Data Scientist

Job Summary

To support proactive fraud detection across Medicare and Medicaid programs, the full-time remote Data Scientist will develop advanced analytical models, algorithms, and data pipelines, while collaborating with stakeholders to produce actionable insights and enhance program integrity efforts.

Key responsibilities

• Lead the development of predictive and statistical models by defining data requirements and validating model performance
• Apply machine learning techniques to identify potential fraud, waste, and abuse in healthcare claims
• Design and automate data pipelines and reporting solutions to enhance operational efficiency and support analytics

Required qualifications

• Bachelor's degree in a quantitative field such as Mathematics, Statistics, or Data Science; advanced degree preferred
• At least 5 years of experience in data analysis and modeling using SQL, Python, or R
• Expert knowledge of healthcare claims data, including Medicare and Medicaid
• Experience with machine learning techniques and statistical analysis methods
• Familiarity with cloud environments like Databricks, Snowflake, or Microsoft Azure