Healthcare Data Scientist – Claims, Quality, Provider Performance
Vālenz® Health
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
SeniorLead
Tech Stack
PythonSQL
About the role
- Utilize reference data sources and advanced validation techniques to ensure accuracy, completeness, and integrity of healthcare claims data.
- Assess provider scoring methodologies, identify discrepancies, and develop insights to optimize coverage accuracy.
- Design, develop, and maintain retrospective models for historical performance analysis, and predictive models to identify high-risk patients and prioritize actionable interventions.
- Translate complex analytical findings into clear, actionable insights, and effectively communicate results and recommendations to internal stakeholders and external clients.
- Aggregate and reconcile multiple data sources, applying statistical and computational methods to verify data integrity, identify anomalies, and implement necessary corrections.
- Execute comprehensive data analysis workflows, evaluate outcomes, and implement enhancements to improve model accuracy and data reliability.
- Review and optimize claim-matching processes, troubleshoot inconsistencies, and resolve data discrepancies to maintain high-quality outputs.
- Investigate data quality issues, conduct root cause analysis, document findings, and deliver actionable recommendations for process improvements.
- Collaborate with cross-functional teams to enhance analytical tools, refine methodologies, and implement scalable solutions that improve efficiency and analytical capabilities.
Requirements
- Bachelor’s degree in a quantitative field (e.g., Statistics, Mathematics, Engineering, Computer Science, Finance, or Economics).
- 7+ or more years of experience analyzing healthcare claims data, including complex and imperfect datasets.
- Strong analytical, problem-solving, and critical-thinking skills with proven ability to uncover root causes
- Proficiency in SQL for querying and manipulating data; familiarity with Python or similar data tools preferred.
- Advanced Excel skills, including PivotTables and complex formulas, for data modeling and reporting.
- Knowledge of healthcare network rosters, provider data, and quality measurement methodologies.
- Exceptional attention to detail with a commitment to accuracy, data validation, and quality assurance.
- Highly organized and self-motivated, with the ability to manage multiple priorities independently while collaborating effectively with others.
Benefits
- Competitive benefits package with generous employer subsidies
- Flexible and remote working options
- 401k with generous employer match and immediate vesting
- Personal and professional development opportunities
- Supportive family benefits, including paid leave for new family members
- Companywide philanthropic program, Valenz Communities Connection
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
data analysisstatistical methodspredictive modelingdata validationSQLPythonExceldata modelingroot cause analysisdata integrity
Soft skills
analytical skillsproblem-solvingcritical thinkingattention to detailorganizational skillsself-motivationcollaborationcommunicationinsight developmentprocess improvement