Principal Data Scientist, Claims & Payment Integrity

Job Description

A bit about this role: 

As a Principal Data Scientist, you will serve as a key partner to Devoted Health’s Claims and Payment Integrity (PI) teams, and broader Core Service Operations, leading efforts to improve payment accuracy and drive opportunities that allow us to invest more dollars in our members. 

You will build and maintain robust data pipelines and shape how Devoted uses data to identify overpayment and underpayment risk, quantify savings opportunities, and design systems that scale accuracy and throughput in both pre-pay and post-pay operations.

This high-impact role is essential for Devoted’s success, reporting into our Data Science team and working alongside Product Managers, Software Engineers, Business Intelligence Analysts, and Operation Leaders to design scalable, technology-driven solutions.

In this role, you will:

•  Leverage domain knowledge of claims data and provider billing behavior to drive meaningful cost savings and improve operational decision-making

• Define high-impact analytical problems in Claims and PI, collaborating with business leads, product managers, engineers, and technical teammates.

• Collaborate closely with engineering and business partners to ensure scalable, maintainable data pipelines, and determine our most impactful work to scale our payment accuracy program with new opportunities and technology

• Scope, communicate, and implement technical solutions collaboratively, delivering value iteratively while independently executing

• Advise stakeholders on evaluating and implementing internally developed LLM based agents to improve workflows, and perform data extraction to leverage output of those agents in feature stores and analysis.  

Required skills and experience:

• Ability to thrive in a fast-paced, high-growth environment

• 7+ years of individual technical contributor experience

• Strong background in SQL, with fluency in modern data ecosystems (Snowflake, dbt, Looker, Python)

• Skilled at collaborating with cross-functional teams and influencing decisions with data-driven insights

• Comfort with both building scalable, maintainable data pipelines, and doing deep-dive statistical analysis, predictive modeling and/or experimental design to drive business strategies

Desired skills and experience:

• Claims, Payment Integrity, or Medical Economics experience, especially in Medicare Advantage

• LLM integrated into personal development workflows or to support operations
  #LI-Remote
  Salary range: Salary range: $128,057- $187, 083 annually plus eligibility for discretionary performance based bonus paid out annually. Target bonus is 10% however the actual payout is based on the terms of the bonus plan. The total compensation for this role is: $140,862-$205,791 (base plus bonus)

The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• Employer sponsored health, dental and vision plan with low or no premium

• Generous paid time off

• $100 monthly mobile or internet stipend

• Stock options for all employees

• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

• Parental leave program

• 401K program

• And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family.  We are committed to a diverse and vibrant workforce. 

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States.  And we've just started. So join us on this mission!

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.