Sr Decision Scientist- Medical Affairs

We are one of the nation's leading healthcare companies, committed to improving health outcomes and making care more accessible, affordable, and and convenient for the millions of people we serve. Our work spans pharmacy, health services, and insurance solutions, all united by a shared mission to help people on their path to better health. Our core values emphasize innovation, collaboration, and a people-first approach, fostering an inclusive and supportive workplace for all employees.

About the role

We are looking for a Decision Scientist to join a newly funded pod focused on bringing AI into advanced reporting for our Medicaid business. Today, much of this reporting is built and maintained manually; the goal of this initiative is to use AI to reduce that manual burden over time, starting with specific, high-priority reporting use cases and building toward broader automation. In this initial phase, the pod will work closely with business stakeholders to gather requirements and stand up the first set of solutions, with the first project focused on reporting tied to Medicaid network contracts. This is a senior decision scientist role on a small, newly formed team consisting of a squad lead/product manager, two data engineers, and two decision scientists.

Responsibilities

• Partner directly with business stakeholders to understand current reporting processes and translate their needs into requirements for AI-enabled solutions.
• Design and build advanced reporting solutions, starting with reporting tied to Medicaid network contracts, using GenAI tools and approaches to reduce manual effort.
• Work closely with data engineers and the squad lead/product manager to scope, prioritize, and deliver pod initiatives.
• Build initial solutions for specific reporting use cases as a first step, laying the groundwork for broader automation as the pod matures.
• Apply healthcare and Medicaid domain knowledge to ensure solutions reflect real business rules, contract terms, and reporting requirements.
• Build and validate reporting solutions using SQL and Python, incorporating GenAI/LLM tools (e.g., Claude) where appropriate.

Requirements

Education

• Bachelor's degree in a quantitative field (e.g., Statistics, Data Science, Computer Science) or equivalent experience.

Experience

• 5+ years of relevant experience as a decision scientist, data scientist, or similar analytical role (P3 level).
• Healthcare domain experience is critical; experience with Medicaid, network contracts, or health plan operations is strongly preferred.

Skills

• Strong SQL and Python skills.
• Hands-on experience with GenAI/LLM tools; experience coding with Claude specifically is a plus.
• Comfortable gathering requirements directly from business stakeholders and translating them into technical solutions.
• Comfortable operating in a newly formed team with an evolving structure and scope.
• Ownership mindset, able to move quickly from requirements to working solutions.
• Strong communicator, able to work cross-functionally with engineers, product, and business stakeholders.

Preferred Qualifications

• Experience with Medicaid managed care, network contracting, or other government health programs.
• Experience applying GenAI tools to real-world reporting or analytics workflows.
• Prior experience joining or helping stand up a new team or pod.

Benefits

• High-visibility engagement on a newly funded, executive-sponsored AI initiative.
• Remote flexibility, with a strong preference for EST or CST time zones.
• Opportunity to shape a first-of-its-kind AI-enabled reporting solution from the ground up.
• Close collaboration with a small, dedicated pod rather than a large, siloed team.
• Potential for continued engagement as the pod's scope and automation roadmap evolve.