Health Plan Data Scientist
Core
Identify, quantify, and prioritize total cost of care (TCOC) savings opportunities across health plan levers (clinical programs, utilization management, payment integrity, network contracting, benefit design) using data science and GenAI to support SCAN's mission of keeping seniors healthy.
Role type
Senior IC data scientist (health plan economics & AI)
Builds
Production analytics for claims, clinical, and contract data to drive cost management strategy
Domain
Health insurance / Medicare Advantage / Managed care
Deliverable
production ML models | dashboards & analysis
Required skills
statistical modeling, segmentation, trend analysis, GenAI/agentic AI, SQL, Python, R, Snowflake, Databricks, Power BI
Preferred skills
Streamlit, GenAI/LLM tools (RAG, embeddings, LangChain), Medicare Advantage experience, clinical coding knowledge (ICD-10, CPT, DRG), managed care economics (PMPM, MLR, HCC/RAF), MLOps (MLflow, Azure DevOps)
Technologies
Snowflake, Databricks, Power BI, Streamlit, LangChain, LangGraph, Azure DevOps, MLflow
Responsibilities
Apply data science methods to claims/clinical/contract data to identify and size TCOC savings; collaborate with clinical, finance, and network stakeholders to convert findings into strategy; create requirements, validate analyses, and communicate opportunity sizing; shape and implement medical economics analytics and AI strategy; mentor other analytics practitioners
Seniority
Senior, hands-on IC with mentorship
