Data Scientist – Medicare Part D, Market Access

This is a fully remote position, open to applicants in United States.

📋 Description

• Utilize real-world data and advanced healthcare analytics to address complex questions that impact the evaluation, valuation, reimbursement, and accessibility of innovative therapies.

• Create, validate, and implement predictive and statistical models using Python or R to project prescription drug expenditures, patient usage, and market trends.

• Examine Prescription Drug Event (PDE) claims, formulary tier frameworks, and beneficiary out-of-pocket expenses to enhance plan performance and market strategy.

• Extract, clean, and integrate extensive unstructured administrative healthcare datasets, including both public and restricted CMS data files, utilizing SQL and cloud data platforms.

• Develop data-mining algorithms to uncover market irregularities, monitor attrition rates, and identify potential fraud, waste, or abuse.

• Collaborate with market access experts, health economists, and consulting associates to convert analytical results into strategic reports.

• Modify existing data models to accommodate evolving federal healthcare regulations, benefit redesigns, and contemporary payment frameworks.

• Design and perform analyses leveraging Medicare, Medicaid, commercial claims, pharmacy, EHR, and other real-world healthcare data.

• Engage extensively with CMS data, which includes PDE data, CCW, VRDC, and other Medicare and Medicaid data sources.

• Create and sustain analytical programs using SAS.

• Contribute to observational research and real-world evidence studies that support life sciences clients.

• Aid in the development of client-facing presentations, reports, exhibits, and various deliverables.

• Convey intricate analytical concepts and findings to both technical and non-technical audiences.

• Implement programming, documentation, validation, and quality assurance practices.

• Participate in projects related to market access, reimbursement, pricing, healthcare policy, and value strategy.

⛳️ Requirements

• Bachelor’s degree in Computer Science, Data Science, Biostatistics, Epidemiology, Public Health, Health Economics, or another quantitative field.

• Direct experience with Medicare PDE data is mandatory.

• Professional proficiency in using SAS is essential.

• Background in healthcare analytics, HEOR, RWE, observational research, or a similar domain is required.

• Familiarity with healthcare claims and pharmacy data is necessary.

• Knowledge of Medicare and Medicaid data, reimbursement processes, and healthcare policy is important.

• Experience with CMS Chronic Conditions Warehouse (CCW), Virtual Research Data Center (VRDC), T-MSIS, or comparable healthcare data environments is required.

• Strong analytical, problem-solving, and communication capabilities are essential.

• Ability to work collaboratively in a consulting setting and manage multiple project priorities is necessary.

• Candidates must possess legal authorization to work full-time in the United States at the time of hire.

• ADVI does not provide employment sponsorships currently or in the future.

• Proficiency or experience with Python, R, SQL, SAS, Medicare PDE, CCW, VRDC, T-MSIS, healthcare claims, pharmacy data, and CMS data sources is expected.

🏝️ Benefits

• Medical, dental, and vision coverage.

• 8 paid holidays, including one ADVI Anniversary Day each calendar year.

• 401(k) retirement contribution matching, along with a safe harbor company contribution.

• Health Reimbursement Account.

• Life insurance and short-term and long-term disability coverage.

• Paid vacation and sick leave.

• Bonus plan.