Healthcare Statistical Data Scientist

SmartLight Analytics is seeking a Healthcare Statistical Data Scientist to support the development of analytical models for identifying payment anomalies in healthcare claims data. The role requires a foundational knowledge of statistical models and machine learning, as well as collaboration with various stakeholders to analyze and interpret healthcare 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.)