Healthcare Navigation Data Scientist

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

📋 Description

• Examine healthcare and book-of-business data to uncover cost drivers, utilization patterns, and chances to enhance member outcomes while minimizing healthcare expenses.

• Create and refine methodologies for provider scoring, ranking, and recommendations utilizing cost, quality, specialty alignment, and provider experience.

• Integrate and transform claims, provider, pricing, and network data for analytical and modeling projects.

• Construct, validate, and optimize statistical, predictive, and machine learning models to enhance provider search relevance and personalization.

• Assess business rules, scoring outputs, and recommendation effectiveness in relation to clinical and business goals.

• Track key performance indicators and suggest improvements to data sources, models, and processes.

• Collaborate with Product, Engineering, Clinical, and Business teams to convert analytical insights into actionable solutions that deliver measurable business value.

⛳️ Requirements

• Proficient in handling large, complex datasets using SQL and Python and/or R.

• Experience in developing data models, scoring frameworks, predictive analytics, or machine learning solutions.

• Familiarity with healthcare datasets and concepts, including claims data, CPT, ICD, NPI, provider networks, and healthcare pricing.

• Understanding of healthcare cost drivers, utilization analytics, quality metrics, and provider performance indicators.

• Strong analytical, problem-solving, and communication skills to translate intricate findings into actionable business insights.

• Experience with provider search, recommendation systems, ranking models, or personalization algorithms.

• Knowledge of clinical quality measures such as HEDIS, CMS, or other related healthcare standards.

• Experience applying machine learning techniques within healthcare, health technology, or navigation contexts.

• Bachelor’s degree in data science, Statistics, Mathematics, Computer Science, Healthcare Analytics, or a related discipline.

• Applicants must be residents of the United States in one of the 50 states or the District of Columbia.

• Proof of US citizenship is required at the time of hiring.

• Must have work authorization that does not currently or in the future require visa sponsorship in the employing country.

• A background check is mandatory if an offer is extended.

• An advanced degree is preferred.

🏝️ Benefits

• Health, dental, and vision coverage beginning on Day One.

• Wellbeing programs.

• Retirement plans with contribution matching.

• Generous paid time off.

• Parental leave.

• Continuing education opportunities.

• Career advancement possibilities.

• Flexible work arrangements.

• Competitive total rewards package.

• Ongoing education and training.

• Comprehensive benefits package.

• Reasonable accommodations during the hiring process.