Lead Data Scientist

Humana

Lead Data Scientist developing policy-adherence metrics and valuation models for Humana’s healthcare and insurance operations. Transforming complex claims-related data into actionable compliance and network insights.

Posted 8/19/2026full-timeRemote • Illinois, North Carolina, North Dakota, Ohio, Oklahoma • 🇺🇸 United StatesSenior💰 $156,500 - $215,300 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Expertise in transforming complex data into actionable insights through advanced analytics, mathematics, and statistics, with a strong focus on compliance and operational consistency. Proven ability to lead projects and manage stakeholder expectations while developing and maintaining data sets for reporting and strategic decision-making.

Highest-signal resume keywords

Data TransformationSQL ProficiencyProject LeadershipAdvanced AnalyticsPolicy Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

MathematicsStatisticsModelingMachine LearningData AnalysisData ReportingData CollectionData ManagementValuation ModelingPolicy Adherence Metrics

Soft Skills

Independent JudgmentDecision MakingStakeholder Management

Tools & Technologies

Databricks

Certifications & Qualifications

Master's DegreeDoctorate Degree

Industry Keywords

ComplianceOperational ConsistencyPolicy GovernanceClaims DatasetsMHPAEA

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Transform high volumes of complex data into advanced analytic solutions using mathematics, statistics, modeling, business analysis, and technology
Develop, maintain, and collect structured and unstructured data sets for analysis and reporting
Create reports, projections, models, and presentations to support business strategy and tactics
Advise executives on significant, often segment-specific, functional strategies
Shape strategy for innovative analytics solutions providing actionable insights into policy adherence, compliance, operational consistency, and decision-making
Research, design, and implement a policy adherence metric using FRAC and PA denials information and advanced data modeling
Design valuation models to measure savings from removing non-compliant outliers
Partner with National BH, Contracting, Medicaid, and ND&PPS teams to support operational use of the metric, including MHPAEA and Humana policy compliance
Shape future measurement of ancillary/inpatient psychiatric provider types and other opportunity areas
Manage stakeholders and expectations across data source owners, compliance, policy/governance, business, PTC, and National program partners
Influence priorities, tradeoffs, and roadmap decisions while implementing a scalable solution

Requirements

What you’ll need

Master's Degree
Minimum 8 years of professional experience in data and analytics transforming data sets for actionable insights and reporting
Minimum 5 years of experience utilizing SQL
Minimum 4 years of project leadership experience
Experience using mathematics, statistics, modeling/Machine Learning modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions
Demonstrated experience working on problems of diverse scope and complexity ranging from moderate to substantial
Experience developing, maintaining, and collecting structured and unstructured data sets for analysis and reporting
Experience creating reports, projections, models, and presentations to support business
Ability to exercise independent judgment and decision making on complex issues
Ability to work under minimal supervision using independent judgment
Minimum download speed of 25 Mbps and upload speed of 10 Mbps
Wireless, wired cable, or DSL connection suggested; satellite, cellular, and microwave connections require leadership approval
Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information
Preferred: Doctorate degree
Preferred: Experience with claims datasets
Preferred: Experience with Databricks

Benefits

Comp & perks

Bonus incentive plan based on company and/or individual performance
Medical, dental, and vision benefits
401(k) retirement savings plan
Paid time off
Company holidays
Personal holidays
Paid parental leave
Paid caregiver leave
Short-term disability
Long-term disability
Life insurance
Home or Hybrid Home/Office telephone equipment
Bi-weekly internet expense payment for associates living and working from home in California, Illinois, Montana, or South Dakota
Occasional travel to Humana offices for training or meetings