Payer Healthcare Data Scientist

As an operations consulting generalist at PwC, you will possess a broad understanding of various aspects of operations consulting. You will provide comprehensive guidance and support to clients in optimising operational efficiency and effectiveness. Working in this area, you will analyse client needs, develop operational solutions, and offer recommendations tailored to specific business requirements.

Enhancing your leadership style, you motivate, develop and inspire others to deliver quality. You are responsible for coaching, leveraging team member’s unique strengths, and managing performance to deliver on client expectations. With your growing knowledge of how business works, you play an important role in identifying opportunities that contribute to the success of our Firm. You are expected to lead with integrity and authenticity, articulating our purpose and values in a meaningful way. You embrace technology and innovation to enhance your delivery and encourage others to do the same.

Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to:

Analyse and identify the linkages and interactions between the component parts of an entire system. Take ownership of projects, ensuring their successful planning, budgeting, execution, and completion. Partner with team leadership to ensure collective ownership of quality, timelines, and deliverables. Develop skills outside your comfort zone, and encourage others to do the same. Effectively mentor others. Use the review of work as an opportunity to deepen the expertise of team members. Address conflicts or issues, engaging in difficult conversations with clients, team members and other stakeholders, escalating where appropriate. Uphold and reinforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance), the Firm’s code of conduct, and independence requirements.

The Opportunity

As part of the Operations Consulting team, you will apply advanced data science and machine learning techniques to large-scale claims, clinical, and member data to surface actionable insights that reduce cost of care and improve population health outcomes for our payer clients. As a Manager, you will lead teams and manage client accounts, focusing on strategic planning and mentoring junior staff while securing project success and maintaining exemplary standards. This role offers the chance to work on innovative analytics products and collaborate with industry leaders, making a significant impact in healthcare.

Responsibilities

• Apply advanced data science and machine learning methodologies to analyze vast claims and clinical data
• Generate actionable insights aimed at reducing healthcare costs and enhancing population health
• Lead and mentor teams while managing client relationships and expectations
• Secure successful project execution while upholding quality standards
• Collaborate with industry leaders to develop innovative analytics solutions
• Present findings and strategies to senior stakeholders, including Chief Actuaries
• Play a key role in the development of new analytics products for payer strategies
• Foster a culture of continuous improvement and knowledge sharing within the team

Bachelor’s Degree

• At least 6 years of experience in data science and machine learning, Master’s Degree in Statistics, Computer Science, Applied Mathematics, Biotechnology preferred
• Prior consulting or advisory firm experience preferred
• Contributing to commercial analytics product development
• Familiarity with NCQA HEDIS specifications and CMS Star Ratings
• Knowledge of government payer programs and Medicaid
• Experience with NLP or unstructured clinical text
• Exposure to social determinants of health data integration

The salary range for this position is: $99,000 - $232,000. Actual compensation within the range will be dependent upon the individual’s skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glance

At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs, develop operational strategies, and offer guidance and support to help clients streamline processes, improve productivity, and drive business performance.