Data Scientist

Location: California

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve.

In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Alignment Healthcare is a data and technology driven healthcare company focused partnering with health systems, health plans and provider groups to provide care delivery that is preventive, convenient, coordinated, and that results in improved clinical outcomes for seniors.
We are seeking a mission-driven Data Scientist to join our growing team and support risk adjustment strategy within our Medicare Advantage line of business. This role focuses on enhancing risk score accuracy, CMS audit preparedness (RADV), and building AI-powered tools that improve clinical documentation review and integrity.
You’ll play a key role in advancing AVA, our proprietary clinical intelligence platform, by developing next-generation models that support autonomous chart review and NLP/GenAI-driven documentation analytics. This is a unique opportunity to work at the intersection of healthcare, compliance, and machine learning—transforming how we ensure both quality and regulatory alignment.
** Job Duties/Responsibilities:
** Collaborate with key business leaders to understand their business problems and come up with analytical solutions. Applying coding skills and knowledge data structures to develop projects in partnership with other scientists and engineers in the team Build customer segmentation models to better understand our customers and tailor the clinical outcome and healthcare care experience for them. Build and fine-tune models for both LLMs and OCR-based document understanding, enabling accurate extraction from scanned or low-quality medical charts.

Develop scalable model pipelines that integrate NLP, computer vision, and unstructured data, leveraging cloud-based infrastructure (Azure) and containerized environments. Collaborate with engineering teams to version, test, and deploy models using Git, CI/CD pipelines, and virtual machine (VM) environments. Design algorithms to predict audit risk and detect documentation anomalies across cohorts and markets. Partner with Coding, Compliance, CDI, Clinical, and Legal teams to ensure data outputs are aligned with CMS guidance.

Help standardize definitions, documentation logic, and reporting workflows to scale enterprise-wide AI-readiness. Help analytical support for CMS Star Ratings strategy, including:
* Audit sampling methodology validation
* Chart review error pattern identification
* Root cause analysis on deletion rates and extrapolation exposure
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* Supervisory Responsibilities:

** N/A
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* MINIMUM REQUIREMENTS:

** To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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* Minimum Experience:

*** 2+ years of relevant experience in predictive modeling and analysis
** Education/Licensure:
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* Required:

PhD in Computer Science, Engineering, Mathematics, Statistics, or related field, or equivalent experience
** Other:
*** Excellent communication, analytical and collaborative problem-solving skills
* Experience in building end to end data science solutions and applying machine learning methods to real world problems with measurable outcomes.
* Deep understanding and experience with various machine learning algorithms, including deep neural networks, natural language processing and LLMs.
* Solid data structures & algorithms background.
* Strong programming skills in one of the following:
Python, Java, R, Scala or C++
* Demonstrated proficiency in SQL and relational databases.
* Experience with data visualization and presentation, turning complex analysis into insight.
* Experience in setting experimental analytics frameworks or strategies for complex scenarios.
* Understanding of relevant statistical measures such as confidence intervals, significance of error measurements, development, and evaluation data sets, etc.
* Experience with manipulating and analyzing complex, high-volume, high-dimensionality and unstructured data from varying sources
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* Preferred Qualifications:

*** Healthcare experience
* Experience in Big Data processing technologies:
Databricks
* Experience in Azure, AWS or other cloud ecosystems.
* Experience in No

SQL databases.
* Published work in academic conferences or industry circles.
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