SmartLight Analytics is focused on providing analytical solutions in the healthcare sector. They are seeking a Healthcare Statistical Data Scientist to support the development of analytical models aimed at identifying payment anomalies in healthcare claims data.
Responsibilities:
- Support the research and development of analytical models for new and ongoing product lines under the guidance of senior data scientists
- Apply ML techniques including gradient boosting, NLP, and probabilistic modeling, with guidance on approach selection and implementation
- Assist in developing and training machine-learning models for use cases such as claims cost prediction, fraud and abuse detection, and provider performance analysis
- Contribute to ongoing monitoring of product lines, including tracking success metrics to support executive decision-making
- Develop understanding of key organizational initiatives and contribute analytical work that supports actionable recommendations
- Analyze and interpret medical, pharmacy, and dental claims data (CPT/HCPCS, ICD-10, DRG, NDC) with growing independence
- Translate domain knowledge into features and model strategies with direction from senior team members
- Collaborate with clinicians, product managers, and business stakeholders to understand problem definitions and measurement approaches
- Communicate analytical findings clearly to team members and stakeholders, with support on complex or executive-facing deliverables
Requirements:
- 2+ years of experience in healthcare analytics or a related analytical role; equivalent academic project experience considered
- Foundational exposure to statistical, analytical, or data mining techniques and a demonstrated ability to apply them in a business context
- Proficiency in Python and SQL programming required
- Basic understanding of healthcare claims, adjudication, and claims content; willingness to deepen knowledge on the job
- Demonstrated ability to solve problems with moderate direction and escalate appropriately when needed
- Familiarity with healthcare data and common analytics terminology (ICD, CPT, REV, DRG, etc.) preferred