Medicare Stars Senior Data Scientist - Work From Home

Health Care Service Corporation•National, NV

1d•$92,700 - $167,500•Remote

About The Position

This position is responsible for providing advanced mathematical and statistical methods to solve complex business problems with minimal direction while supporting the analytics strategy for HCSC’s Medicare Stars program. Senior Data Scientists collect, integrate, and analyze data from healthcare claims, clinical outcomes, quality measures, provider performance, member outcomes, and internal business processes to identify opportunities to improve Medicare Star Ratings. The role performs complex statistical analysis to validate and quantify trends, adapts machine learning, predictive modeling, and probabilistic methods to develop predictive algorithms, and verifies model effectiveness based on real-world results. Senior Data Scientists design experiments and methodologies, create visualizations and analytical applications, and translate findings into actionable recommendations that support critical business decisions, program enhancements, and new quality improvement initiatives. Working closely with clinical, pharmacy, customer experience, product, and operations teams, this individual will represent the data science perspective on cross-functional teams, contribute to consequential decisions, and help drive innovative solutions that improve member outcomes, Stars performance, affordability, and enterprise value.

Requirements

Bachelor’s degree and 3 years of work experience in a mathematical, statistical, computer science, engineering, physics, economics or related quantitative field; OR Actuarial credential; OR Master’s degree and 2 years of work experience in a mathematical, statistical, computer science, engineering, physics, economics or related quantitative field; OR Ph.D. in a mathematical, statistical, computer science, engineering, physics, economics or related quantitative field; OR 7 years experience in a mathematical, statistical, computer science, engineering, physics, economics or related quantitative field.
Strong learning and growth mindset
Customer focus
Strong interpersonal, verbal and written communication skills.
Proficiency in at least four of the following six areas: 1) data analysis and relational-style query languages; 2) machine learning and/or statistical modeling; 3) data visualization; 4) a high-level programming language; 5) distributed computing; 6) understanding of healthcare.

Nice To Haves

Master's or Ph.D. in a quantitative field, or bachelor's degree with significant healthcare experience.
Experience with diverse healthcare data preferred, including claims, EHR, demographic, pharmacy, lab, biometrics, genomics, and text.
Experience with statistical software program such as SAS, Dataiku, R and/or Python is required.
Statistical and/or data mining experience in propensity score modeling, multivariate regression, machine learning
Comprehension of healthcare data (e.g., claims, utilization, provider information) and demonstrated understanding of health care and delivery system processes.

Responsibilities

Collect, integrate, and analyze data from healthcare claims, clinical outcomes, quality measures, provider performance, member outcomes, and internal business processes to identify opportunities to improve Medicare Star Ratings.
Perform complex statistical analysis to validate and quantify trends.
Adapt machine learning, predictive modeling, and probabilistic methods to develop predictive algorithms.
Verify model effectiveness based on real-world results.
Design experiments and methodologies.
Create visualizations and analytical applications.
Translate findings into actionable recommendations that support critical business decisions, program enhancements, and new quality improvement initiatives.
Represent the data science perspective on cross-functional teams.
Contribute to consequential decisions.
Help drive innovative solutions that improve member outcomes, Stars performance, affordability, and enterprise value.