Principal Data Scientist, Compliance and Claims

Principal Data Scientist, Compliance and Claims

This job is no longer open

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States.  And we've just started. So join us on this mission!

Job Description

Why Devoted:

Make a difference... a big difference. You will have the opportunity, in a unique and dynamic culture, to be a part of something incredibly meaningful. We’re a disruptive startup with an inspiring mission. Learn and grow alongside our world-class team of healthcare, technology, and data leaders, dedicated to building a health plan and clinical services that care for everyone like they were our own mothers or fathers. Our team and board members have decades of experience in health care entrepreneurship, data, technology, services, and policy. With their support, we look forward to building a health plan and clinical services that will give seniors easy access to the high-quality care they deserve.

A bit about this role:

The Principal Data Scientist will serve as a crucial partner to many business areas, ensuring visibility into and measurement of all elements of Devoted’s health plan compliance reporting and program effectiveness; including partnering with our claim operations team on ongoing oversight and performance.
This individual will partner with Product Managers and Software Engineers to ensure core audit concepts are appropriately represented in Devoted’s proprietary software. This individual will build robust data pipelines that underpin our operations and audits of them. They will foster a data-driven culture by using their technical expertise to identify opportunities to improve key outcomes and operational efficiency. They will partner with business leads and our delegated operations team to measure and improve program effectiveness. This is a high profile role that is critical to Devoted Health’s success.

This role will be the technical lead in audits of our business. This individual will become a SME in the technical specifications of CMS audits, collaborate across business areas to ensure a consistent technical implementation of specifications, and represent Devoted in audits.
Experience in highly regulated areas with extensive audits is a big PLUS. 

Responsibilities will include:

  • Serve as the technical lead of audits, ensuring consistent implementation of audit concepts across the business and helping build a robust tool set for data extraction and submission

  • Working closely with key business stakeholders to provide visibility and insight in a rapid, iterative, and collaborative process

  • Designing and developing comprehensive monitoring of performance and supplemental benefit operations across compliance, finance, member experience, and ops SLAs of delegated entities 

  • Partnering with business leads to Identify patterns and improve the speed and accuracy of our processes

  • Communicating results to an audience of mixed technical backgrounds

Required skills and experience:

  • Ability to work in a fast-paced startup environment

  • 7+ years of individual technical contributor experience

  • 5+ years of working on Data Science initiatives 

  • Experience collaborating effectively with stakeholders

  • Advanced SQL skills

  • Experience with Python or R

  • Equally comfortable building dashboards and reports for KPIs, and leading technical solutions to support data extraction and submission in audits

  • Knowledge of CMS audits is strongly preferred

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Salary range: $161,000 - $180,000 per year

Our Total Rewards package includes:

  • Employer sponsored health, dental and vision plan with low or no premium

  • Generous paid time off

  • $100 monthly mobile or internet stipend

  • Stock options for all employees

  • Bonus or commission eligibility for all roles

  • Parental leave program

  • 401K program

  • And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

The salary and/or hourly range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, years of relevant experience, education, credentials, budget and internal equity).

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

This job is no longer open
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