Healthcare Data Scientist - Claims, Quality, & Provider Performance

Job Description

Job Description

Vālenz® Health is the platform to simplify healthcare – the destination for employers, payers, providers and members to reduce costs, improve quality, and elevate the healthcare experience. The Valenz mindset and culture of innovation combine to create a distinctly different approach to an inefficient, uninspired health system. With fully integrated solutions, Valenz engages early and often to execute across the entire patient journey – from care navigation and management to payment integrity, plan performance and provider verification. With a 99% client retention rate, we elevate expectations to a new level of efficiency, effectiveness and transparency where smarter, better, faster healthcare is possible.

About This Opportunity : As a Healthcare Data Scientist at Valenz, you’ll work hands-on with large, complex healthcare claims and provider datasets to ensure data accuracy and integrity. You’ll continuously dig into the data, investigate anomalies, and contribute to models that inform how we evaluate provider performance, care quality, and risk.

Using SQL and Python, you’ll identify and resolve data issues, apply statistical methods, and deliver clear, actionable insights to support smarter decision-making across the organization. This is a highly analytical and collaborative role with real impact on how care is measured, delivered, and improved.

Things You’ll Do Here :

• Utilize reference data sources and advanced validation techniques to ensure accuracy, completeness, and integrity of healthcare claims data.
• Assess provider scoring methodologies, identify discrepancies, and develop insights to optimize coverage accuracy.
• Design, develop, and maintain retrospective models for historical performance analysis, and predictive models to identify high-risk patients and prioritize actionable interventions.
• Translate complex analytical findings into clear, actionable insights, and effectively communicate results and recommendations to internal stakeholders and external clients.
• Aggregate and reconcile multiple data sources, applying statistical and computational methods to verify data integrity, identify anomalies, and implement necessary corrections.
• Execute comprehensive data analysis workflows, evaluate outcomes, and implement enhancements to improve model accuracy and data reliability.
• Review and optimize claim-matching processes, troubleshoot inconsistencies, and resolve data discrepancies to maintain high-quality outputs.
• Investigate data quality issues, conduct root cause analysis, document findings, and deliver actionable recommendations for process improvements.
• Collaborate with cross-functional teams to enhance analytical tools, refine methodologies, and implement scalable solutions that improve efficiency and analytical capabilities

Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

What You’ll Bring to the Team :

A plus if you have…

Where You’ll Work : This is a fully remote position, and we’ll provide all the necessary equipment!

Why You'll Love Working Here

Valenz is proud to be recognized by Inc. 5000 as one of America’s fastest-growing private companies. Our team is committed to delivering on our promise to engage early and often for smarter, better, faster healthcare . With this commitment, you’ll find an engaged culture – one that stands strong, vigorous, and healthy in all we do.

Benefits

At Valenz, we celebrate, support, and thrive on inclusion, for the benefit of our associates, our partners, and our products. Valenz is committed to the principle of equal employment opportunity for all associates and to providing associates with a work environment free of discrimination and harassment. All employment decisions at Valenz are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social, or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and / or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.

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