Sr Data Scientist - Integrity

Who We Are

Point
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Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point
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Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are.

We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point
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Health.

Position will report into Payment Integrity’s Sr Manager Provider Audit. The Sr Data Scientist is responsible for delivering innovative, data-driven solutions through the analysis of complex, high-dimensional datasets. This role leverages exploratory data analysis, advanced statistical techniques, and AI-powered technologies to uncover patterns, identify opportunities, and generate actionable business insights. The Sr Data Scientist translates complex data into strategic recommendations, formulates critical business questions, and develops advanced analytical and AI-driven products that address key business challenges and drive measurable value.

• Design, develop and orchestrate experiments, models, algorithms, and visualizations.
• Lead multiple and concurrent projects and manage project phases or smaller projects in their entirety. Communicate results and insights in a clear and concise manner to a non-technical audience.
• Identify, define, and translate business needs/problems into analytical questions.
• Apply advanced machine learning, natural language processing, statistical and computational methodologies to provide actionable insights and identify strategic opportunities that optimize quality, consumer experience, and healthcare costs.
• Lead and develop scalable, efficient, and automated processes for large scale data analyses and model development, validation, and implementation.
• Provide supervision and mentorship to junior team members and create/adhere to governance and ethical norms.
• Other duties and projects as assigned.

• Relevant certifications are a plus.

• Master’s degree in data science, Applied Mathematics, Computer science, Statistics, Epidemiology, or equivalent combination of experience and education.

• 8 - 10 years of work experience in a Data Scientist or similar role, or equivalent combination of transferrable experience and education.
• 8 - 10 years’ experience with advanced machine learning, statistics, and statistical packages (SAS, SQL) as well as Excel/PowerPoint skills (including visual graphics and analytics).
• Experience in information management best practices, including information lifecycle management, data modeling, and carrying out business audits and requirements gathering.

• Advanced knowledge and mastery in Python or other programming languages along with competence in using advanced statistical analysis, computational methodologies, and techniques.
• Mastery in developing supervised and unsupervised machine learning algorithms and data structures.
• Advanced knowledge in model evaluation, tuning, performance, operationalization, scalability of scientific techniques, and establishing decision strategies.
• Experience with cloud platforms like Azure, AWS, or Google Cloud.
• Proficiency in data analysis, cleaning, and preparation along with full understanding of data sources and limitations, warehousing system, and the impact of the data on business decisions.
• Knowledge of the agile development framework.
• Excellent written, visual, and oral communication skills.
• Lead projects and manage project phases along…