Overview
Skills
Job Details
Role Type: Data Science Consultant AI/ML
Duration : 6 months
Telecommute : Yes
Description:
Utilizes creative thinking and understanding of Claim Operations to uncover the "art of the possible when applying Artificial Intelligence/Machine Learning solutions to Claim Operations business problems
Participates in translation of product vision into operational design
Serve as a thought leader for the Claim Operations domain. Provide expert advisory services for Claim Product strategy, metrics, product development, and analytics vision to
senior leadership
Extend influence to Consumer Operations and Provider Operations data analytics teams through insight delivery, data product development and Artificial Intelligence development
Work with vast amounts of data from multiple sources to deliver high-impact actionable insights to senior leadership and business operations; enable data-driven decision-making across the enterprise to improve the efficiency and effectiveness of Health Care Company Operations and Experience.
Serve as a subject matter expert in Artificial Intelligence dealing specifically with medical claim data and additional related data sources utilized and created by Claim Operations. Provide guidance and mentorship to team members
Perform exploratory data analysis from structured, unstructured, and diverse datasets; apply knowledge of statistics, machine learning, programming, data modeling, simulation, and advanced mathematics to recognize patterns, identify opportunities, pose business questions, and make valuable discoveries leading to prototype development and product improvement
Partners with Data Scientists, Data Analysts and Data Engineers to develop capabilities and bring capabilities into production
Influence without authority by building relationships and driving awareness and knowledge of Core Operations data and capabilities across the Enterprise
Work across three lines of business Employee & Individual, Medicare & Retirement and Community & State Stays up to date on advancements and trends in Artificial Intelligence
Make presentations to Sr. executives and decision-makers
Work across three lines of business Employee & Individual, Medicare & Retirement and Community & State
Stays up to date on advancements and trends in Artificial Intelligence
Required skills:
Bachelor's degree in Data Science, Computer Science, Statistics, Applied Mathematics, or a related quantitative field.
Sound business focus; must excel at connecting business requirements to analytic objectives and to measurable business value
5+ years experience analyzing Medical claim data, as well as standard processes that generate data through the health care claim adjudication process.
2+ years experience working in cloud environments such as Azure, AWS, or Google Cloud Platform
2+ years Experience applying artificial intelligence, machine learning algorithms, simulation techniques, and advanced mathematics to solve complex business problems.
Ability to work with structured, semi-structured,and unstructured data from diverse sources.
Experience identifying efficiency opportunities, process improvements, and cost-saving strategies through data-driven analysis.
Understanding of healthcare operations, especially within claims, member services, or provider networks.
Strong interpersonal skills to collaborate across technical and non-technical teams.
Proven ability to present complex findings in a clear, concise, and compelling manner to stakeholders at all levels.
Preferred Qualification:
Master's Degree or higher in a highly quantitative field or MBA with an AI and data focus
Experienced with Python and/or R
Extensive experience with SQL
Experienced in data visualization tools such as Tableau; PowerBI