Data Scientist

Alignment Healthcare USA, LLC in; Orange (CA); On-site; USD 150,000 - 225,000; Full time

Job summary

Alignment Health is seeking a Data Scientist (Finance) to advance CAHPS and HOS modelling and support Stars strategy within Medicare Advantage. You will build predictive models, quantify member behaviors, and present insights to stakeholders to drive strategic decisions.

Collaborate with engineering, Compliance, and clinical teams to deploy scalable pipelines, ensure CMS alignment, and contribute to enterprise-wide AI-readiness.

Qualifications

• PhD in a relevant field with strong quantitative skills.
• 2+ years of predictive modeling and analytics experience.
• Experience with CAHPS and HOS modelling.
• Proficiency in SQL and data visualization.

Responsibilities

• Collaborate with business leaders to understand problems and design analytical solutions.
• Develop scalable pipelines and deploy models with version control.
• Build customer segmentation models to tailor healthcare experiences.
• Communicate insights to strategic stakeholders.

Skills

Python

Java

R

Scala

C++

SQL

Deep Learning

NLP

LLMs

CAHPS modelling

Education

PhD in Computer Science/Engineering/Mathematics/Statistics or related field

Tools

Hadoop

Spark

Cosmos

Azure

AWS

NoSQL

Job description

Data Scientist (Finance)

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.

We are seeking a mission-driven Data Scientist (CAHPS and HOS) to join our growing team and support Star rating strategy decisions within our Medicare Advantage line of business. This role focuses on enhancing the analytics and predictive modeling that inform the CAHPS and HOS elements of Stars strategy. You'll play a key role in modeling the behaviors of our member base from multiple angles and communicating the insights of those models to strategic stakeholders. 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.

GENERAL 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 predicting member behaviors at the individual level.
• Develop scalable, automated pipelines for model outputs.
• Collaborate with engineering teams to version, test, and deploy models using Git, CI/CD pipelines, and virtual machine (VM) environments.
• 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.
• Support the analytics backbone of the Stars team with data cleaning, aggregation, and dashboarding.

Supervisory responsibilities:

N/A

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.

Minimum Experience:

Education/Licensure:

• Required: PhD in Computer Science, Engineering, Mathematics, Statistics, or related field

Required:

• 2+ years of relevant experience in predictive modeling and analysis
• Excellent communication, analytical, and collaborative problem-solving skills;
• Must have experience with CAHPS and HOS modelling.
• 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

Preferred Qualifications:

• Healthcare experience
• Experience in Big Data processing technologies: Hadoop, Spark, Cosmos
• Experience in Azure, AWS, or other cloud ecosystems.
• Experience in NoSQL databases.
• Published work in academic conferences or industry circles.
• Demonstrable track record of handling ambiguity, prioritizing needs, and delivering results in an agile, dynamic startup environment.
• Knowledge of CMS Stars rating procedures.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay Range: $149,882.00 - $224,823.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.