Data Scientist

Summary

Join Abarca, a healthcare revolutionizing company, as a Drug Value Strategy Senior Manager. You will leverage your coding skills (Python, R, SQL) to transform big data into actionable insights and customized solutions for clients. This critical role involves developing advanced data reporting tools, specialty reports, and collaborating with stakeholders. You will design data solutions, build predictive models, and lead the development of analytic tools. The position offers a flexible hybrid work model and the opportunity to make a significant impact in healthcare.

Requirements

• Bachelor’s degree in business or related area of study, or equivalent combination of education and/or related work experience (In lieu of a degree, equivalent relevant experience may be considered.)
• 8+ years of experience with working with healthcare data analytics (e.g. medical and pharmacy claims data)
• 2+ years of experience with medical or pharmacy data in a health plan or pharmacy benefit manager (PBM)
• Excellent written, interpersonal communication, and presentation skills, including ability to present complex technical concepts in a clear, concise manner to audiences with varying levels of technical understanding
• Experience in Python, R, SQL, advanced statistical methods, and advanced proficiency to utilize data-oriented programming languages, statistical modeling, and visualization software (such as Tableau, PowerBI, etc.)
• Experience with cloud-based data analysis (such as Snowflake)
• Strong problem-solving skills in healthcare cost and utilization analysis
• Experience in project management, KPI’s, and data visualization
• Experience managing key strategic initiatives in healthcare/PBM industry
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable)

Responsibilities

• Design and develop data solutions - utilize data mining, data modeling, natural language processing, and machine learning to extract insights from large data sources
• Evaluate data scenarios through a product-oriented lens and deliver predictive models that inform business solutions as part of the drug value strategy portfolio
• Utilize data-oriented programming languages and visualization software to explore, analyze, and interpret large volumes of data in various forms and solve complex business problems
• Lead the development of analytic tools that will provide data reporting for our clients
• Develop and manage new and innovative specialty programs based on collaboration with the specialty network of pharmacies and track progress (partnerships (i.e. ROI, launch of initiatives, outreach, metric tracking, etc.)
• Develop monthly and quarterly specialty spend reports to include initiatives, trends in the market, pipeline drugs, and other impactful events
• Optimize and manage specialty claims auditing process (in conjunction with analytics team)
• Drive generation of client-facing tools that help with feasibility, context, and budget and drug forecast models
• Serve as a SME to the analytics team to develop complex reporting
• Other tasks and projects as needed

Preferred Qualifications

• Multiple successfully completed data science projects involving ML or algorithm application. For example, prediction of clinical outcomes (disease state complications using support vector machines)
• Expertise in healthcare coding (CPT, ICD, HCPCS)
• Understanding of the healthcare market dynamics
• Significant experience in formulary and regulatory requirements for Medicaid and/or Medicare
• Experience in designing and developing AI applications and systems

Benefits

We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)