- Applied Machine Learning: Application of a variety of machine learning techniques to increase identification of payment integrity issues for our clients, reduce the cost of auditing processes or increase the quality of care and outcomes. Must have implemented machine learning solutions within production environments at scale
- Big Data Analysis: Strong ability to manage and analyze data in a Big Data environment using a variety of scripts, potentially including but not limited to Scala/Spark and Python as well as Cloud based Artificial Intelligence/Machine Learning capabilities.
- Reasoning and Problem Solving: Ability to actively and skillfully conceptualize, apply, analyze, synthesize, and/or evaluate information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to belief and action
- Consulting: Demonstrated ability to make and gain acceptance of data-driven recommendations made to business owners. Strong ability to appropriately summarize and effectively communicate complex concepts & varied data sets to inform stakeholders, gain approval, or prompt actions; Applies to multiple audiences ranging from the analyst to executive level; Includes oral & written communication and multimedia presentation
- Statistical Analysis: Apply statistical methodology to solve business problems; appropriately interprets meaning from results
- Business Knowledge: Good understanding of the tenets of health insurance, the managed care model, industry coding/policy standards, the claim adjudication process, and issues related to fraud waste and abuse. Ability to apply this knowledge to the development & evaluation of new initiatives and support leading the team strategy toward best practices.
- Financial Analysis: Ability to understand, generate and evaluate healthcare utilization, unit cost and medical cost trends. This includes understanding levers that effect healthcare cost, such as contracting, networks, policies, benefit structures, and product design. Ability to draw conclusions and make recommendations based on financial data
- Functional Programming: Ability to work with, understand and create object oriented/functional programming solutions using modern application frameworks.
- A degree in relevant discipline (Math, Statistics, Computer Science, Engineering or Health Sciences) or commensurate professional work experience. MS or PHD is preferred.
- 4-7 years experience in advanced analytics
- 3+ years experience in working in Big Data environments
- Experience developing machine learning models in an exploratory data analytics environment and working with others to develop production ready versions of the models that are deployed within operational environments
- Experience in using machine learning tools to develop production strength models including, but not limited to, Python, TensorFlow, Keraes, pandas, numpy, scikit-learn, spark, scala, hive, impala
- Significant experience in working with data tools like SQL, SAS, R, Python, etc., ability to efficiently extract data from relational databases
- Ability to work independently as well as collaborate as a team
- Flexibility to work with global teams as well geographically dispersed US based teams
- Professional with ability to properly handle confidential information
- Be value-driven, understand that success is based on the impact of your work rather than its complexity or the level of effort.
- Ability to handle multiple tasks, prioritize and meet deadlines
- Ability to work within a matrixed organization
- Proficiency in all required skills and competencies above
Additional Beneficial Requirements:
- Knowledge or experience of DevOps lifecycle tools like GitHub/Gitlab/BitBucket, Jenkins, Jira
- Experience in natural language processing (NLP) techniques
- Experience in deep learning techniques
- Proficiency in applying various mathematical and statistical models to include, but not limited to: Random Forest, Gradient Boosting, Time Series, Support Vector Machines, Collaborative Filtering, and Unsupervised Clustering
- Experience or knowledge of the health insurance industry in the U.S.
- Application of a variety of machine learning techniques to increase identification of payment integrity issues for our clients, reduce the cost of auditing processes or increase the quality of care and outcomes.
- Experience developing machine learning models in an exploratory data analytics environment and working with others to develop production ready versions of the models that are deployed within operational environments
- Experience in using machine learning tools to develop production strength models including, but not limited to, Python, TensorFlow, Keraes, pandas, numpy, scikit-learn, spark, scala, hive, impala.
Base compensation ranges from $108,000.00 to $135,000.00. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.
Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.
Since this job will be based remotely, all interviews will be conducted virtually.
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