Sr Data Scientist - Payment Integrity

Who We Are Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.  We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health . Job Summary Position will report into Payment Integrity’s Sr Manager Provider Audit. The Sr Data Scientist is responsible for delivering innovative, data-driven solutions through the analysis of complex, high-dimensional datasets. This role leverages exploratory data analysis, advanced statistical techniques, and AI-powered technologies to uncover patterns, identify opportunities, and generate actionable business insights. The Sr Data Scientist translates complex data into strategic recommendations, formulates critical business questions, and develops advanced analytical and AI-driven products that address key business challenges and drive measurable value. Job Description Design, develop and orchestrate experiments, models, algorithms, and visualizations. Lead multiple and concurrent projects and manage project phases or smaller projects in their entirety. Communicate results and insights in a clear and concise manner to a non-technical audience. Identify, define, and translate business needs/problems into analytical questions.  Apply advanced machine learning, natural language processing, statistical and computational methodologies to provide actionable insights and identify strategic opportunities that optimize quality, consumer experience, and healthcare costs. Lead and develop scalable, efficient, and automated processes for large scale data analyses and model development, validation, and implementation. Provide supervision and mentorship to junior team members and create/adhere to governance and ethical norms. Other duties and projects as assigned. Certification and Licensure Relevant certifications are a plus. Education Master’s degree in data science, Applied Mathematics, Computer science, Statistics, Epidemiology, or equivalent combination of experience and education. Experience (minimum years required) : 8 - 10 years of work experience in a Data Scientist or similar role, or equivalent combination of transferrable…