Data Science Advisor (Medicare Advantage Advanced Analytics)

Key Skills

Apache Hadoop, Data science techniques, Effective communication skills, Keras software library, Natural Language Processing (NLP), NumPy, Pandas, Python Programming, R Programming, SAS, Scikit-learn, SQL, Statistical modeling, TensorFlow, Teradata

Job Description

The Data Scientist position is a hands-on role responsible for the end-to-end design, testing and development of models to assess and improve upon key initiatives related to Medicare Advantage Risk Adjustment. Your work will require a deep understanding of Medicare data, machine learning, deep learning, feature engineering, unsupervised modeling (ex. NLP, clustering), data exploration, and advanced analytic solutions to solve business problems. As a Data Scientist in Medicare Risk Adjustment you will work closely with other team members and business stakeholders to provide expertise to our operations, finance, clinical, and marketing teams to identify coding gaps, assess opportunity, forecast, and analyze risk. You will help lead key efforts around risk score forecasting, revenue assessment, predictive suspecting, program evaluations, and strategic guidance related to Medicare Advantage Risk Adjustment. You will research and prepare data for analysis, perform data exploration, apply machine learning and statistical techniques to draw conclusions and build innovative analytic solutions to improve operational effectiveness and efficiency. The ideal candidate for this role will have strong coding skills (preferably in Python), a passion for creating technology to improve health care, and an attitude of creativity and continual learning.

Responsibilities

• Work individually and/or with team members to create models using ML/AI to predict risk and identify actionable insights
• Extract and analyze large healthcare claims using SQL, R, Python, Teradata, Hadoop etc.
• Perform complex data research and analysis to support business operations including: creating data mining architectures/models/protocols, statistical reporting, NLP, and data analysis methodologies to identify trends in large data sets
• Deliver well documented, clean, reusable, and scalable code
• Interview stakeholders in order to understand pain points
• Ensure analytic approach and results are clearly understood by business partners
• Provide expert content/professional leadership on complex Business Analytics assignments/projects
• Analyze results and present analytics in a consumable method using overview, major takeaways, major questions, and next steps
• Clearly present findings to leadership and be able to articulate and influence the business case for change
• Understand how analytics affect the broader business and bridge the gap between data science and stakeholders
• Maintain analytics skillset through understanding new technologies, modeling techniques, and the ability to execute and apply to our work

Qualifications

• 5+ years' of hands-on, industry experience in machine learning algorithms and statistical modeling techniques such as clustering, classification, regression, decision trees, neural nets, support vector machines, ensemble modeling and text mining techniques such as sentiment analysis, topic modeling and entity extraction
• Multi-year experience with Python and SQL: Proficiency in performing statistical analysis in SAS, R, or Python, data science libraries such as Scikit-learn, Pandas, Numpy, Tensorflow, and Keras
• Use relevant technology/software to wrangle data, perform analytics, and visualize for consumption
• Degree in Data Science, Computer Science, Statistics, Mathematics, Computational Linguistics or related field, strongly preferred. MS or PhD preferred.
• Ability to establish and maintain strong working relationships across the organization
• Excellent communication skills
• Healthcare experience preferred
• Demonstrated experience in challenging problems and driving outstanding results
• Proven ability to work collaboratively in complex matrix organizations and multiple teams
• Experience blending creativity, problem-solving, and business acumen

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 95,300 - 158,900 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.