Role overview

Qualifications

5+ years’ experience in data science with focus on predictive models
Expertise with intelligent routing and prioritization systems
Strong knowledge of data pipeline design and ML model integration
Experience with healthcare claims data and processing workflows

Responsibilities

Lead development of Intelligent Claims Routing models
Design complexity scoring engine and optimal routing algorithms
Develop dynamic priority scoring algorithms for optimal workflows
Lead user enablement and training initiatives

Key facts

Remote from: Indiana (USA)
Full time
Senior (5-10 years)
Data Scientist
English

Hard skills

Predictive Modeling Medical Insurance Claims IP Routing Artificial Intelligence System Optimization Model Validation Business Metrics Machine Learning Data Architecture Customer Success Management Engineering Documentation

Other skills

Prioritization
Training And Development
Leadership

About the company

Cotiviti

Cotiviti is a leading solutions and analytics company that is reshaping the economics of healthcare, helping its clients uncover new opportunities to unlock value. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and network performance management programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit www.cotiviti.com.

Company details

Company typeLarge

Industry

Company size5001 - 10000

Links

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Job description

Overview:

We are seeking for an Experienced data scientist leading Intelligent Claims Routing models, developing scoring algorithms and prioritization systems to optimize claims workflows.

Responsibilities:

Lead development of Intelligent Claims Routing models.
Design complexity scoring engine and optimal routing algorithms.
Develop dynamic priority scoring algorithms for optimal workflows.
Create documentation and training for AI features.
Support expansion planning and optimization for AI systems.
Lead user enablement and training initiatives.

Qualifications:

5+ years’ experience in data science with focus on predictive models
Expertise with intelligent routing and prioritization systems
Strong knowledge of data pipeline design and ML model integration
Experience with healthcare claims data and processing workflows
Knowledge of model evaluation and validation techniques
Understanding of SLA compliance and business metrics

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