Senior Data Scientist - Medicare Advantage Stars Analytics REMOTE or Hybrid

Emergent Holdings • Lansing, MI • 3h ago

The primary focus of this role is to develop and manage analytical tools that support improvements in Medicare Advantage Star Ratings. This includes CAHPS and HOS experience analytics, HEDIS dynamics, Pharmacy modeling, Operation metric movement to high reliability state all with a provider performance assessment and integration of CMS dynamic rule modifications. In addition, this position will be expected to understand the business goals (growth) and capital strength and make strategic recommendations to enhance business processes and reflect our strategic goals. RESPONSIBILITIES/TASKS: Responsibilities will be multi-disciplinary and will include: Provides technical and quantitative analysis for predictive modeling group. Develops & maintains robust Stars analytical models, ensuring accuracy & adapting to evolving data and regulatory shifts. Assists in statistical data mining and actuarial research by applying advanced statistical concepts. Conducts A/B testing & implements interventions, maximizing effectiveness for Star Ratings and member outcomes. Develops methodologies to measure Stars initiatives' impact, optimizing analytic tools for performance improvements Participates in and is responsible for projects requiring advanced statistical analyses, innovative research, mathematical calculations, and technical skills. Conducts research utilizing predictive modeling. Interprets data and identifies correlations using both univariate and multivariate analysis. Participates in and is responsible for advanced projects. Presents findings and recommendations to appropriate groups. Prepares and delivers summary reports to the relevant or affected areas within the company. Helps to determine what actionable steps can be taken based on the findings. Communicates and trains users on model results. Develops custom, explainable models that enhance business processes to reflect corporate goals, experience, and current market conditions using pattern recognition, evolutionary computation, and machine learning algorithms. Document model requirements. Examine and analyze data to determine optimal modeling approach. Identify candidate risk factors. Build models using training, test, and cross-validation data sets. Share model results. Finalize model. Delivers conclusions. Deploy and maintain models with or without the assistance of the IT department Oversees the creation, development and maintenance of our models. Further involvement in communication of predictive model results to other departments. Involvement in the implementation of predictive model results into the appropriate system. Works with, mentors and provides direction (as necessary) to Predictive Modeler I. Participates in development of annual budget, goals, objectives and systems. Further involvement in the implementation of predictive model results into the appropriate system. Additional communication to all affected departments. This includes the creation of appropriate documents (PowerPoint presentations, etc.) to be used in the communication of predictive model results to the company. Lead the deployment and maintenance of models with or without the assistance of the IT department. This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. EDUCATION: Bachelor's degree in insurance, math, economics, statistics, or computer science required. Advanced degree in statistics, actuarial science, or applied mathematics preferred. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged. EXPERIENCE: 4-6 years of research and modeling in Healthcare industry experience required. Medicare Advantage experience is preferred. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: Excellent interpersonal, organ

Similar Jobs

Lead Software Engineer

Lumen • Lansing, MI • 3h ago

IT & Engineering

About Lumen Lumen connects the world. We are igniting business growth by connecting people, data and applications - quickly, securely, and effortlessly. Together, we are building a culture and company from the people up...

3h ago

Go to Apply

Senior Analyst, Advanced Business Analytics

Ally • Lansing, MI • 3h ago

IT & Engineering

General information Ref # 20134 Remote? No Ally and Your Career * Ally Financial only succeeds when its people do - and that's more than some cliché people put on job postings. We live this stuff! We see our people as, w...

3h ago

Go to Apply

Director, Data Science

Confluent • Lansing, MI • 3h ago

IT & Engineering

Location: Remote, United States Employment Type: FullTime Location Type: Remote Department Finance & Operations, Business Technology, Data, & Operations Compensation: $292.5K - $351K At Confluent, we are committe...

3h ago

Go to Apply

Launch Electrical Wiring Coordinator

General Motors • Lansing, MI • 13h ago

IT & Engineering

Job Description GM DOES NOT PROVIDE IMMIGRATION-RELATED SPONSORSHIP FOR THIS ROLE. DO NOT APPLY FOR THIS ROLE IF YOU WILL NEED GM IMMIGRATION SPONSORSHIP NOW OR IN THE FUTURE. THIS INCLUDES DIRECT COMPANY SPONSORSHIP, EN...

13h ago

Go to Apply

Launch Electrical Process Coordinator

General Motors • Lansing, MI • 13h ago

IT & Engineering

13h ago

Go to Apply

Data Scientist

Meta • Lansing, MI • 2d ago

IT & Engineering

Summary: Meta Platforms, Inc. (Meta), formerly known as Facebook Inc., builds technologies that help people connect, find communities, and grow businesses. When Facebook launched in 2004, it changed the way people connec...

2d ago

Go to Apply

Data Scientist, Product

Meta • Lansing, MI • 2d ago

IT & Engineering

2d ago

Go to Apply

Senior Software Engineer, SmartRequest

Datavant • Lansing, MI • 2d ago

IT & Engineering

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is power...

2d ago

Go to Apply

Software Engineer

Meta • Lansing, MI • 3d ago

IT & Engineering

3d ago

Go to Apply

Senior Specialist, Engineering - External Manufacturing Vaccine Technical Operations

Merck • Lansing, MI • 3d ago

IT & Engineering

Job Description Position Description: The External Manufacturing Vaccine Drug Product Technical Operations (ExM Vaccine DP TO) organization is seeking a highly motivated individual for a Sr. Specialist Engineering positi...

3d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.