Sr Data Scientist - Payment Integrity

Point32Health • Canton, MA

3d • $129,566 - $194,348

About The Position

The Sr Data Scientist delivers innovative, data-driven solutions by analyzing complex, high-dimensional datasets. The role uses exploratory data analysis, advanced statistical techniques, and AI-powered technologies to uncover patterns, identify opportunities, and generate actionable business insights. The Sr Data Scientist translates complex data into strategic recommendations, formulates critical business questions, and develops advanced analytical and AI-driven products that address business challenges and deliver measurable value. The position reports to the Payment Integrity Sr Manager Provider Audit.

The role designs and develops experiments, models, algorithms, and visualizations; leads concurrent projects; and communicates results to non-technical audiences. It applies machine learning, natural language processing, statistical, and computational methods to improve quality, consumer experience, and healthcare costs. The position also develops scalable and automated processes for large-scale analysis and model development, validation, and implementation, while providing supervision and mentorship to junior team members and following governance and ethical norms.

The position requires a master’s degree in a relevant field or an equivalent combination of education and experience, and 8–10 years of relevant work experience. The role calls for advanced programming and statistical expertise, machine learning capabilities, experience with cloud platforms, data management and analysis skills, and the ability to lead projects and deliver actionable insights. Work may be performed under normal office conditions or from home as required. Duties may include additional hours beyond the standard work schedule.

Requirements

• Master’s degree in data science, applied mathematics, computer science, statistics, epidemiology, or an equivalent combination of experience and education.
• 8–10 years of work experience in a Data Scientist or similar role, or an equivalent combination of transferable experience and education.
• 8–10 years of experience with advanced machine learning, statistics, and statistical packages such as SAS and SQL, as well as Excel and PowerPoint, including visual graphics and analytics.
• Experience with information management best practices, including information lifecycle management, data modeling, business audits, and requirements gathering.
• Advanced knowledge and mastery of Python or other programming languages, as well as advanced statistical analysis, computational methodologies, and techniques.
• Mastery in developing supervised and unsupervised machine learning algorithms and data structures.
• Advanced knowledge of model evaluation, tuning, performance, operationalization, scalability of scientific techniques, and establishing decision strategies.
• Proficiency in data analysis, cleaning, and preparation, and understanding of data sources and limitations, warehousing systems, and the impact of data on business decisions.
• Knowledge of the agile development framework.
• Excellent written, visual, and oral communication skills.
• Ability to lead projects, manage project phases, delegate and prioritize work independently, and meet or exceed deadlines.
• Ability to think strategically and broadly, taking an end-to-end view when analyzing complex business problems.
• Ability to apply Lean thinking and continuous improvement approaches to identify and address inefficiencies.
• Strong decision-making, teamwork, and collaboration skills, with a proven record of creating actionable insights that drive decisions and business processes.
• Ability to work under normal office conditions and work from home as required.
• Ability to use a telephone or headset and a PC or keyboard simultaneously, and to sit for extended durations.
• May be required to work additional hours beyond the standard work schedule.

Nice To Haves

• Relevant certifications are a plus.
• Experience with cloud platforms such as Azure, AWS, or Google Cloud.

Responsibilities

• Design, develop, and orchestrate experiments, models, algorithms, and visualizations.
• Lead multiple concurrent projects and manage project phases or smaller projects in their entirety.
• Communicate results and insights clearly and concisely to non-technical audiences.
• Identify, define, and translate business needs and problems into analytical questions.
• Apply advanced machine learning, natural language processing, statistical, and computational methodologies to provide actionable insights and identify opportunities to optimize quality, consumer experience, and healthcare costs.
• Lead the development of scalable, efficient, and automated processes for large-scale data analyses and for model development, validation, and implementation.
• Provide supervision and mentorship to junior team members.
• Create and adhere to governance and ethical norms.
• Perform other duties and projects as assigned.

Benefits

• Medical, dental, and vision coverage.
• Retirement plans.
• Paid time off.
• Employer-paid life and disability insurance, with additional buy-up coverage options.
• Tuition program.
• Well-being benefits.
• Benefits supporting career development, individual and family health, and financial health.
• Eligibility for variable pay; any bonus, commission, benefits, or other compensation remains at the Company’s discretion.

What This Job Offers

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