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The Lead Data Scientist uses mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions. The Lead Data Scientist works on problems of diverse scope and complexity ranging from moderate to substantial.
The Lead Data Scientist develops, maintains, and collects structured and unstructured data sets for analysis and reporting. This individual will create reports, projections, models, and presentations to support business strategy and tactics. The Lead will advise executives to develop functional strategies (often segment specific) on matters of significance.
Additional expectations include:
Being a thought partner in shaping the strategy for innovative analytics solutions that provide actionable insights into policy adherence, enabling improved compliance, operational consistency, and decision-making
Researching, designing, and implementing a policy adherence metric rooted in FRAC and PA denials information using advanced data modeling techniques
Quick/responsive : first 90 days of billing;
Comprehensive for professional provider @types and facilities and s calable ;
Actionable : leading to network decisions;
Current: Created and refreshed on a meaningful cadence
Designing valuation model(s) to measure savings tied to removing outliers who are non-compliant with the policy adherence metric
Partnering with National BH/Contracting/Medicaid/ND&PPS teams to support use of this metric in operations including compliance with MHPAEA and other HUM policies;
Shaping the path to measuring ancillary / inpatient psychiatric provider @types and/or other opportunity areas in the future
Managing stakeholders/expectations while working across different teams including data source owners, compliance, policy/governance, business, PTC/National program partners
Influencing priorities, tradeoffs, roadmap decisions in driving the implementation of a scalable solution
Use your skills to make an impact
Required Qualifications
Master's Degree
Minimum 8 years of professional experience in data and analytics transforming data sets for actionable insights and reporting
Minimum 5 years of experience utilizing SQL
Minimum 4 years of project leadership experience
Experience in using mathematics, statistics, modeling/Machine Learning modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions
Successful demonstrated experience in working on problems of diverse scope and complexity ranging from moderate to substantial
Experience in developing, maintaining, and collecting structured and unstructured data sets for analysis and reporting
Experience in creating reports, projections, models, and presentations to support business
Ability to exercise independent judgment and decision making on complex issues regarding job duties and related tasks
Ability to works under minimal supervision, using independent judgment
Work-At-Home Requirements
At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Preferred Qualifications
Doctorate degree
Experience with claims datasets
Experience with Databricks
Additional Information
As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$156,500 - $215,300 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?Humana.com?and at?CenterWell.com.
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Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
