Payer Healthcare Data Scientist, Manager

Opportunity

As part of the Operations Consulting team, you will apply advanced data science and machine learning techniques to large-scale claims, clinical, and member data to surface actionable insights that reduce cost of care and improve population health outcomes for our payer clients.

The Opportunity

• Apply advanced data science and machine learning methodologies to analyze vast claims and clinical data
• Generate actionable insights aimed at reducing healthcare costs and enhancing population health
• Lead and mentor teams while managing client relationships and expectations
• Secure successful project execution while upholding quality standards
• Collaborate with industry leaders to develop innovative analytics solutions
• Present findings and strategies to senior stakeholders, including Chief Actuaries
• Play a key role in the development of new analytics products for payer strategies
• Foster a culture of continuous improvement and knowledge sharing within the team

Responsibilities

• Apply advanced data science and machine learning methodologies to analyze vast claims and clinical data
• Generate actionable insights aimed at reducing healthcare costs and enhancing population health
• Lead and mentor teams while managing client relationships and expectations
• Secure successful project execution while upholding quality standards
• Collaborate with industry leaders to develop innovative analytics solutions
• Present findings and strategies to senior stakeholders, including Chief Actuaries
• Play a key role in the development of new analytics products for payer strategies
• Foster a culture of continuous improvement and knowledge sharing within the team

Requirements

• Bachelor's Degree
• At least 6 years of experience in data science and machine learning
• Master's Degree in Statistics, Computer Science, Applied Mathematics, Biotechnology preferred
• Prior consulting or advisory firm experience preferred
• Contributing to commercial analytics product development
• Familiarity with NCQA HEDIS specifications and CMS Star Ratings
• Knowledge of government payer programs and Medicaid
• Experience with NLP or unstructured clinical text
• Exposure to social determinants of health data integration

Qualifications

• Master's Degree in Statistics, Computer Science, Applied Mathematics, Biotechnology preferred
• Prior consulting or advisory firm experience preferred
• Contributing to commercial analytics product development
• Familiarity with NCQA HEDIS specifications and CMS Star Ratings
• Knowledge of government payer programs and Medicaid
• Experience with NLP or unstructured clinical text
• Exposure to social determinants of health data integration

Skills

• Analyse and identify the linkages and interactions between the component parts of an entire system
• Take ownership of projects, ensuring their successful planning, budgeting, execution, and completion
• Partner with team leadership to ensure collective ownership of quality, timelines, and deliverables
• Develop skills outside your comfort zone, and encourage others to do the same
• Effectively mentor others
• Use the review of work as an opportunity to deepen the expertise of team members
• Address conflicts or issues, engaging in difficult conversations with clients, team members and other stakeholders, escalating where appropriate
• Uphold and reinforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance), the Firm's code of conduct, and independence requirements

Benefits

• Paid time off
• Medical, dental, and vision insurance
• 401(k) retirement plan
• Holiday pay
• Family and personal sick leave
• Discretionary bonus

Pay

The salary range for this position is: $99,000 - $232,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws.