Lead Data Scientist - Provider Strategy amp Analytics

Profile

Description

The Provider Analytics organization's vision is to improve member healthcare through innovative analytics and actionable insights, which empower members, and providers to drive higher quality, lower cost of care, and improved health outcomes. Provider Analytics develops and applies actionable analytics and insights, which are integral to business needs, to drive informed provider network strategy.

Responsibilities

As a Lead Data Scientist, you will have the opportunity to assess provider risk opportunities, provider network design, provider reimbursement strategies, and medical cost savings that could positively impact the financial performance of Humana.

In this role, you will utilize multiple data sources, maintain stakeholder relationships and create advanced analytics to facilitate contracting initiatives and support our National hospital and ancillary contractors. Additionally this role will utilize technical skills to build, maintain and improve tools and processes.

Key responsibilities:

Quantify trend effect from known and suspected trend drivers

Find contract provisions likely to have contract load issues

Poorly worded outlier contracts

Short stay observations

Hospital mergers

Physician mergers

Non-linear, interrelated consequences of contractual changes

Support implementation of trend initiatives

Data work will migrate to Azure - collaboration with experts on Humana's tables

Special projects

Investigate contract gaming

Investigate contract driven utilization

Required Qualifications

Bachelor's Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field with 5 or more years of experience OR Master's Degree and 3 or more years of experience.

2 or more years project leadership experience

Advanced experience working with big and complex data sets within large organizations

Advanced skillset using SQL, SAS, Python, R, and/or other languages

Experience in using mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions

Successful demonstrated experience in working on problems of diverse scope and complexity ranging from moderate to substantial

Experience in developing, maintaining, and collecting structured and unstructured data sets for analysis and reporting

Experience in creating reports, projections, models, and presentations to support business

Ability to exercise independent judgment and decision making on complex issues regarding job duties and related tasks

Ability to works under minimal supervision, using independent judgment

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Advanced Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field

Experience with tools such as Power BI, Tableau, and/or Qlikview for creating data visualizations

Expertise in data mining, forecasting, simulation, and/or predictive modeling

Experience creating analytics solutions for various healthcare sectors

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com