Note: The job is a remote job and is open to candidates in USA. AmeriHealth Caritas is hiring a Data Scientist to deliver recurring and ad hoc analyses supporting clinical performance, utilization trends, readmissions, care gaps, and risk adjustment reporting. The role develops reports and dashboards, supports HEDIS supplemental data efforts, and translates business questions and complex data into actionable insights for operational, quality, and executive stakeholders.

Responsibilities

• Produce independent analyses on utilization, readmission patterns, care gaps, and related clinical trends
• Develop and maintain recurring reports and ad hoc analyses for operational and quality stakeholders
• Support HEDIS supplemental data efforts and risk adjustment reporting
• Translate business questions into clear analytical approaches and summarize findings for non-technical audiences
• Contribute to dashboard development and documentation of metric definitions
• Translate complex data into executive-ready insights, dashboards and decision support
• Experience designing KPI frameworks and operational reporting assets

Skills

• Bachelor's Degree in analytics, public health, health informatics, mathematics, economics or a related field required
• Minimum of 4 years of experience analyzing claims, care management, quality, or utilization management data in a relevant capacity
• Experience with AI copilots, natural-language BI, agentic workflows or autonomous analytics assistants
• Strong written communication and ability to present trends, drivers, and implications clearly
• Familiarity with Python or R and working knowledge of HEDIS/Stars concepts
• Familiarity with AI/BI tooling such as Genie Rooms, agentic AI enabled coding platforms (Claude, CoPilot)
• The ideal candidate will have the ability to evaluate when AI should assist with analysis versus when human review/judgement is required
• Must have advanced experience using SAS, SQL, SQL Server, Power BI, Tableau or another reporting software, Azure Databricks

Benefits

• For roles that are 100% remote or hybrid, fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.
• Flexible work solutions including remote options, hybrid work schedules
• Paid time off including holidays and volunteer events
• Health insurance coverage for you and your dependents on Day 1
• 401(k)
• Tuition reimbursement
• Remote role

Company Overview

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