Sr Data Scientist - Payment Integrity

P32HS Point32Health Services Inc; Canton (MA); Hybrid; USD 130,000 - 194,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Retirement plans

Paid time off

Life and disability insurance

Tuition program

Well-being benefits

Job summary

Point32Health is seeking a Sr Data Scientist to deliver innovative, data-driven solutions across high-dimensional datasets. You will apply advanced machine learning, natural language processing, and statistical methods to uncover patterns, generate actionable business insights, and guide strategic decisions.

The role involves designing experiments, leading projects, mentoring teammates, and translating complex analytics into practical recommendations that improve quality, patient experience, and

Qualifications

• Master’s degree in data science, applied mathematics, computer science, statistics, epidemiology, or equivalent.
• 8–10 years of experience as a Data Scientist or similar role with advanced ML and statistical packages.

Responsibilities

• Design, develop and orchestrate experiments, models, algorithms, and visualizations.
• Lead multiple projects and manage project phases end-to-end.
• Communicate results clearly to non-technical audiences.
• Apply ML, NLP, and statistical methods to uncover opportunities that optimize healthcare quality and costs.
• Lead scalable data analyses and model development with governance and ethics in mind.
• Mentor junior team members and contribute to governance and process improvements.

Skills

Python programming

Statistical modeling

Machine learning

Data visualization

Data cleansing

Communication

Team leadership

Education

Master’s degree in data science or related field

Tools

SAS

SQL

Excel/PowerPoint

Job description

Who We Are

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.

Job Summary

Position will report into Payment Integrity’s Sr Manager Provider Audit. The Sr Data Scientist is responsible for delivering innovative, data-driven solutions through the analysis of complex, high-dimensional datasets. This role leverages exploratory data analysis, advanced statistical techniques, and AI-powered technologies to uncover patterns, identify opportunities, and generate actionable business insights. The Sr Data Scientist translates complex data into strategic recommendations, formulates critical business questions, and develops advanced analytical and AI-driven products that address key business challenges and drive measurable value.

Job Description

• Design, develop and orchestrate experiments, models, algorithms, and visualizations.
• Lead multiple and concurrent projects and manage project phases or smaller projects in their entirety.
• Communicate results and insights in a clear and concise manner to a non-technical audience.
• Identify, define, and translate business needs/problems into analytical questions.
• Apply advanced machine learning, natural language processing, statistical and computational methodologies to provide actionable insights and identify strategic opportunities that optimize quality, consumer experience, and healthcare costs.
• Lead and develop scalable, efficient, and automated processes for large scale data analyses and model development, validation, and implementation.
• Provide supervision and mentorship to junior team members and create/adhere to governance and ethical norms.
• Other duties and projects as assigned.

Certification and Licensure

Relevant certifications are a plus.

Education

Master’s degree in data science, Applied Mathematics, Computer science, Statistics, Epidemiology, or equivalent combination of experience and education.

Experience

8 - 10 years of work experience in a Data Scientist or similar role, or equivalent combination of transferrable experience and education 8 - 10 years’ experience with advanced machine learning, statistics, and statistical packages (SAS, SQL) as well as Excel/PowerPoint skills (including visual graphics and analytics).

Skill Requirements

• Advanced knowledge and mastery in Python or other programming languages along with competence in using advanced statistical analysis, computational methodologies, and techniques.
• Mastery in developing supervised and unsupervised machine learning algorithms and data structures.
• Advanced knowledge in model evaluation, tuning, performance, operationalization, scalability of scientific techniques, and establishing decision strategies.
• Experience with cloud platforms like Azure, AWS, or Google Cloud.
• Proficiency in data analysis, cleaning, and preparation along with full understanding of data sources and limitations, warehousing system, and the impact of the data on business decisions.
• Knowledge of the agile development framework.
• Excellent written, visual, and oral communication skills.
• Lead projects and manage project phases along with ability to delegate and prioritize work independently and meet/exceed deadlines.
• Think strategically and broadly (end to end process), analyzing complex business problems.
• Act as a Lean thinker applying continuous improvement philosophies and approaches to identify and address inefficiencies in day-to-day work.
• Strong decision-making ability, teamwork, and collaborative skills.
• Proven track record of creating strong actionable insights that drive decision making and business process.

Working Conditions and Additional Requirements

Must be able to work under normal office conditions and work from home as required. Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations. May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Salary Range

Salary Range $129,565.60 -$194,348.40

Compensation & Total Rewards Overview

The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization. The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity. As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law. Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

• Medical, dental and vision coverage
• Retirement plans
• Paid time off
• Employer-paid life and disability insurance with additional buy-up coverage options
• Tuition program
• Well-being benefits
• Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

We welcome all

All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.