Senior Data Scientist - Risk Adjustment

About the role

We are seeking experienced professionals across multiple disciplines to join our operations, engineering, data science, client success, quality, and product teams. These full-time positions are based in Hyderabad, Manila, Wilmington (DE), or remote within the US, depending on the role.

Responsibilities

• Lead and execute coding operations, quality assurance, and claims processing activities
• Develop and maintain software solutions using Python and LangGraph frameworks
• Conduct evaluations and data analysis to drive insights and improvements
• Manage client success initiatives and payer operations strategies
• Oversee quality and compliance audits, including HEDIS and CCS standards
• Handle revenue cycle management, denials management, and provider RCM functions
• Drive product development in the B2B healthtech space

Requirements

• Coding Operations: CRC certification and 5+ years of relevant experience
• Quality Operations: RN license and 3+ years of HEDIS experience
• Claims Operations: 3+ years of U.S. claims processing experience
• Engineering: Strong proficiency in Python, LangGraph, and evaluation methodologies
• Data Science: PhD or MS degree with 5+ years of experience
• Client Success: 10+ years of payer operations experience
• Quality & Compliance: CCS certification and 4+ years of audit experience
• Provider RCM: 3+ years of denials management experience
• Product: B2B healthtech product experience
• Client Success (PMP track): PMP certification and healthcare industry experience

Skills

• Strong analytical and problem-solving abilities
• Excellent communication and collaboration skills
• Ability to work independently and in team environments
• Proficiency in relevant tools, frameworks, and industry standards
• Adaptability to fast-paced and evolving project needs

Benefits

• Full-time employment with competitive compensation
• Remote work options available for eligible US-based roles
• Opportunity to work on cutting-edge healthtech solutions
• Collaborative and growth-oriented work culture

Pay

Compensation is commensurate with experience and role-specific market standards.

Schedule

Full-time schedule with flexibility based on role and location requirements.