Data Scientist IV

Job not on LinkedIn

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $113k - $197.7k / year

⏰ Full Time

🟠 Senior

🔴 Lead

📊 Data Scientist

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Lead operationalization of AI and machine learning solutions from prototype through scalable production deployment • Establish technical standards, design reviews, best practices, and reusable frameworks for AI, machine learning, and advanced analytics • Design, develop, and oversee predictive modeling, machine learning, and statistical solutions using claims, EHR/EMR, laboratory, utilization management, clinical, and operational datasets • Conduct data cleansing, feature engineering, exploratory data analysis, and derive actionable recommendations • Design, develop, test, deploy, and govern Generative AI, Agentic AI, NLP, deep learning, and RAG solutions using MLOps and LLMOps practices • Evaluate emerging AI technologies and recommend enterprise adoption strategies based on business value, risk, and scalability • Ensure HIPAA/PHI compliance and collaborate with privacy, security, and compliance partners to mitigate AI risks • Collaborate with clinical leadership, risk adjustment, care management, operations, IT, and analytics stakeholders to prioritize work, define KPIs, communicate results, tradeoffs, and roadmap progress • Serve as an enterprise subject matter expert for AI, machine learning, and advanced analytics • Mentor data scientists and contribute hands-on to innovative AI and machine learning capabilities • Perform other job-related duties as requested

🎯 Requirements

• Bachelor's degree in Data Science, Mathematics, Statistics, Engineering, Computer Science, or another related field required • Equivalent years of relevant work experience may be accepted in lieu of required education • Eight (8) years of experience in predictive analytics, data science, or a related field required • Three (3) years of technical leadership, solution ownership, or mentoring experience required • One (1) year of experience with cloud services such as Azure, AWS, or GCP and modern data stacks such as Databricks or Snowflake required • Three (3) years of experience delivering LLM and/or generative AI solutions from prototype through production required • Expert knowledge of predictive modeling, machine learning, deep learning, NLP, generative AI, and healthcare analytics methodologies • Expertise in Agentic AI, LLMs, prompt engineering, RAG, evaluation methodologies, and scalable trustworthy AI solutions • Expert knowledge of transformer architectures, deep learning frameworks, and generative modeling concepts • Familiarity with AI-powered document intelligence, OCR, language extraction, annotation, retrieval, and review workflows • Familiarity with MLOps/LLMOps practices including CI/CD, experiment tracking, model and prompt versioning, automated testing, monitoring, observability, and reproducible pipelines • Understanding of AI governance, responsible AI, privacy-by-design, HIPAA/PHI handling, model risk management, prompt injection safeguards, and data leakage prevention • Expert knowledge in SQL and working knowledge of data modeling, data quality, and feature engineering for large healthcare datasets • Knowledge of healthcare operations, payer and provider models, and industry trends • Knowledge of CPT-4, HCPCS, ICD-9/10, DRG, and Revenue Codes • Knowledge of managed care required • Excellent analytical, problem-solving, critical-thinking, written, verbal communication, and presentation skills • Strong project/program leadership skills • Ability to travel as required by business needs

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Comprehensive total rewards package • Employee total well-being support