Data Scientist
Core
Apply advanced analytics and data science to healthcare data for claims forecasting, fraud detection, member segmentation, and utilization analysis to support value-based care and cost optimization.
Role type
Data Scientist (Healthcare Analytics)
Builds
Predictive models for claims, fraud, segmentation, and utilization; dashboards for strategic decision-making.
Domain
Healthcare / Health Insurance
Deliverable
production ML models | dashboards & analysis
Required skills
Predictive modeling, claims forecasting, fraud detection, member segmentation, utilization analysis, statistical analysis, machine learning, data collection strategy, data quality management, cross-functional collaboration, stakeholder presentation, regulatory compliance
Preferred skills
SAS, SQL, Python, R, Power BI, Databricks
Technologies
SAS, SQL, Python, R, Power BI, Databricks
Responsibilities
Design and implement data collection strategies from internal and external sources; Develop and validate predictive models for claims forecasting, fraud detection, member segmentation, and utilization analysis; Partner with business units to translate analytical needs into actionable insights; Ensure data integrity, accuracy, and compliance with healthcare regulations.
Seniority
Individual Contributor
