Description:
·Utilizes creative thinking and understanding of Claim Operations to uncover the “art of the possible” when applying Artificial Intelligence/Machine Learning solutions to Claim Operations business problems
·Participates in translation of product vision into operational design
·Serve as a thought leader for the Claim Operations domain.
Provide expert advisory services for Claim Product strategy, metrics, product development, and analytics vision to senior leadership Extend influence to Consumer Operations and Provider Operations data analytics teams through insight delivery, data product development and Artificial Intelligence development
·Work with vast amounts of data from multiple sources to deliver high-impact actionable insights to senior leadership and business operations; enable data-driven decision-making across the enterprise to improve the efficiency and effectiveness of Operations and Experience.
·Serve as a subject matter expert in Artificial Intelligence dealing specifically with medical claim data and additional related data sources utilized and created by Claim Operations.
Provide guidance and mentorship to team members
·Perform exploratory data analysis from structured, unstructured, and diverse datasets; apply knowledge of statistics, machine learning, programming, data modeling, simulation, and advanced mathematics to recognize patterns, identify opportunities, pose business questions, and make valuable discoveries leading to prototype development and product improvement
·Partners with Data Scientists, Data Analysts and Data Engineers to develop capabilities and bring capabilities into production
·Influence without authority by building relationships and driving awareness and knowledge of Core Operations data and capabilities across the Enterprise
·Work across three lines of business – Employee & Individual, Medicare & Retirement and Community & State
·Stays up to date on advancements and trends in Artificial Intelligence
·Make presentations to Sr. executives and decision-makers
·Work across three lines of business – Employee & Individual, Medicare & Retirement and Community & State
·Stays up to date on advancements and trends in Artificial Intelligence
Required skills:
·Bachelor’s degree in data science, Computer Science, Statistics, Applied Mathematics, or a related quantitative field.
·Sound business focus; must excel at connecting business requirements to analytic objectives and to measurable business value
·5+ years experience analyzing Medical claim data, as well as standard processes that generate data through the health care claim adjudication process.
·2+ years experience working in cloud environments such as Azure, AWS, or Google Cloud Platform
·2+ years’ experience applying artificial intelligence, machine learning algorithms, simulation techniques, and advanced mathematics to solve complex business problems.