Principal Data Scientist, AI Development and Governance

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

📋 Description

• Establish modeling and validation standards for the Data Science team.

• Define the documentation, monitoring, and evaluation processes for model drift and bias.

• Assess models prior to production and suggest necessary modifications.

• Draft and uphold policies regarding responsible AI and generative AI.

• Develop and implement models to detect fraud, waste, and abuse utilizing healthcare claims data.

• Conduct supervised risk scoring, extensive feature engineering, and validation amidst class imbalances and evolving fraud strategies.

• Articulate models, AI-assisted processes, validation outcomes, and controls to HFPP Partners and internal auditors.

• Assess generative AI capabilities for applications in healthcare fraud, waste, and abuse.

• Determine which generative AI functionalities are appropriate for pilot testing.

• Collaborate with Data Scientists, BI Developers, and FWA Subject Matter Experts.

• Act as the governance liaison across sub-teams.

• Operate as a senior individual contributor without direct reports.

⛳️ Requirements

• Master’s degree in a quantitative discipline, or a Bachelor’s in a related field with comparable hands-on experience.

• Over 8 years of experience in building, validating, and deploying machine learning models with real-world data.

• Proven ability to establish technical benchmarks for other data scientists to follow.

• Proficient understanding of responsible AI and model risk protocols, including documentation, monitoring, bias detection, and drift assessment.

• Experience in evaluating generative AI and LLM use cases for their feasibility and associated risks.

• Proficiency in Python and SQL.

• At least 2 years of experience working with healthcare claims data.

• Familiarity with medical terminology and healthcare coding systems, such as ICD-10, CPT, HCPCS, and DRG.

• Experience in presenting technical and governance-related decisions to clients, partners, or auditors.

• Expertise in AI Governance, Artificial Intelligence (AI), and Generative AI.

• Preferred experience in graph or network analytics, entity resolution, or record linkage.

• Preferred experience in piloting generative AI tools within regulated or high-scrutiny environments.

• Familiarity with AWS and/or Snowflake platforms, including Snowpark or model lifecycle tools, is preferred.

• Preferred background in payer coverage policy and industry claim adjustments.

• US citizenship is not a prerequisite.

• No security clearance is necessary.

🏝️ Benefits

• Comprehensive medical plan options, including some that feature Health Savings Accounts.

• Dental plan choices.

• Vision plan options.

• 401(k) plan with company matching contributions.

• Flexible work weeks.

• Paid time off, encompassing vacation, sick leave, personal days, holidays, paid parental leave, military leave, bereavement leave, and jury duty leave.

• Typically, 15 days of paid leave are granted per calendar year.

• 10 paid holidays each year.

• Up to 160 hours of paid family leave within a rolling 12-month period for eligible employees.

• Short-term and long-term disability benefits.

• Life insurance coverage.

• Accidental death and dismemberment insurance.

• Personal accident insurance.

• Critical illness insurance.

• Business travel and accident insurance.

• AI-driven career tool that identifies career progression steps and learning opportunities.

• An internal mobility team dedicated to supporting career aspirations.

• An award-winning culture centered around innovation.

• A military-friendly workplace.