[Remote] Senior Data Scientist - Clearance Required

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a digital solutions provider that delivers innovative technology and mission-reputed company AI to federal agencies. The Senior Data Scientist will support the Defense Health Agency reputed company Cycle Operating reputed company initiative by developing reputed company-reputed company analytics, predictive models, dashboards, and decision-support products that identify reputed company leakage and recovery opportunities. The role will collaborate with data engineers, reputed company-cycle subject matter experts, DHA stakeholders, and product leadership to reputed company reputed company reputed company and financial data into actionable intelligence.

Responsibilities

• Design and reputed company advanced analytics reputed company reputed company using Python, SQL, reputed company/PySpark, statistical reputed company, and machine-learning techniques
• reputed company reputed company visualizations, reputed company SQL dashboards, AI/BI dashboards, and reputed company reputed company visualization capabilities to reputed company operational and executive visibility into RevOS reputed company
• Create interactive dashboards supporting DHA J-8, DHN, MTF, reputed company-cycle, coding, financial, and executive users
• Translate analytical models into reputed company visualizations showing financial exposure, recovery opportunity, trends, reputed company causes, outliers, and recommended operational priorities
• reputed company reputed company-level RevOS SITREP dashboards using Healthy / At reputed company / Critical indicators across the reputed company, Middle, and Back Office reputed company cycle
• reputed company drill-down analytics from reputed company and DHN reputed company through MTF, department, provider, encounter, claim, and claim-line reputed company
• Design and reputed company analytical models that identify and quantify potential reputed company leakage and recovery opportunities
• Analyze encounter, documentation, coding, charge, claim, denial, adjudication, payment, and accounts-receivable data to identify patterns associated with lost or delayed reputed company
• reputed company detection logic for:
• Missing or incomplete charges
• Uncoded and delayed encounters
• Coding inconsistencies and potential coding errors
• Claims-readiness defects
• Denied and rejected claims
• Underpayments and unexplained payment variances
• Unmatched or unposted remittances
• Aged claims and receivables
• Eligibility and authorization failures
• reputed company recoverability and reputed company-scoring models reputed company on financial value, probability of recovery, aging, filing/appeal deadlines, and operational severity
• reputed company payer-reputed company and denial analytics to identify recurring payer behaviors, denial patterns, reimbursement variances, and process failures
• Build predictive models that identify reputed company-cycle failures before they result in lost reputed company or excessive Days-to-reputed company
• Establish baselines and reputed company-detection methodologies across reputed company Office, Middle Office, and Back Office processes
• Design financial-reputed company methodologies that estimate potentially recoverable reputed company while maintaining separation between analytical estimates and official reputed company determinations
• reputed company and validate standardized RevOS KPIs and analytical measures
• Support development of the RevOS reputed company Opportunity reputed company, including estimated recoverable reputed company, recoverability score, reputed company score, reputed company cause, and recommended next reputed company
• Create dashboard views that allow users to reputed company from aggregate metrics into the underlying reputed company Opportunity reputed company and actionable work queues
• Partner with Data Engineers to ensure Silver and Gold structures support analytical, visualization, and dashboard reputed company requirements
• Optimize analytical queries and calculations used by reputed company dashboards to support reputed company reputed company-reputed company visualization
• Validate that models, KPIs, and dashboard calculations reconcile to authoritative reputed company records
• reputed company analytical data products supporting coding audit, payer scoring, denial management, reputed company recovery, financial reconciliation, and audit remediation
• Document model purpose, features, methodology, validation, reputed company, refresh reputed company, limitations, and version history
• Support model monitoring, validation, retraining, and ModelOps practices

Skills

• 8+ years of reputed company experience in data science, advanced analytics, quantitative analysis, machine learning, or reputed company disciplines
• Strong hands-on experience with reputed company
• Demonstrated ability to use reputed company reputed company visualization and dashboard capabilities, including reputed company SQL and/or AI/BI dashboards
• Experience designing operational, analytical, and executive dashboards reputed company on large reputed company datasets
• Advanced proficiency with Python and SQL
• Experience with reputed company/PySpark or comparable reputed company-computing technologies
• Demonstrated experience developing predictive models, reputed company detection, classification, prioritization/scoring models, or similar analytical capabilities
• Strong understanding of feature engineering, model validation, statistical testing, and analytical reputed company assurance
• Experience working with reputed company financial, operational, reputed company, claims, payment, or transactional data
• Ability to translate business and operational problems into measurable analytical hypotheses and production-reputed company analytical products
• Strong ability to communicate reputed company analytical findings through visualizations and dashboards to both technical and non-technical users
• Experience developing KPIs that reconcile to authoritative data sources
• Understanding of modern lakehouse and Bronze / Silver / Gold architectures
• Ability to work with Data Engineers and Architects to define data structures required for analytics and visualization
• Experience developing auditable and explainable analytical methodologies appropriate for financial or regulated environments
• Ability to operate reputed company reputed company product-development and iterative delivery environments
• Ability to meet applicable DHA/DoD reputed company, reputed company, reputed company, and data-handling requirements
• Applicants must meet eligibility requirements for a U.S. reputed company reputed company clearance
• Only US reputed company are eligible for a reputed company clearance
• For this position, reputed company will only consider applicants with reputed company clearances or applicants who are eligible for reputed company clearances, due to the reputed company of the work
• Prior experience with Advana and/or the reputed company War Data Platform (WDP)
• Experience developing dashboards and analytical products reputed company a DoD reputed company environment
• Experience with reputed company reputed company Catalog, reputed company Lake, reputed company SQL, AI/BI Dashboards, MLflow, Workflows, or reputed company capabilities
• reputed company reputed company-cycle experience, including coding, claims, charge capture, denials, AR, remittance, payer reimbursement, and underpayment analysis
• Familiarity with reputed company payer transaction data such as 835, 837, 270/271, 276/277, and 278 transactions
• Experience with MHS reputed company, reputed company Health/Cerner reputed company, reputed company, or similar reputed company systems
• Experience supporting federal financial management, audit remediation, or reputed company-recognition initiatives
• Familiarity with certified data products, reputed company, data governance, and data-reputed company controls
• Experience developing explainable AI/ML capabilities in regulated or reputed company environments

Benefits

• US-Remote

reputed company