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Principal Data Scientist - Payment Integrity - MN or Telecommute

UnitedHealth Group

Eden Prairie, MN
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Job Details

726686 Principal Data Scientist Payment Integrity MN or Telecommute

Principal Data Scientist - Payment Integrity - MN or Telecommute (726686)

Position Description

We're changing the way health care works for the better. That means consulting with our members, partnering with our physicians, and delivering drugs in the most efficient and effective way. Join us and start doing your life's best work.(sm)


Primary Responsibilities:

  • Analytic thought leader with strong analytic, communication, and program management skills to lead management, development and integration of a portfolio of analytics that will form the intelligent engine of visually displayed insight to help health care professionals uncover fraud and other types of overpayments
  • Lead, develop, evaluate and present new techniques and methodologies to identify fraud and other forms of overpayments
  • Collaborate with other analytic teams to create analytic development projects that will be deployed through Optum end user tools for fraud and overpayment detection
  • Translate the results of the new methodologies into requirements for tool developers to include in end user applications
  • Create and provide sound statistical analyses and develop predictive models using structured and unstructured data, and frame business scenarios that are meaningful and which impact our critical business processes and / or decisions
  • 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 analytic results and predictive models to business partners and clients
  • Provide on - going tracking and monitoring of performance of analytic applications and recommend ongoing improvements to methods and algorithms that lead to findings, including new information

Required Qualifications:

  • Master's or Ph.D. degree in computer science, (bio) statistics, applied statistics, mathematics, machine learning or similar quantitative fields of study
  • 7+ years of experience of hands - on predictive modeling skills and strong analytic programming skills using either SAS, R and/or Python
  • 7+ years of experience manipulating large datasets and using databases using SQL and / or SAS
  • Experience with health care claims data with working knowledge and understanding of medical coding, including ICD, CPT, DRG, etc.
  • Self - motivated, capable to grasp analytical concepts and clearly understand how analytical solutions can help customers reduce their healthcare claim costs

Preferred Qualifications:

  • 3+ years program management skills
  • Experience with payment integrity modeling such as fraud detection, credit risk scoring, etc.
  • Experience with analysis and modeling using unstructured (text) data
  • H20 experience
  • Strong communication and influencing skills

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.



Job Keywords: Machine Learning, Hadoop, ICD, CPT, DRG, SAS, R, SQL, Statistics, Modeling, Predictive, Eden Prairie, MN, telecommute, remote, work from home

Job Details

  • Contest Number726686
  • Job TitlePrincipal Data Scientist - Payment Integrity - MN or Telecommute
  • Job FamilyPharmaceutical Research
  • Business SegmentOptum Operations

Job Location Information

  • Eden Prairie, MN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelDirector
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionYes
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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