Sr. Data Scientist – Medicare/Remote 12824 Position Available In Alcorn, Mississippi

This is a Job Description for a[]{#_Hlk142289191}[]{#_Hlk142304825} Senior Data Scientist — Medicare Advantage Stars Analytics REMOTE or Hybrid. This is a remote position.

Summary:

The primary focus of this role is to develop and manage analytical tools that support improvements in Medicare Advantage Star Ratings. This includes CAHPS and HOS experience analytics, HEDIS dynamics, Pharmacy modeling, Operation metric movement to high reliability state all with a provider performance assessment and integration of CMS dynamic rule modifications.

Duties and Responsibilities:

Develops & maintains robust Stars analytical models, ensuring accuracy & adapting to evolving data and regulatory shifts. Develops methodologies to measure Stars initiatives’ impact, optimizing analytic tools for performance improvements. Participates in and is responsible for projects requiring advanced statistical analyses, innovative research, mathematical calculations, and technical skills. Interprets data and identifies correlations using both univariate and multivariate analysis. Prepares and delivers summary reports to the relevant or affected areas within the company. Delivers conclusions. Oversees the creation, development and maintenance of our models. This includes the creation of appropriate documents (PowerPoint presentations, etc.) to be used in the communication of predictive model results to the company. Provides technical and quantitative analysis for predictive modeling group. Build models using training, test, and cross-validation data sets. Involvement in the implementation of predictive model results into the appropriate system. Further involvement in the implementation of predictive model results into the appropriate system. Document model requirements. Conducts research utilizing predictive modeling. Communicates and trains users on model results. Presents findings and recommendations to appropriate groups. Further involvement in communication of predictive model results to other departments. Additional communication to all affected departments.

Requirements and Qualifications:

4-6 years of research and modeling in Healthcare industry experience required. Medicare Advantage experience is preferred. Resourceful problem-solving skills and desire to succeed. Ability to work effectively as a member of a team. Ability to manage responsibilities as unexpected pressures/dilemmas arise. Ability to establish workflows, manage multiple projects, meet necessary deadlines, and work without supervision. Ability to apply the principles of independent logical thinking to define problems, collect data, establish facts, draw valid conclusions and make actionable strategic recommendations. Expertise in statistical programming languages like Python, R, SAS and SQL. Knowledge of insurance and underwriting techniques, agency and policyholder needs. Strong database querying skills including Databricks, MS SQL server. Bachelor’s degree in insurance, math, economics, statistics, or computer science required. Advanced degree in statistics, actuarial science, or applied mathematics preferred. Exercise sufficient discretion and independent judgment with a wide degree of creativity and latitude. Continuous learning, as defined by the Company’s learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

Equal Opportunity/Affirmative Action Employer.