying continuous improvement philosophies and approaches to identify and address inefficiencies in day-to-day work.
  • Strong decision-making ability teamwork and collaborative skills. Proven track record of creating strong actionable insights that drive decision making and business process.

Working Conditions and Additional Requirements (include special requirements e.g. lifting travel):

  • Must be able to work under normal office conditions and work from home as required.
  • Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
  • May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Salary Range

$129565.60 -$194348.40

Compensation & Total Rewards Overview

The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors including the scope and complexity of the role; the skills education training credentials and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program colleagues are also eligible for variable pay. Eligibility for any bonus commission benefits or any other form of compensation andbenefits remains in the Companys sole discretion and maybe modified at the Companys sole discretion consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

  • Medical dental and vision coverage

  • Retirement plans

  • Paid time off

  • Employer-paid life and disability insurance with additional buy-up coverage options

  • Tuition program

  • Well-being benefits

  • Full suite of benefits to support career development individual & family health and financial health

For more details on our total rewards programs visit welcome all
All applicants are welcome and will receive consideration for employment without regard to race color religion gender gender identity or expression sexual orientation national origin genetics disability age or veteran status.

Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact you may contact


Required Experience:

Senior IC

Who We ArePoint32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality affordable healthcare. Serving nearly 2 million members Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and em...

About Company

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Learn more about Point32Health, a not-for-profit health and well-being company based in New England. You’ll also find more information on company achievements, health equity initiatives andPoint32Health’s family of companies, including Harvard Pilgrim Health Care and Tufts Health Plan ... View more

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