Data Scientist, Pharmacy (Part D Stars)

Alignment Health; United States; Remote; USD 150,000 - 225,000; Full time

Job summary

Alignment Health is seeking a Data Scientist on the Pharmacy team to advance the analytics engine behind Medicare Star measures. You’ll translate business problems into predictive models, build dashboards, and deliver production-ready tools that help shape strategy.

You will collaborate with data and engineering teams, explore new data sources, and apply time-series methods to forecast Star trajectories under CMS rules. The role emphasizes clear communication and measurable outcomes.

Qualifications

• 2+ years of predictive modeling and data analysis.
• Strong programming skills in Python, Java, R, Scala or C++.
• Experience with time-series analysis or forecasting.
• Proficient in SQL and data visualization.
• Ability to turn analyses into actionable insights.

Responsibilities

• Collaborate with Pharmacy leadership on problem framing and actionable takeaways.
• Design dashboards and production-ready tools.
• Model projections for Star rating scenarios.
• Lead end-to-end analytics projects from definition to deployment.
• Collaborate with data/engineering for versioning and deployment.

Skills

Predictive modeling

Data analysis

SQL

Python

R

Statistics

Communication

Education

Bachelor/Master in CS/Engineering/Math

Tools

Git

CI/CD

Spark

Job description

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.

As a Data Scientist on the Pharmacy team, you’ll play a key role in evolving the analytical engine behind our pharmacy data and Part D Star measures within our Medicare Advantage line of business. This role focuses on applied data science to enhance the analytics, trending, and predictive modeling that inform pharmacy and Part D Star strategy. You’ll help make tools more transparent, precise, adaptable, and actionable — incorporate new methods, partnerships, and technologies along the way.

Job Duties/Responsibilities:

• Partner with Pharmacy leadership to understand business problems, propose analytical solutions, and turn findings into clear, actionable takeaways for stakeholders.
• Convert analytical models and business rules into scalable, production-ready tools.
• Design dashboards and reporting that track Stars measure trajectories and intervention impact.
• Build cut-point projection and simulation models to forecast Star Rating outcomes under varying performance and CMS methodology scenarios.
• Build out prioritization rules, measure improvement models, and next-best-action (NBA) logic.
• Analyze the financial impact of pharmacy and Star performance to help leadership prioritize investment and interventions.
• Manage projects end to end – from problem definition through analysis, model building, validation, deployment support, and ongoing monitoring.
• Collaborate with data and engineering teams to version, test, and deploy models using Git, CI/CD pipelines, and virtual machine (VM) environments.
• Help standardize definitions, documentation logic, and reporting workflows to scale enterprise-wide AI-readiness.
• Bring in new data sources, techniques, and emerging tools to continuously improve analytical capabilities.
• Other duties as assigned by your manager.

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:

• 2+ years of relevant experience in predictive modeling and data analysis

Education/Licensure:

• Bachelor or Master’s in Computer Science, Engineering, Mathematics, Statistics, or related field (PhD a plus), or equivalent related experience.

Other:

• Excellent communication, analytical and collaborative problem-solving skills.
• Experience in building data science solutions and applying machine learning methods to real world problems with measurable outcomes.
• Familiarity with time-series analysis or forecasting methods.
• 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:

• Prior healthcare experience, ideally supporting Stars or Part D analytics.
• Experience in Big Data processing technologies: Hadoop, Spark, Cosmos.
• Experience in Azure, AWS or other cloud ecosystems.
• Strong understanding of CMS Stars rating measures and methodology.
• Published work in academic conferences or industry circles.
• Demonstrated track record in navigating ambiguity, shifting priorities, and delivering results in an agile environment.

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.

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.

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.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affi-cative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [e-mail].

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.