Job Description

Job DescriptionThe Principal Data Scientist will serve as the principal lead to provide accurate and quality analyses that translate data in sound organizational decisions. In this role you will provide strategic thought leadership and partner with other functional areas to deliver collaborative work products that align with divisional and enterprise strategy. You will own delivery of multiple large and/or complex data science and engineering projects.What You'll DoLead in the development and testing of hypotheses across all functional data setsLead requirements gathering sessions with business and technical staff to distill technical requirement from business requestsDefine and implement integrated data models, allowing integration of data from multiple sourcesDesign and develop scalable, efficient data pipeline processes to handle data ingestion, cleansing, transformation, integration, and validationDefine and implement data stores based on system requirements and consumer requirementsDesign and develop models to understand and solve multiple complex business solutions using a variety of methods including data mining, statistical analysis, predictive modeling and analysis, stochastic modeling, pattern recognition, probability analysis, and network analysisDesign and implement production models leveraging technologies such Python, and RLeverage existing data sets and engineer new data sets including development of SQL queries, data integration and resolution of data quality issuesApply advanced conceptual understanding of Big Data systems to data set engineering and analytic model implementationLead development and reviews of complex analytic models and algorithmsIdentify actionable insights, suggest recommendations, and influence business direction by effectively communicating results to cross functional groupsDocument and test analytic processes including performance and thorough data validation and verificationEngage with enterprise business areas to incorporate feedback into audit process including but not limited to Payment Integrity, SIU, Provider, Behavioral Health, Med Policy, Claims, PharmacyArticulate analytic methods and drive business outcomes with responsible business areasConsult with executive level leadership across the organization – with responsibility to drive CoC ideation for Commercial and MedicareInformally lead other analysts and synthesize information and make recommendations to executive leadershipWhat You BringBachelor's degree or advanced degree (where required)8+ years of experience in related field.In lieu of degree, 10+ years of experience in related field.Strong Analytic/Data Science skills:Experience with SnowflakeExperience building AI AgentsUnderstand Bell curve analysisIncorporate Industry benchmarks into analysisPerform outlier detectionStrong healthcare experience with Payment Integrity/FWA business knowledge is requiredunderstanding of FWA concepts, CMS guidelines, Medical/Reimbursement Policy are all strongly preferredSalary RangeAt Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance.$143,616.00 - $229,786.00SkillsBig Data, Complex Data Analysis, Data Analysis, Data Engineering, Data Mining, Data Modeling Techniques, Data Science, Data Visualization, Machine Learning (ML), Predictive Analytics, Predictive Modeling, Python (Programming Language), Statistical Analysis, Statistical Models_____________________________________________________________________JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on . If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.SummaryLocation: Remote Flex - North Carolina; Remote Flex - Mississippi; Remote Flex - Louisiana; Remote Flex - South Carolina; Remote Flex - Kentucky; Remote Flex - Kansas; Remote Flex - Iowa; Remote Flex - Indiana; Remote Flex - Arkansas; Remote Flex - Texas; Hybrid Flex - Durham; Remote Flex - Georgia; Remote Flex - Virginia; Remote Flex - Tennessee; Remote Flex - Pennsylvania; Remote Flex - Michigan; Remote Flex - Wyoming; Remote Flex - Wisconsin; Remote Flex - Idaho; Remote Flex - Utah; Remote Flex - Florida; Remote Flex - South Dakota; Remote Flex - Oklahoma; Remote Flex - Ohio; Remote Flex - Arizona; Remote Flex - Missouri; Remote Flex - AlabamaType: Full time

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