Manager Data Science

Profile

Description

Humana's Provider Payment Integrity organization is looking for an experienced Data Science Manager to join the Claims Cost Management (CCM) Solutions Support team working from home anywhere in the US. This dedicated team is focused on building data-driven analytical solutions to prevent fraudulent claims.

Responsibilities

The Data Science Manager within Provider Payment Integrity will utilize their leadership skills and improvement process experience to lead a remote team of 6 highly skilled associates that are located throughout the country. This team will consists of Data Scientist, Cognitive/Machine Learning Professionals and a Database Engineer. This Manager will be experienced and knowledgeable in mathematics, statistics, modeling, business analysis and technology to transform high volumes of complex data into advanced analytic solutions.

Primary Focus


Utilize process improvement and gap analysis for continuous improvement of Humana's current telephonic Natural Language Processing (NLP) systems
Guide and lead a strong technical team in determining, developing, and implementing new processes
One of the primary focus of this team is to identify potential Fraud, Waste, and Abuse occurring with Humana
Continuously staying up to date with industry news and working closely with new and existing vendors


Required Qualifications


Bachelor's degree
Minimum 4 years of experience in Healthcare data analytics, artificial intelligence, and/or data engineering
Previous direct and/or indirect leadership experience
Previous SQL, Python, R and/or Splunk experience
Previous experience implementing analytics within cloud technology (i.e. AWS, Azure)
Experience in using mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions
Experience with providing strategic advice and guidance to functional teams
Experience in developing, maintaining, and collecting structured and unstructured data sets for analysis and reporting
Experience in creating reports, projections, models, and presentations to support business strategy and tactics
Successful demonstrated experience in working with senior executives to develop and drive segment or enterprise-wide functional strategies


Work-at-home Requirements


Must ensure designated work area is free from distractions during work hours and virtual meetings
Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required


Preferred Qualifications


Master's Degree
NLP experience
Prior Experience with identifying Fraud, Waste, and Abuse with healthcare


Covid-19 Vaccine Policy

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field. Every associate and contractor who work inside a Humana facility or in the field, regardless of vaccination status, must complete a daily health screening questionnaire.

Additional Information

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews #LI-Remote

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****

Company info

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