• Design and implement traditional advanced analytics as well as machine learning models that support healthcare quality improvement, cost containment, and risk stratification.
• Translate traditional healthcare datasets, administrative data and third-party datasets into insights that inform clinical and operational decision-making.
• Partner with internal stakeholders and business owners to ensure models are aligned with regulatory, payer, and provider needs.
• Contribute to the development of production-ready pipelines that integrate seamlessly into Cotiviti’s analytics platforms.
• Create actionable and pragmatic data science methodologies and action plans for review so models can be developed with minimal supervision.
• Document your approach, thinking and results in standard approaches to allow other data scientists to collaborate with you on the work planned or completed.
• Understands business needs and identifies potential use cases in more than one business unit.
• Consistently collaborates with fellow data scientists and frequently interacts with business partners to build analytic capabilities and drive business value.
• Develop an exploratory data analysis approach to verify the initial hypothesis associated with potential AI/ML use cases.
• Work with production operations to deploy your model into production and support them in monitoring model performance.
• Participate in other data science teams collaborating with your peers to support their projects
• Participate in knowledge sharing sessions to bring new insights and technologies to the team.
• Provide End to End value-based solutions, including data pipeline, model creation and application for end user consumption.
• Complete all responsibilities outlined in the annual performance review and/or goal setting.  Required
• Complete all special projects and other duties as assigned.  Required
• Must be able to perform duties with or without reasonable accommodation. Required

This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties, and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and the requirements of the job.  Required

• Advanced degree (MS or PhD) in Epidemiology, Biostatistics, Health Informatics, MHA, Data Science or a related field or commensurate professional work experience. 
• 1-3 years of experience in advanced analytics in Cloud, Big Data and traditional environments.
• Experience working with healthcare datasets (e.g., claims, HEDIS, risk adjustment, social determinants of health).
• Strong understanding of healthcare delivery systems, population health frameworks, and quality metrics.
• Demonstrated ability to work in cross-functional teams and deliver measurable business impact.
• 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 with SQL, ability to write SQL queries to efficiently extract data from relational databases.
• 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 ML/AI capabilities.

Additional Beneficial Requirements

• Knowledge or experience of DevOps lifecycle tools like GitHub/Gitlab/BitBucket, Jenkins, and 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. 

Conitive/Mental Requirement:

• 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 interpret the meaning of 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 affect 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.
• Ability to work independently as well as collaborate as a team.
• Flexibility to work with global teams as well as geographically dispersed US-based teams.
• Professional with the 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.

Physical Requirements and Working Conditions:

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Repeating motions that may include the wrists, hands and/or fingers.
• Must be able to provide a dedicated, secure work area.
• Must be able to provide high-speed internet access/connectivity and office setup and maintenance.

Base compensation ranges from $ 95,000 to $ 115,000per year. 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.

Date of posting:

Applications are assessed on a rolling basis. We anticipate that the application window will close on , but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.