Managed Care Contracts Data Scientist

EWINGS INC.; United States; Remote; USD 100,000 - 125,000; Full time

Job summary

An established industry player is searching for a Managed Care Contracts Data Scientist to enhance contract modeling and performance analysis. In this role, you will leverage your analytical skills to ensure data integrity and support the implementation of a contract modeling system. Collaborating with key stakeholders, you'll produce actionable insights that drive improvements in data quality. This is a fantastic opportunity to work remotely, contributing to impactful healthcare solutions while developing your expertise in a dynamic environment.

Qualifications

• Experience in managed care contracting and payer reimbursement models.
• Strong proficiency in SQL and Python for data analysis.

Responsibilities

• Support PMMC system implementation and maintenance efforts.
• Design dashboards to monitor contract compliance and performance indicators.

Skills

Analytical Skills

Data Mining Techniques

Data Wrangling

Data Cleaning

SQL

Python

Data Visualization Tools

Healthcare Economics

Communication Skills

Collaboration

Tools

Tableau

Power BI

Job description

EWINGS is seeking a Managed Care Contracts Data Scientist to support a health plan's Managed Care contract modeling, pricing, and performance efforts by leveraging a contract modeling system -- the PMMC platform. This role is responsible for analyzing contract data from various sources, ensuring data integrity, and supporting the implementation and maintenance of the system. The scientist collaborates closely with managed care and key stakeholders to produce actionable insights and improve data quality.

Project Highlights

• Location: Remote (Preference for candidates in the Central or Eastern Time Zones)
• Contract Type: 1099
• Hours: Full-Time Consulting
• Start Date: ASAP
• Duration: 12+ months

Key responsibilities

• Support PMMC system implementation, testing, configuration, and ongoing maintenance efforts in partnership with IT, vendors, and operational stakeholders.
• Design and generate dashboards and reports to monitor contract compliance, payment accuracy, and key performance indicators.
• Support PMMC contract implementations for accurate contract upload, reporting, operational alignment, and integration of systems.
• Support managing business needs, translate them into system requirements, and ensure alignment
• Support development of applications and analytics frameworks that improve speed, and accuracy
• Provide strategic guidance on healthcare data solutions PMMC, R1 Insights, and other platforms
• Support upgrades testing, implementation and maintenance

Experience/Skills

• Strong analytical skills, including the ability to collect, analyze, and interpret data from various sources.
• Experience with data mining techniques, data wrangling, and data cleaning. Advanced proficiency in SQL and Python.
• Experience with data visualization tools such as Tableau, Power BI, or similar platforms.
• Experience in managed care contracting, payer reimbursement models, and healthcare economics.
• Experience working with healthcare datasets such as claims, fee schedules, cost reports, chargemaster, and utilization data.
• Skilled in both written and spoken communication are essential for conveying findings to both technical and non-technical audiences.
• Excellent communication skills, with a focus on proactive, responsive, and clear user interaction.
• Proven ability to collaborate effectively across teams, identifying and supporting process improvements with minimal direction.
• Self-motivated and driven to advance project milestones independently.

Hiring Process

The hiring process will consist of:

• 1-2 interviews with EWINGS.
• 1-2 interviews with the client team.

About EWINGS

EWINGS is a leader in helping clients build large-scale healthcare provider networks. Since 2002, we have developed provider networks for clients in over 3,000 cities across all 50 states.

A network assignment with EWINGS provides you the opportunity to gain valuable experience developing networks in multiple states for a variety of products with organizations of various sizes.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Temporary

Job function

• Job function

  Human Resources

• Industries

  Insurance

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