Primary Responsibilities:

• Apply advanced statistical and predictive modeling techniques to build, maintain, and improve on multiple predictive detection engines in Optum Insight payer analytics 


• Lead discovery processes with Data Scientists and partner with Payment Integrity Operation management to identify the business requirements and the expected outcome 


• Create and provide sound statistical analyses and frame business scenarios that are meaningful and which impact on critical business processes and/or decisions 


• Collaborates with the data steward to gather information to be used for analytics and predictive model building purpose and to ensure the data meets the qualification and assurance requirements of the analyses 


• Design sampling methodology, prepare data, including data cleaning, univariate analysis, missing value imputation, etc., identify appropriate analytic and statistical methodology, develop predictive models and document process and results 


• Communicate analytics results and predictive models to business partners and clients 


• Provide on-going tracking and monitoring of performance of statistical models and recommend ongoing improvements to methods and algorithms that lead to findings, including new information 


• Recommends ongoing improvements to methods and algorithms that lead to findings, including new information

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• BS, Master's or Ph.D. degree in computer science, applied mathematics, (bio) statistics, applied statistics, economics, or similar quantitative fields of study


• 3+ years of hands-on experience in data analysis and predictive analytics with machine learning/statistical modeling techniques.


• 5+ years of experience of hands-on modeling skills and strong analytic programming skills using R or Python


• 5+ years of experience manipulating large datasets and using databases


• Experience working with analytical concepts and analytical solutions that can help customers; solutions around healthcare claims cost reduction preferred  


• Experience learning and working with new concepts and technologies – all the way down to the theorems – and to come out with original solutions to mathematical issues


• Telecommute is available for this role

Preferred Qualifications:

• Experience with health care claims data


• Experience with Post Payment Integrity processes


• Experience with SQL, Python, Hadoop (MapReduce, PIG, Hive, Spark), R, H2O, or equivalent


• UI design experience for automated and-or end-user-interactive visualizations, displays or reports based on the models’ outcomes (for example using Tableau)


• Experience with Version Control (for example Git Version Control system)


• Working knowledge and understanding of medical coding, including ICD, CPT, DRG, etc.