Data Scientist - HOS Analytics

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

Job summary

Alignment Healthcare USA, LLC in Orange, CA is seeking an on-site Data Scientist on the Stars team to build predictive analytics for Star Ratings and translate HOS signals into targeted interventions aligned with CMS guidance.

You will analyze item-level HOS responses, track cohorts across survey cycles, and collaborate with clinical and care management leaders to identify performance drivers and prioritize outreach based on predicted physical and mental health trajectories.

Qualifications

• Master’s degree or PhD in a related field.
• Experience with CMS HOS survey methodology and longitudinal cohort designs.
• Proficiency in programming languages and data science methods.
• Strong SQL and data visualization skills.

Responsibilities

• Collaborate with Stars, clinical, and care management leaders to translate HOS performance drivers into analytics solutions.
• Segment members by survey response likelihood and health trajectory to guide outreach.
• Build and fine-tune models predicting risk of HOS composite decline.
• Analyze item-level HOS data to identify drivers of measure performance.
• Create pipelines to track HOS cycles and validate CMS-based case-mix adjustments.
• Version/test/deploy models using Git, CI/CD, and VM environments.
• Coordinate with vendors and cross-functional teams to align with CMS guidance.
• Develop dashboards showing HOS performance against Star Rating cut points and trends.

Skills

Python

SQL

R

Java

Scala

C++

Data visualization

Communication

Education

Master’s degree in Computer Science, Engineering, Mathematics, Statistics, or related field

PhD highly desired

Tools

Git

CI/CD pipelines

VM environments

Job description

Use data science to improve Health Outcomes Survey (HOS) performance and member outcomes on Alignment Healthcare USA’s Stars team. This onsite role in Orange, CA focuses on building predictive analytics for Star Ratings, translating HOS signals into targeted interventions aligned with CMS Star Ratings methodology.

Build models that go beyond composite scores. You will analyze item-level HOS responses, track baseline and follow-up cohorts across survey cycles, and partner with clinical and care management leaders to identify performance drivers and prioritize outreach based on predicted physical and mental health trajectories.

Responsibilities

• Collaborate with Stars, clinical, and care management leaders to understand HOS performance drivers and translate them into analytical solutions.
• Segment members by likelihood to respond to the HOS survey and by predicted physical or mental health trajectory to support outreach and intervention prioritization.
• Build and fine-tune models predicting member-level risk of HOS composite decline, including Improving/Maintaining Physical Health, Improving/Maintaining Mental Health, Monitoring Physical Activity, and Reducing the Risk of Falling.
• Analyze item-level HOS survey data to identify which specific survey questions drive measure performance.
• Create pipelines to track HOS survey administration cycles, including baseline and follow-up cohorts, sampling, fielding, and response rates, and validate case-mix adjustment logic against CMS methodology.
• Model statistical significance and year-over-year variance to separate genuine performance shifts from survey noise or sampling error.
• Coordinate with HOS survey vendors on cohort tracking, sampling methodology, fielding timelines, and case-mix adjustment specifications.
• Work with engineering teams to version, test, and deploy models using Git, CI/CD pipelines, and virtual machine (VM) environments.
• Partner with clinical, care management, complex case management, Compliance, and Legal teams to ensure HOS-related outputs and interventions align with CMS guidance.
• Build dashboards tracking measure-level HOS performance against Star Rating cut points and prior-year trends for each composite.
• Help standardize definitions, documentation logic, and reporting workflows to scale HOS analytics enterprise-wide.

Requirements

• 2+ years of relevant experience in predictive modeling and analysis, with demonstrated application to longitudinal or outcomes-based member data.
• Master’s degree in Computer Science, Engineering, Mathematics, Statistics, or a related field; PhD highly desired.
• Demonstrated experience with CMS HOS survey methodology, including baseline/follow-up cohort design, case-mix adjustment, and item response theory or other psychometric methods.
• Working knowledge of individual HOS composite measures: Improving/Maintaining Physical Health, Improving/Maintaining Mental Health, Monitoring Physical Activity, and Reducing the Risk of Falling.
• Working knowledge of CMS Star Ratings procedures, including weighting of HOS measures, how cut points are determined, and how measures roll into overall Star Ratings.
• Excellent communication, analytical, and collaborative problem-solving skills.
• Experience building end-to-end data science solutions and applying machine learning methods to real-world problems with measurable outcomes.
• Solid data structures and algorithms background.
• Strong programming skills in one or more: Python, Java, R, Scala, or C++.
• Demonstrated proficiency in SQL and relational databases.
• Experience with data visualization and presentation for non-technical stakeholders.
• Experience setting experimental or analytical frameworks for complex, ambiguous scenarios, including longitudinal/cohort study design.
• Understanding of statistical measures such as confidence intervals, significance of error measurement, and development/evaluation data sets.
• Experience manipulating and analyzing complex, high-volume, high-dimensionality, and unstructured data from varying sources.

Preferred Qualifications

• Healthcare experience, particularly within Medicare Advantage.
• Experience with functional status, frailty, or geriatric outcomes modeling.
• Experience with cloud ecosystems such as Azure or AWS.
• Published work in academic conferences or industry circles related to survey methodology, psychometrics, or health outcomes measurement.
• Demonstrable track record of handling ambiguity, prioritizing needs, and delivering results in an agile, dynamic environment.

Technologies

• Python, Java, R, Scala, C++, SQL, Git
• CI/CD pipelines, virtual machine (VM) environments
• Data visualization

Pay Range

USD 149,882 - 224,823 per year. Pay range may depend on factors including market location, education, responsibilities, and experience.

Essential Physical Functions

• Regularly required to talk or hear.
• Regularly required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
• Frequently lifts and/or moves up to 10 pounds.
• Specific vision abilities required include close vision and the ability to adjust focus.