Data Scientist - REMOTE

The Data Scientist develops algorithms and codes packages using a variety of data mining/data analysis methods and data tools, builds and implements models, and creates simulations. Responsibilities include:  interpreting data, analyzing results using statistical techniques, and providing ongoing reports. Works collaboratively throughout the organization to identify opportunities to leverage Medicare and Medicaid data for the identification of potential fraud, waste, and abuse. This position will also serve as a data lead, and in addition to carrying out data analysis workload, the Data Scientist is expected to assist the management team with ad hoc tasks as well as mentor other data analysts.  

In assuming this position, you will be a critical contributor to meeting CoventBridge Group's objective:  To provide services to our clients that exceed their expectations and contribute to improved healthcare delivery by identifying and eliminating fraud, waste and abuse. 

The Data Scientist will report to the Data Manager and will work in our Grove City, OH office, or if not local, remotely from a home office.

 Responsibilities:

• Lead the development of data mining, advanced analytical, predictive, and/or statistical models by determining data and analytical requirements; translating models; creating complex and custom data models and algorithms leading to actionable insights; and testing, refining, and validating models
• Apply modeling techniques for identification of potential fraud, waste, and abuse. Develop insights, reports, visualizations, and presentations telling a compelling story from large data sets
• Develop processes and tools to monitor and analyze model performance and data accuracy
• Design, implement and automate business and reporting solutions; evaluate and summarize data and results; create summary statistics; design data reports, visualizations, and/or interactive Business Intelligence reports
• Provide subject matter expertise and technical assistance regarding Medicare and/or Medicaid claims data
• Support the data analysis teams in the development of ad hoc data analysis techniques to support various data analysis projects
• Communicate effectively with internal and external customers
• Ensure compliance with PIM guidelines and CMS direction concerning data analysis and data management
• Prepare and submit required reports according to established timeframes
• Identify opportunities for improvement/advocating quality improvement
• Comply with and maintain various documentation and other reporting requirements as needed
• Perform other duties as assigned

Requirements:

• Demonstrated experience and knowledge of health care information (e.g., health claims data specifically Medicare, Medicaid, and health care coding) is required
• Knowledge of Medicare and/or Medicaid claims processing and reimbursement
• Proficiency with data science programming languages such as Python, R, SAS, and/or SQL and the ability to write clear, reproducible code
• Knowledge of a variety of machine learning techniques (clustering, decision trees, neural networks, etc.)
• Knowledge of advanced statistical and data mining techniques and concepts including regression, social network analysis, properties of distributions, statistical tests and proper usage and experience with applications
• Strong critical thinking and problem-solving skills
• Exceptional verbal and written communication skills
• Ability to manage multiple and conflicting priorities
• Must be proficient in Microsoft Word, Excel, and PowerPoint

Educational/Experience Qualifications:

• Bachelor’s Degree in Data Science, Statistics, Math, Computer Science, or related quantitative field. Preference given to those with postgraduate work in a quantitative field
• At least 5 years of relevant work experience performing data analysis and data modeling using SQL, R, Python, or SAS
• At least 3 years of experience creating and using statistical and data mining techniques and machine learning algorithms
• At least 3 years of experience with Medicare, Medicaid, and/or healthcare claims data analysis
• Experience working with cloud environments such as Amazon WorkSpaces and Databricks

• Medical, Dental, Vision plans
• Life, LTD and STD paid by the employer
• 401(k) with company match up to 4%
• Paid Time Off and company paid holidays
• Tuition assistance after 1 year of service

The salary range for this role is $110,000 to $130,000 annually.  This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future.  An employee’s pay position within the salary range will be based on several factors including, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, performance, and business or organizational needs.  

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

About Us:

CoventBridge Group is the global leader in full-service investigations providing Surveillance, SIU and Compliance, Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social Media, Record Retrieval, Canvasses and Vendor Management programs.  The company provides top tier data privacy and security practices, deploys robust case management technology customized to clients’ needs and delivers worldwide coverage via its 1000 employees and affiliates worldwide.

CoventBridge is an equal opportunity employer.  We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, caste, disability, veteran status, and other legally protected characteristics and maintains a drug-free workplace.

CoventBridge is committed to the full inclusion of all qualified individuals.  As part of this commitment, CoventBridge will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: Human Resources; 888-932-7364; humanresources@coventbridge.com.