Senior Data Scientist, Fraud
Core
Design and maintain data pipelines and machine learning models to detect and prevent fraud in healthcare claims and medical utilization data.
Role type
Senior IC data scientist (fraud detection)
Builds
Fraud detection models, analytical tools, and investigative leads for the Special Investigations Unit
Domain
Health insurance / Fraud analytics
Deliverable
production ML models
Required skills
SQL, Python, supervised/unsupervised machine learning, statistical modeling, anomaly detection, graph/network analysis
Preferred skills
Healthcare claims analysis, provider billing pattern analysis, medical/pharmacy utilization data analysis
Technologies
SQL, Python
Responsibilities
Design, build, and maintain data pipelines and ML models for fraud detection; Partner with SIU and Medical Economics to translate business needs into technical solutions; Own projects end-to-end from problem definition to validation; Contribute to the fraud data science roadmap; Mentor junior data scientists
Seniority
Senior, hands-on IC with mentorship
