Lead Data Scientist, HCC

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Job Function:

Data Analytics & Computational Sciences

Job Sub Function:

Data Science

Job Category:

Scientific/Technology

All Job Posting Locations:

Titusville, New Jersey, United States of America

Job Description:

We are currently recruiting for a Lead Data Scientist for our Healthcare Compliance group. This is a hybrid role based in Titusville, NJ, New Brunswick, NJ, Sao Paulo, Brazil and Bogota, Colombia.

Position Summary

The lead data scientist is responsible for designing, developing, and scaling data-driven, AI/ML enabled, solutions that enhance Healthcare Compliance operations globally. The role bridges compliance, analytics, technology, and business teams to identify opportunities, develop innovative solutions, and operationalize digital capabilities that improve monitoring, insights generation, risk management, productivity, and decision-making.

This role serves as a technical lead for advanced analytics, automation, generative AI, Copilot agents, and enterprise AI solutions supporting HCC functions across multiple regions and markets.

Key Responsibilities

• Design, develop, validate, and deploy machine learning models to identify potential healthcare compliance risks, anomalies, and emerging patterns.
• Apply supervised and unsupervised machine learning techniques, including classification, clustering and anomaly detection to business questions.
• Develop statistical and analytical methodologies to support proactive risk monitoring and risk identification.
• Build scalable analytical pipelines and workflows using structured and unstructured data sources.
• Evaluate model performance and continuously improve models through monitoring, retraining, and validation.
• Query and analyze large complex datasets to create reproducible and scalable data science solutions
• Develop and deploy Copilot Agents, chatbot solutions, and knowledge retrieval capabilities to improve efficiency and user experience in our program.
• Ensure governance standards are incorporated in analytic work.
• Partner with governance, compliance, and technology teams to ensure responsible AI adoption and alignment with organizational standards.

Requirements.

• Strong proficiency in Data Science, Machine Learning, and Advanced Analytics to develop predictive, operational, and insight-driven solutions.
• Strong proficiency in Python or R and SQL, for data extraction, feature engineering, modelling, automation, and analytics development.
• Bachelor’s degree in data science, statistics, mathematics, computer science, engineering or related quantitative field with 5 years of relevant experience; OR Masters degree with 3 years of relevant experience.
• Experience in developing and deploying ML models using common libraries and frameworks
• Experience working with NLP libraries, extracting text from documents (OCR), and generating embeddings for downstream work.
• Experience in processing and analyzing large, complex data sets for advanced analytics
• Experience in leading analytical projects and influencing cross-functional teams.
• Experience with AI, Generative AI, and Copilot technologies with the ability to translate emerging technologies into practical business solutions.

Stakeholder Management & Leadership

• Act as a trusted technical advisor to global compliance leaders and business stakeholders.
• Lead solution discussions, proof-of-concepts, demonstrations, and technology evaluations.
• Translate business requirements into technical solutions and drive execution from concept through deployment.
• Mentor team members and promote adoption of modern analytics and AI practices.

Education Qualification:

Bachelor’s degree in data science, statistics, mathematics, computer science, engineering or related quantitative field with 5 years of relevant experience; OR Masters degree with 3 years of relevant experience.

Required Skills:

Preferred Skills:

Communication, Complaints Investigation, Compliance Management, Corporate Governance, Critical Thinking, Data Reporting, Detail-Oriented, Governance Risk and Compliance (GRC) Platforms, Healthcare Industry, Health Care Regulation, Internal Auditing, Legal Services, Medical Compliance, Organizing, Problem Solving, Process Improvements

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