Quality Data Scientist

• Utilize reference data sources and advanced validation techniques to ensure accuracy, completeness, and integrity of healthcare claims data.
• Assess provider scoring methodologies, identify discrepancies, and develop insights to optimize coverage accuracy.
• Design, develop, and maintain retrospective models for historical performance analysis, and predictive models to identify high-risk patients and prioritize actionable interventions.
• Translate complex analytical findings into clear, actionable insights, and effectively communicate results and recommendations to internal stakeholders and external clients.
• Aggregate and reconcile multiple data sources, applying statistical and computational methods to verify data integrity, identify anomalies, and implement necessary corrections.
• Execute comprehensive data analysis workflows, evaluate outcomes, and implement enhancements to improve model accuracy and data reliability.
• Review and optimize claim-matching processes, troubleshoot inconsistencies, and resolve data discrepancies to maintain high-quality outputs.
• Investigate data quality issues, conduct root cause analysis, document findings, and deliver actionable recommendations for process improvements.
• Collaborate with cross-functional teams to enhance analytical tools, refine methodologies, and implement scalable solutions that improve efficiency and analytical capabilities

• Bachelor’s degree in a quantitative field (e.g., Statistics, Mathematics, Engineering, Computer Science, Finance, or Economics) or equivalent professional experience.
• Five (5) or more years of experience analyzing healthcare claims data, including complex and imperfect datasets.
• Strong analytical, problem-solving, and critical-thinking skills with proven ability to uncover root causes
• Proficiency in SQL for querying and manipulating data; familiarity with Python or similar data tools preferred.
• Advanced Excel skills, including PivotTables and complex formulas, for data modeling and reporting. ·
• Knowledge of healthcare network rosters, provider data, and quality measurement methodologies.
• Exceptional attention to detail with a commitment to accuracy, data validation, and quality assurance.
• Highly organized and self-motivated, with the ability to manage multiple priorities independently while collaborating effectively with others.

• Master’s degree preferred.

• Work Environment: You’ll need a quiet workspace that is free from distractions.
• Technology: Reliable internet connection—if you can use streaming services, you’re good to go!
• Security: Adherence to company security protocols, including the use of VPNs, secure passwords, and company-approved devices/software.
• Location: You must be US based, in a location where you can work effectively and comply with company policies such as HIPAA.

• Generously subsidized company-sponsored Medical, Dental, and Vision insurance, with access to services through our own products, Healthcare Blue Book and KISx Card.
• Spending account options: HSA, FSA, and DCFSA
• 401K with company match and immediate vesting
• Flexible working environment
• Generous Paid Time Off to include vacation, sick leave, and paid holidays
• Employee Assistance Program that includes professional counseling, referrals, and additional services
• Paid maternity and paternity leave
• Pet insurance
• Employee discounts on phone plans, car rentals and computers
• Community giveback opportunities, including paid time off for philanthropic endeavors

Valenz