Humana

Data Scientist - Actuarial Valuation

Job description

The Data Scientist 2 will work within Corporate Actuarial Valuation to help build and maintain models related to claims development and reserves, claims payment patterns, and related projections. Enabling a deep understanding of how Humana processes, pays, and reviews claims, how Humana’s members and products impact the claims reserves development, and the potential impact on income and balance sheets will be the primary goals of this role.

Responsibilities

In this role, the Data Scientist 2 will develop models, reporting and analysis that help provide insights and projections of medical claims related development. Additionally, this role will partner and collaborate with Digital Health and Analytics teams on cross-functional projects and have potential exposure and presentation opportunities to senior actuarial, finance, and data science leaders.

Key responsibilities include:

  • Building predictive models related to claims patterns including receipts, reviews, payments, denials, and more

  • Performing exploratory data analysis to determine drivers and best predictors for modeling

  • Recommending and developing best ML/AI modeling techniques given the business objectives

  • Building clear reporting for results and data analysis that communicate the key takeaways from project results

  • Collaboration with other Humana data scientist teams on cross-functional projects

  • Self-motivated and organized to research multiple projects at once

Required Qualifications

  • Bachelor's Degree and 3 years of applicable experience OR Master's Degree and 1 or more years of experience

  • Experience in using mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions

  • Knowledge of SQL, SAS, R and/or Python

  • Develop, maintain, and collect structured and unstructured data sets for analysis and reporting

  • Create reports, projections, models, and presentations to support business

  • Clear and concise oral and written communication skills, with a proven ability to translate complex methodologies and analytical results to higher-level business insights and key takeaways

Preferred Qualifications

  • Master's Degree

  • Experience in Big Data environment, Microsoft Azure

  • Knowledge of machine learning techniques such as neural networks, random forest, etc.

  • Prior health care and/or Insurance experience

Additional Information

Vaccine Policy:

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field. Every associate and contractor who work inside a Humana facility or in the field, regardless of vaccination status, must complete a daily health-screening questionnaire.

Work-At-Home Requirements:

  • WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

  • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.

  • Satellite and Wireless Internet service is NOT allowed for this role.

  • A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Why Humana?

At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few:

  • Work-Life Balance

  • Generous PTO package

  • Health benefits effective day 1

  • Annual Incentive Plan

  • 401K - Immediate company match

  • Well-being program

  • Paid Volunteer Time Off

  • Student Loan Refinancing

If you share our passion for helping people, we likely have the right place for you at Humana.

Social Security Task:

Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.

Interview Format:

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will receive a set of interview questions over your phone and you will provide recorded or text message responses to each question. You should anticipate this interview to take about 15 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

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