Payer Healthcare Data Scientist

Industry/Sector

Health Services

Specialism

Operations

Management Level

Director

Job Description & Summary

The Opportunity

As a Payer Healthcare Data Scientist you will apply advanced data science methods to complex health payer challenges, using statistical modeling, data visualization, and exploratory analysis to translate large, varied data sources into insights that support strategic decisions within our Advisory practice. As a Director you will set direction for client work, shape solution ideas, and guide teams while maintaining executive client relationships, business growth focus, and a culture grounded in quality, integrity, inclusion, and commercial awareness.

In this role at PwC, you will contribute to payer modernization efforts across the health services sector, helping teams design data-driven approaches that improve operational performance and support decision-making. You will also collaborate across the PwC Network and across one or more workstreams, bringing a balanced view of business needs, technical approach, and future growth opportunities while mentoring others and advancing the firm’s presence in data and analytics engineering.

Responsibilities

- Leading payer-focused data science engagements that translate complex health services data into actionable findings for client decision making

- Shaping analytical strategy for healthcare claims, member, provider, and utilization data across modernization and operating model initiatives

- Developing statistical models, machine learning workflows, and predictive approaches to address payer business questions and operational challenges

- Directing exploratory analysis, pattern detection, and data visualization to communicate trends, risks, and opportunities for improvement

- Overseeing data preparation, feature engineering, and model validation across large-scale healthcare data sources and interoperable formats

- Applying knowledge of payer regulations, HIPAA requirements, Medicare and Medicaid programs, and claims processing workflows in solution design

- Guiding teams through data quality review, model troubleshooting, and technical problem solving across analytics deliverables

- Building executive client relationships, identifying new service opportunities, and advancing growth across payer modernization programs

- Coaching emerging leaders and contributing thought leadership on artificial intelligence, advanced analytics, and payer transformation

What You Must Have

- At least a Bachelor's degree

- At least 9 years of experience

What Sets You Apart

- Preference for at least one of the following fields of study: Accounting, Analytics/Data Science, Artificial Intelligence/Robotics, Business Administration/Management, Computer Science/Information Systems, Cybersecurity, Engineering, Mathematics/Statistics, Operations/Supply Chain, Project/Technology Management, Risk Management/Insurance

- Applying advanced analytics, statistical modeling, and data visualization in payer settings

- Translating healthcare data into insights for payer modernization decisions

- Developing machine learning, predictive modeling, or NLP solutions for client needs

- Leading executive-level client conversations across multiple healthcare data efforts

- Mentoring teams while shaping strategy, innovation, and growth for engagements

Travel Requirements

Up to 80%

Job Posting End Date

The salary range for this position is: $155,000 - $410,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glanceAs PwC is an equal opportunity employer, all qualified applicants will receive consideration for employment at PwC without regard to race; color; religion; national origin; sex (including pregnancy, sexual orientation, and gender identity); age; disability; genetic information (including family medical history); veteran, marital, or citizenship status; or, any other status protected by law. PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.Learn more about how we work: https://pwc.to/how-we-workFor only those qualified applicants that are impacted by the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, San Diego County Fair Chance Ordinance, and the California Fair Chance Act, where applicable, arrest or conviction records will be considered for Employment in accordance with these laws.  At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members. We evaluate these factors thoughtfully to establish a secure and trusted workplace for all.Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: https://pwc.to/us-application-deadlines