Job Description
A leading healthcare technology organization is seeking a Senior Data Scientist to support advanced analytics and generative artificial intelligence initiatives within the pharmacy benefit management domain. The Senior Data Scientist will analyze complex healthcare data, assess model quality, and help develop artificial intelligence solutions for claims, rebates, pricing, contractual guarantees, and related business processes.
The position requires deep healthcare or pharmacy benefit management knowledge combined with hands-on expertise in SQL, Python, large language models, conversational AI, and recommendation systems.
Responsibilities
- Analyze healthcare and pharmacy benefit data for generative AI, large language model, chatbot, and recommendation system initiatives.
- Develop SQL queries to extract, combine, and evaluate large datasets.
- Use Python for data exploration, manipulation, model assessment, and analytical support.
- Review outputs from large language model applications for accuracy, reliability, and business relevance.
- Contribute to the development and refinement of an AI-powered recommendation system.
- Support conversational AI agents that answer questions related to claims, rebates, contractual guarantees, and pricing.
- Measure chatbot and AI agent performance and recommend improvements based on identified gaps.
- Help automate the conversion of pricing terms in contract documents into structured technical rules.
- Validate model and automation results before solutions progress toward broader adoption.
- Partner with data engineers, business stakeholders, and technical teams to translate operational needs into implementable solutions.
- Support proofs of concept and help develop successful prototypes into scalable solutions.
Required Experience and Skills
- 9 to 10 years of professional experience in data science, analytics, machine learning, or a related technical discipline.
- Strong experience with pharmacy benefit management, healthcare, pharmacy operations, claims, rebates, pricing, contractual guarantees, or healthcare analytics.
- Advanced SQL skills, including querying, joining, extracting, and analyzing large datasets.
- Advanced Python skills for data analysis, data manipulation, and model evaluation.
- Hands-on experience with large language models, generative AI tools, or AI-enabled applications.
- Experience developing, supporting, or evaluating LLM agents, chatbot agents, or conversational AI solutions.
- Experience implementing, supporting, or assessing recommendation systems.
- Ability to validate analytical and model outputs, identify data quality issues, and assess result accuracy.
- Ability to work independently in a remote environment.
- Strong communication skills and the ability to collaborate with business and technical stakeholders.
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