Senior Data Scientist

BCBSRI; Providence (RI); Remote; USD 98,000 - 164,000; Full time

Job summary

Join a leading healthcare company dedicated to improving lives and outcomes. This role involves designing complex studies and analyses to derive actionable insights from vast data sets, directly contributing to the improvement of healthcare services in Rhode Island. If you have a passion for data-driven solutions in healthcare, this is your chance to make a significant impact.

Qualifications

• 5+ years experience in advanced analytics in health insurance.
• Proficient in R, Python, SQL.
• Deep understanding of healthcare data and statistical methodologies.

Responsibilities

• Design and implement quasi-experimental studies to evaluate programs.
• Perform complex analysis to translate business problems into data science questions.
• Develop strategies to forecast claims utilization using machine learning methodologies.

Skills

Statistical modeling

Data manipulation

Predictive modeling

Problem-solving

Data visualization

Presentation

Education

Bachelor’s degree in computer science, Data Science, Mathematics, Statistics

Tools

R

Python

SAS

SQL

Power BI

Job description

Please email [e-mail] if you are a candidate seeking a reasonable accommodation for the application and/or interview process.

Schedule: Remote

Compensation: $98,100 - $163,400

Jump into the new world of health insurance:

At Blue Cross & Blue Shield of Rhode Island (BCBSRI), our business is healthcare. But our focus is on improving lives. Be part of a team that’s large enough to make a difference but small enough to be innovative. Work in a rapidly changing field. Take a chance to be creative. Move outside the status quo. Shape new ideas with the power of a national brand behind you.

Join others who value a workplace for all: We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.

Why this job matters:

Research, manipulate, and interpret complex data and analyze results using machine learning, advanced statistics, trend analysis, and other artificial intelligence techniques to draw business inferences and clearly articulate findings with the target audience. Design and implement data collection systems and other methods ensuring data integrity and statistical accuracy. Collect and analyze data from multiple internal and external sources. Extract and identify relevant information from databases and systems. Mine and interpret results providing consultative feedback to various areas in order to improve service delivery and enhance program design efforts.

What you’ll do:

• Design and implement quasi-experimental studies (e.g., Difference-in-Differences, Interrupted Time Series, Regression Discontinuity) to evaluate the impact of programs on cost, utilization, and quality outcomes.
• Perform complex analysis to solve multiple business problems; translate business problems into data science questions and develop solutions.
• Segment member populations using healthcare claims and enrollment data to identify high-risk, high-opportunity cohorts.
• Develop strategies to forecast claims utilization using time series and machine learning methodologies at the type of service and individual member level.
• Synthesize complex findings into simplified views that can be presented at the executive level.
• Utilize advanced statistical techniques and mathematical analyses to research, manipulate, and interpret complex data and analyze results using predictive modeling, advanced statistics, trend analysis, and other techniques to develop reports and deploy solutions.
• Develop complex algorithms and statistical predictive models and determine analytical approaches and modeling techniques to evaluate scenarios and potential future outcomes.
• Design and implement data collection systems and other methods ensuring data integrity and statistical accuracy.
• Provide expert analytical support to the organization by developing and promoting consistent analytical methodologies.
• Design and model data extractions and provide comprehensive assessments of trends and data.
• Manage large and complex analytical projects from data exploration, model building, performance evaluation and testing.
• Participate in department initiatives and projects.
• Perform other duties as assigned.

What you need to succeed:

• Bachelor’s degree in computer science, Data Science, Mathematics, Statistics, Economics or related field; or an equivalent combination of education and experience
• 5+ years of experience performing advanced analytics in health insurance, managed care, or healthcare consulting.Experience using R, Python, or SAS

• Proficiency in languages and tools such as: SQL, R and open source R packages (tidyverse, ggplot2, tidymodels, etc.), Python (pandas, scikit-learn, tensorflow, etc.), SAS Enterprise Guide, Power BI for data manipulation, modeling, and visualization
• Deep understanding of statistical modeling and data mining concepts, and a track record of solving problems with these methods
• Familiarity with experimental design approaches such as difference-in-difference, propensity score matching, regression, and survival analysis
• Deep understanding of healthcare data, including claims (medical, pharmacy), eligibility/enrollment, and risk adjustment
• Familiarity with ICD, CPT, HCPCS, NDC and claims adjudication processes
• Advanced analytical skills, with the ability to interpret and synthesize complex data sets
• Good business acumen and political savvy
• Knowledge of business process improvement techniques and strategies
• Excellent ability to visually and verbally communicate complex statistical approaches and findings to a wide audience
• Presentation skills
• Decision-making skills
• Good problem-solving skills
• Ability to interface with employees at all levels
• Ability to effectively navigate ambiguous situations with limited direction
• Excellent organizational skills and ability to successfully prioritize multiple tasks
• Ability to handle multiple priorities/projects

The extras:

• Master’s degree or Ph.D. in a quantitative field
• Knowledge of Medicare market and/or Medicare Advantage product Familiarity with a cloud environment (e.g. AWS, Google Cloud, Microsoft Azure).

Location:

BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:

• In-office: onsite 5 days per week
• Hybrid: onsite 2-4 days per week
• Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia

Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer.

The law requires an employer to post notices describing the Federal laws. Please visit https://www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.