Data Scientist

Claims Review

Confirmed live in the last 24 hours

11-50 employees

Website

ML precision delivery healthcare company

Company Overview

HEALTH[at]SCALE is on a mission to usher in a new era of care that is proactive, personalized, and precise. HEALTH[at]SCALE is a healthcare machine intelligence company that uses proprietary advances in artificial intelligence and machine learning to optimize care delivery for individuals by empowering at-risk payers, employers and providers.

Data & Analytics

Social Impact

Cybersecurity

AI & Machine Learning

Financial Services

Consumer Goods

Company Stage

Series A

Total Funding

$16M

Founded

2015

Headquarters

San Jose, California

Growth & Insights

Headcount

6 month growth

↓ -8%

1 year growth

↑ 0%

2 year growth

↑ 40%

Locations

United States

Experience Level

Entry

Junior

Mid

Senior

Expert

Desired Skills

Data Analysis

Data Science

SQL

Python

CategoriesNew

Data & Analytics

Requirements

Bachelor's degree in a computer science, data science, informatics or statistics with excellent programming skills
Proficiency in Python programming language, database queries, and SQL
Highly desirable to have healthcare data and subject-matter experience related to identifying patterns of low-value care
Strong analytical and problem-solving skills, well-organized and with thorough attention to detail
Excellent communication and interpersonal skills with ability to work independently and as part of a team

Responsibilities

Conduct data analyses and evaluate healthcare claims for inappropriate utilization and/or reimbursement
Work with healthcare professionals to identify potential cases and identify patterns of low-value care
Conduct thorough analysis of healthcare claims and transactions
Develop and implement strategies to improve payment integrity and claims processing
Develop reports and presentations on cases for management and other stakeholders
Stay current with healthcare regulations and policies

Health at Scale is the market leader in precision health -- digital health programs that offer smart, hyper-personalized insights to help individuals choose the best providers, treatments, care settings and lifestyle choices for their unique healthcare needs. Founded by leading machine learning and clinical faculty from MIT, Stanford, Harvard and the University of Michigan, we work with some of the largest payers, employers and providers in the U.S. to improve outcomes, costs, access, and equity for their members. Health at Scale operates some of the largest deployments of AI in healthcare to date, covering millions of lives in production settings. We have been recognized for our innovation and as one of the fastest growing private companies by Forbes, Fast Company, Inc 500, UCSF Digital Health, Becker’s, TechCrunch, Bloomberg and MIT News. For more information, please visit our website.

As a Data Scientist involved in claims review, you will work with an exceptional team of clinicians, engineers and scientists to analyze healthcare data to improve payment workflows. You will collaborate with other team members to develop strategies to inform improvements to our products and bring in the next generation of payment integrity and claims processing technologies.

Responsibilities

Conduct data analyses and evaluate healthcare claims for inappropriate utilization and/or reimbursement
Work with healthcare professionals to identify potential cases and identify patterns of low-value care
Conduct thorough analysis of healthcare claims and transactions
Develop and implement strategies to improve payment integrity and claims processing
Develop reports and presentations on cases for management and other stakeholders
Stay current with healthcare regulations and policies

Requirements

Bachelor’s degree in a computer science, data science, informatics or statistics with excellent programming skills
Proficiency in Python programming language, database queries, and SQL
Highly desirable to have healthcare data and subject-matter experience related to identifying patterns of low-value care
Strong analytical and problem-solving skills, well-organized and with thorough attention to detail
Excellent communication and interpersonal skills with ability to work independently and as part of a team

Health at Scale is an equal opportunity employer and is committed to diversity in its hiring and business practices. To all recruitment agencies: Health at Scale does not accept agency resumes. Please do not forward resumes to this job alias, company employees or any organization location. Health at Scale is not responsible for any fees related to unsolicited resumes.