Data Scientist - Healthcare Fraud Waste and Abuse - REMOTE - 256553

Medix is currently seeking a Data Science Analyst for an exciting contract to hire job opportunity with one of our Healthcare Analytics Services clients. This role focuses on developing and optimizing predictive models for analyzing financial data related to Healthcare Claims Fraud, Waste, and Abuse, with an emphasis on identifying anomalies and achieving measurable cost savings.

Responsibilities:

• Building and deploying predictive models to assess anomalies and patterns for fraud, waste, and abuse in Healthcare Claims / Financial Data
• Developing and owning complex data products that can help automatically identify and prevent FWA
• Building data pipelines (structured, text, documents, images) optimized for LLMs and multi-modal models
• Designing, developing and deploying LLM-based solutions (RAG, embeddings, instruction tuning) for claims handling, document understanding, and related use cases
• Conducting deep-dive analyses, heavy SQL coding, and predictive modeling to identify patterns in the data
• Working with Agentic AI tools to develop, implement, and maintain advanced operational workflows to integrate vendor solutions with client environments
• Serving as a liaison and communicator to leadership (department heads). This will include meeting regularly with business leaders to help solution how to embed automatic data processes into every day revenue cycle workflows
• Visualizing data via dashboards and present complex findings to non-technical stakeholders and/or legal teams

Requirements:

• Required Bachelor of Science Degree
• Must have at least 2 years of Healthcare Domain experience - specifically within Revenue and Finance, Fraud, Waste, Abuse
• Strong background in applied statistics, regression analysis, and clustering techniques
• Advanced hands-on experience with Python and Python-based libraries (PySpark, Numpy, SciPy)
• Advanced hands-on experience with SQL