Payer Healthcare Data Scientist, Director

PwC•Tampa, FL

1d•$155,000 - $410,000

About The Position

As a Payer Healthcare Data Scientist, you will lead data science efforts within PwC’s Advisory practice, focusing on payer modernization work that improves core operations, platform execution, and member experience across healthcare organizations. At the Director level, you will set direction for multiple workstreams, shape executive client relationships, drive business growth, and guide teams in developing ideas and solutions using data, technology, and industry insight. You will apply advanced analytic methods to healthcare payer data, translate business questions into data-driven approaches, and present findings that support decisions across claims, care management, digital experience, and operating model transformation. You will help identify market needs, develop thought leadership, and contribute to delivery quality for the Payer Modernisation offering, within the Advisory practice, Health Services sector, and Business & Supply Chain Operations network.

Requirements

At least a Bachelor's degree.
At least 10 years of experience.

Nice To Haves

Preference for study in one or more of the following fields: Accounting, Actuarial Science, Analytics/Data Science, Business Administration/Management, Computer Science/Information Systems, Economics, Engineering, Finance, Government/Public Policy, Health Administration/Public Health, Mathematics/Statistics, Operations/Supply Chain, Organizational Management/Behavior, or Risk Management/Insurance.
Experience demonstrating payer modernization analytics in health services settings.
Experience applying business data analytics to operational transformation initiatives.
Experience using predictive modeling and statistical methods for payer decisions.
Ability to translate data insights into executive recommendations and action.
Ability to guide cross-functional teams through change and process improvement.
Clear communication of findings to clients and leadership teams.

Responsibilities

Lead payer modernization data science initiatives that inform strategy, improve operations, and support client growth.
Develop predictive models, statistical analyses, and scenario-based insights for healthcare payer operations and platform decisions.
Translate business questions into analytical approaches using AI fluency, digital tooling, and business data analytics.
Synthesize claims, reimbursement, utilization management, and customer experience data into actionable findings.
Present findings and recommendations to executive client leaders through clear data narratives and visual storytelling.
Oversee multiple analytical workstreams across core systems, front office, middle office, and operational process improvement efforts.
Guide technical teams in using payer platforms such as Oracle OHI, Epic, Facets, and Nasco.
Apply operations strategy, process optimization, and business performance metrics to identify efficiency opportunities.
Collaborate across strategy, technology, and risk functions to support transformation roadmaps and implementation planning.
Advise on data quality, analytical methods, and responsible use of AI in healthcare payer environments.