Job Description

Job Description JThe Senior Data Scientist, Clinical Data Science (HEDIS & PCR) provides analytical and data science support for quality improvement programs. This role focuses on the Healthcare Effectiveness Data and Information Set (HEDIS) and Patient Care Record (PCR) domains-core drivers of CMS Star Ratings and clinical performance. This position is designed for an emerging data science professional ready to work independently while contributing to a collaborative and highly visible team. The ideal candidate demonstrates curiosity, problem-solving skill, and a balance of technical fluency and business partnership. They will automate recurring analytics, conduct impact and descriptive analyses, surface meaningful insights, and effectively communicate findings to both technical and non-technical audiences. Analytic & Data Science Execution: - Perform data exploration, descriptive analytics, and trend identification to monitor HEDIS and PCR performance across Medicare Advantage populations. - Execute impact analyses to quantify the effectiveness of quality interventions, provider initiatives, and member outreach strategies. - Build and maintain analytic workflows, dashboards, and automation pipelines to streamline recurring processes and enable near-real-time insight generation. - Apply statistical and machine learning methods to identify patterns, predict outcomes, and support continuous quality improvement. - Support the enhancement of clinical and quality models used for member targeting and opportunity identification. Collaboration & Communication: - Translate complex analytical results into clear, actionable insights for non-technical business partners, including Clinical Operations, Quality, and Member Experience teams. - Collaborate with cross-functional stakeholders to define analytical questions, validate findings, and recommend data-driven actions. - Work closely with data engineering and analytics colleagues to ensure data integrity, accuracy, and alignment with enterprise governance standards. Independence & Continuous Improvement: - Manage assigned projects with minimal supervision-scoping, executing, and delivering on deadlines. - Identify opportunities to automate manual processes or improve analytical efficiency using Python, SQL, or cloud-native tools. - Contribute to the team's learning culture by documenting methods, sharing techniques, and proactively suggesting enhancements to models or workflows. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: Skills and Requirements - 1-3 years of hands-on experience in data science, applied analytics, or statistical modeling (healthcare experience preferred). - Strong proficiency in Python and SQL, with experience using data manipulation and visualization libraries (pandas, matplotlib, seaborn, etc.). - Demonstrated ability to conduct impact and descriptive analytics that influence decision-making. - Proven capability to work independently and communicate complex analyses to non-technical business audiences. - Strong understanding of data structures, quality metrics, and reporting concepts relevant to HEDIS and Medicare Advantage. - Master's degree in Data Science, Statistics, Public Health, Epidemiology, or related quantitative field. - Experience working with HEDIS, PCR, or other CMS quality datasets. - Familiarity with Google Cloud Platform (GCP), Databricks, or similar analytics environments. - Exposure to healthcare quality, Stars Ratings, or clinical outcomes analytics.

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