Lead Data Scientist

Humana • Puerto Rico, VT

3d • $156,500 - $215,300 • Remote

About The Position

The Lead Data Scientist uses mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions. The Lead Data Scientist works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Data Scientist develops, maintains, and collects structured and unstructured data sets for analysis and reporting. This individual will create reports, projections, models, and presentations to support business strategy and tactics. The Lead will advise executives to develop functional strategies (often segment specific) on matters of significance. Additional expectations include: Being a thought partner in shaping the strategy for innovative analytics solutions that provide actionable insights into policy adherence, enabling improved compliance, operational consistency, and decision-making. Researching, designing, and implementing a policy adherence metric rooted in FRAC and PA denials information using advanced data modeling techniques. Designing valuation model(s) to measure savings tied to removing outliers who are non-compliant with the policy adherence metric. Partnering with National BH/Contracting/Medicaid/ND&PPS teams to support use of this metric in operations including compliance with MHPAEA and other HUM policies. Shaping the path to measuring ancillary / inpatient psychiatric provider types and/or other opportunity areas in the future. Managing stakeholders/expectations while working across different teams including data source owners, compliance, policy/governance, business, PTC/National program partners. Influencing priorities, tradeoffs, roadmap decisions in driving the implementation of a scalable solution.

Requirements

• Master's Degree
• Minimum 8 years of professional experience in data and analytics transforming data sets for actionable insights and reporting
• Minimum 5 years of experience utilizing SQL
• Minimum 4 years of project leadership experience
• Experience in using mathematics, statistics, modeling/Machine Learning modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions
• Successful demonstrated experience in working on problems of diverse scope and complexity ranging from moderate to substantial
• Experience in developing, maintaining, and collecting structured and unstructured data sets for analysis and reporting
• Experience in creating reports, projections, models, and presentations to support business
• Ability to exercise independent judgment and decision making on complex issues regarding job duties and related tasks
• Ability to works under minimal supervision, using independent judgment

Nice To Haves

• Doctorate degree
• Experience with claims datasets
• Experience with Databricks

Responsibilities

• Develops, maintains, and collects structured and unstructured data sets for analysis and reporting.
• Creates reports, projections, models, and presentations to support business strategy and tactics.
• Advises executives to develop functional strategies on matters of significance.
• Shapes the strategy for innovative analytics solutions that provide actionable insights into policy adherence.
• Researches, designs, and implements a policy adherence metric rooted in FRAC and PA denials information using advanced data modeling techniques.
• Designs valuation model(s) to measure savings tied to removing outliers who are non-compliant with the policy adherence metric.
• Partners with National BH/Contracting/Medicaid/ND&PPS teams to support use of this metric in operations.
• Shapes the path to measuring ancillary / inpatient psychiatric provider types and/or other opportunity areas in the future.
• Manages stakeholders/expectations while working across different teams including data source owners, compliance, policy/governance, business, PTC/National program partners.
• Influences priorities, tradeoffs, roadmap decisions in driving the implementation of a scalable solution.

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Senior