Job Description

Data Scientist

Job Ref: TE0061
Category: Professional
Department: ANALYTICS AND REPORTING
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Work Arrangement: Hybrid
Salary Range: $128,824.00 - $138,824.00

Under the Senior Director of Analytics, the position of Data Scientist is responsible for engaging stakeholders in understanding business requirements and needs and developing and executing reporting requirements in a timely and consistent manner. This position will assess, maintain, and enhance existing data process and reporting routines and provide support for regulatory reporting. This individual will provide meaningful and actionable insights to help drive financial and operational decision making. This role will work closely with various operational, medical management, and IT departments across the organization.

The successful candidate must have healthcare experience and knowledge in planning membership and claims data, able to work autonomously and collaboratively with other Health Analytic team members, and with various subject matter experts and stakeholders across the organization. Technical proficiency and sharp healthcare and technical knowledge are equally required—the ability to effectively communicate with business users of varying data competencies & complexity in business needs and objectives is vital. This position requires an analytical-minded individual who enjoys and thrives working in a fast-paced, nebulous, challenging, but rewarding environment.

Scope of Role & Resposabilities 

Working with various stakeholders throughout the organization in assessing business requirements and developing and implementing reports and dashboards

Assist in creating comprehensive documentation of existing workflows, data processing, and reporting logics.

Working closely with membership and roster data to create meaningful insights on membership status, retroactivities, and trends.

Working with various departments across the organization in providing support for regulatory reporting and auditing needs.

Create dashboards, data visualization, and presentations in communicating actionable & timely findings to a variety of key decision makers

Translate raw data and information into concise metrics that is understandable by non-technically individuals

Drive the delivery & management of routine weekly, monthly, and quarterly reports, as well as providing support on numerous ad-hoc reporting.

Prepare and conduct projection analyses on membership, claims and utilization, including underlying trends.

Manage and prioritize concurrently projects in a timely and consistent manner

Works with clinical and non-clinical users to understand reporting needs, and to ensure that reporting is done in a clear and concise manner.

Collaborate with other Health Analytics team members and other departments & SME’s to understand company needs and devise possible solutions including data integrity / data governance solutions to remove joint obstacles to timely and high-quality data analytics

Able to conduct effective analysis on clinical interventions and outcomes related evaluations.

Deep knowledge of advanced analytics tools and machine learning techniques to analyze large data sets from multiple data sources. Able to translate key findings of statistical model into understandable language and briefing.

Familiar with the model training cycle and validation methodology. Interested in exploring feature engineering, regularization and hyperparameter tuning to improve under/over fitted models.    

Strong interest in natural langue process (NLP) and have deal with large free txt data set.

Required Education, Training & Professional Experience 

Bachelor’s degree in health sciences, Statistics, Health Informatics, Health Economics or similar fields. Master’s degree preferred.

Health care insurance background is required.

3-5 years required experience in progressively complex healthcare data analytics

3+ years of Microsoft SQL (required)

Experience working with 834 and WMS enrollment data (required)

Previous experience with business intelligence platforms (e.g., Tableau, Power BI) (required)

Previous experience in supervised and non-supervised machine learning techniques (Neural Networks, SVM, Cluster Analysis, Decision Tree Based Models and Advanced Regression Models) (desired)

Experience with healthcare data types (claim, ICD-10/CPT Code/HCPCS Code, EHR data) (desired)

Apply statistical techniques (e.g. propensity score matching, difference-in-difference, regression) to evaluate outcomes of clinical programs and estimate treatment effect from various data sources.

Define and calculate key performance indicators (KPIs) related to care management interventions, clinical outcomes, utilization, and patient engagement.

Superior analytical abilities: can draw insight from findings and understand business relevance.

Strong business acumen and curiosity to understand the “why” behind the data.

Professional Competencies 

Integrity and Trust

Customer Focus

Functional/Technical skills

Excellent verbal and written communication skills, including experience preparing and presenting to internal stakeholders at all levels of the organization

Excellent problem-solving skills, critical thinking, and conceptual thinking abilities

Ability to work independently and in a team environment

Strong organizational & project management skills; ability to prioritize and manage multiple projects concurrently

Superior analytical abilities: can draw insight from findings and understand business relevance.

#LI-Hybrid

#MHP50

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