Healthcare Payer AI Decision Science Consultant

About the role

This is an industry-specific role focused on the healthcare payer domain—designing AI solutions that fit payer operations, data, and the regulatory environment, and that create real leverage across the member and provider lifecycle. As a Healthcare Payer AI Decision Science Consultant, you will:

Responsibilities

• Assist in the delivery of Data Science, Artificial Intelligence, Analytics initiatives / program for healthcare payer clients
• Collaborate with onshore and offshore teams to execute projects.
• Work forward-deployed with payer clients, co-creating solutions using our platforms and AI tooling to move quickly from idea to working solution.
• Understand and be able to bridge between business and technical domains (for both internal and external purpose)
• Engage with business and analytics stakeholders to understand their needs and build relationships.
• Support the sales process by contributing to sales solutioning for DS & ML related opportunities.
• Develop and customize DS / ML / AI / Analytics models and solutions for specific business problems within an industry or function.
• Help scope payer-focused AI programs and target high-value payer functions such as prior authorization, claims and utilization management, member engagement, care management, and risk adjustment.
• Collaborate across Accenture’s network and partner with strategy, consulting, and tech teams in the sales and delivery processes.
• Identify AI use cases in an industry and/or function by understanding an organization’s goals and areas of need, developing the business case, determining ROI, and creating the transformation roadmap.
• Contribute to the technical architecture of AI programs in payer environments, designing for payer data and compliance constraints, and help reimagine the future way of working for payer operations rather than simply automating today’s processes.
• Advise organization on adoption of responsible AI solutions and governance by training users on new processes, maintaining solutions, tracking results, and communicating the realized value.

Requirements

• Ability to travel up to 80%; travel as needed based on client expectations.

Qualifications

• Bachelor’s Degree, preferably in Data Science, Computer Science, Statistics, or a related field.
• 3+ years of experience in Data Science, Machine Learning, AI, or Advanced Analytics.
• Understanding of core payer functions and operations: prior authorization, claims / utilization management, member engagement, care management, and risk adjustment.
• Comfortable with payer data—claims, eligibility, and benefits—and the regulatory environment (e.g., HIPAA, CMS).
• Hands-on experience using Claude or an equivalent frontier AI tool to do the work.

Skills

• Strong analytical and problem-solving skills.
• Experience with machine learning frameworks and libraries (e.g., TensorFlow, PyTorch, scikit-learn).
• Proficiency in programming languages such as Python, R, or SQL.
• Knowledge of big data technologies (e.g., Hadoop, Spark).
• Knowledge of agent-based modeling, reinforcement learning, and autonomous systems is highly desirable.
• Experience with AI Native and cloud platforms (e.g., Open AI, Anthropic, AWS, Azure, Google Cloud).
• Experience with data visualization tools (e.g., Tableau, Power BI).
• Strong program management and communication skills, both verbal and written.
• Familiarity with data visualization tools (e.g., Tableau, Power BI).
• Fluent in English (both spoken and written).
• You have experience bringing innovative ideas to projects.
• Master’s degree in Data Science, Computer Science, Statistics, or a related field.
• Experience delivering AI or technology programs inside payer organizations.

Benefits

• No specific benefits mentioned.

Pay

• No specific pay mentioned.

Schedule

• No specific schedule mentioned.