Leads healthcare payer data science initiatives involving claims, membership, and operational data. Develops statistical models, predictive algorithms, and machine learning solutions for risk adjustment, utilization, and population health. Advises clients on payer modernization and operating model improvements, translates findings into visualizations and recommendations, coordinates multidisciplinary workstreams, validates data and models, and coaches analytical teams through complex client-facing projects.
The Opportunity
As a Payer Healthcare Data Scientist you will focus on advanced analytics and statistical techniques to extract insights from large datasets and support data-driven decision making within our Advisory practice. As a Senior Manager you will lead large projects, leverage your influence and network, coach teams through complex problem-solving, and use sound judgment to decide when to act and when to escalate.
In this role at PwC, you will guide client-facing data science efforts for the health services sector, shaping exploratory and descriptive analysis, statistical modeling, and data visualizations that help inform strategy and operational decisions. You will also bring together multidisciplinary teams, communicate findings in a clear and compelling way, and contribute to the development of inclusive teams that deliver consistent results across payer modernization initiatives.
Responsibilities
- Leading healthcare payer data science initiatives that turn complex claims, membership, and operational data into actionable insights
- Advising client stakeholders on analytics approaches that support payer modernization, operating model improvement, and member experience priorities
- Developing statistical models, predictive algorithms, and machine learning solutions for risk adjustment, utilization trends, and population health use cases
- Directing exploratory analysis, feature engineering, and data quality validation across large-scale healthcare data sources
- Coordinating data science workstreams across technical teams and client leaders to move from business question to model output
- Translating analytical findings into clear narratives, visualizations, and recommendations for decision makers
- Reviewing model performance, interpreting results, and adjusting methods based on feedback and observed outcomes
- Coaching team members through complex problem solving, analytical design choices, and delivery of client-facing work
- Applying healthcare payer knowledge, regulatory awareness, and technology fluency to frame analytics solutions within operational constraints
- Identifying opportunities to improve data pipelines, modeling workflows, and analytical methods for repeatable delivery
What You Must Have
- At least a Bachelor's degree
- At least 7 years of experience
What Sets You Apart
- Preference for at least one of the following fields of study: Accounting, Analytics/Data Science, Artificial Intelligence/Robotics, Business Administration/Management, Computer Science/Information Systems, Cybersecurity, Engineering, Mathematics/Statistics, Operations/Supply Chain, Project/Technology Management, Risk Management/Insurance
- Demonstrating healthcare payer data science experience in advisory settings
- Applying statistical modeling to member, claims, or utilization data
- Translating complex findings into clear client-ready narratives
- Leading analytical teams through ambiguous, multi-stakeholder projects
- Using Python, R, SQL, or visualization tools for insights
The salary range for this position is: $124,000 - $280,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glance
As PwC is an equal opportunity employer, all qualified applicants will receive consideration for employment at PwC without regard to race; color; religion; national origin; sex (including pregnancy, sexual orientation, and gender identity); age; disability; genetic information (including family medical history); veteran, marital, or citizenship status; or, any other status protected by law.
PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.
Learn more about how we work: https://pwc.to/how-we-work
For only those qualified applicants that are impacted by the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, San Diego County Fair Chance Ordinance, and the California Fair Chance Act, where applicable, arrest or conviction records will be considered for Employment in accordance with these laws. At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members. We evaluate these factors thoughtfully to establish a secure and trusted workplace for all.
Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: https://pwc.to/us-application-deadlines
As a Payer Healthcare Data Scientist you will focus on advanced analytics and statistical techniques to extract insights from large datasets and support data-driven decision making within our Advisory practice. As a Senior Manager you will lead large projects, leverage your influence and network, coach teams through complex problem-solving, and use sound judgment to decide when to act and when to escalate.
In this role at PwC, you will guide client-facing data science efforts for the health services sector, shaping exploratory and descriptive analysis, statistical modeling, and data visualizations that help inform strategy and operational decisions. You will also bring together multidisciplinary teams, communicate findings in a clear and compelling way, and contribute to the development of inclusive teams that deliver consistent results across payer modernization initiatives.
Responsibilities
- Leading healthcare payer data science initiatives that turn complex claims, membership, and operational data into actionable insights
- Advising client stakeholders on analytics approaches that support payer modernization, operating model improvement, and member experience priorities
- Developing statistical models, predictive algorithms, and machine learning solutions for risk adjustment, utilization trends, and population health use cases
- Directing exploratory analysis, feature engineering, and data quality validation across large-scale healthcare data sources
- Coordinating data science workstreams across technical teams and client leaders to move from business question to model output
- Translating analytical findings into clear narratives, visualizations, and recommendations for decision makers
- Reviewing model performance, interpreting results, and adjusting methods based on feedback and observed outcomes
- Coaching team members through complex problem solving, analytical design choices, and delivery of client-facing work
- Applying healthcare payer knowledge, regulatory awareness, and technology fluency to frame analytics solutions within operational constraints
- Identifying opportunities to improve data pipelines, modeling workflows, and analytical methods for repeatable delivery
What You Must Have
- At least a Bachelor's degree
- At least 7 years of experience
What Sets You Apart
- Preference for at least one of the following fields of study: Accounting, Analytics/Data Science, Artificial Intelligence/Robotics, Business Administration/Management, Computer Science/Information Systems, Cybersecurity, Engineering, Mathematics/Statistics, Operations/Supply Chain, Project/Technology Management, Risk Management/Insurance
- Demonstrating healthcare payer data science experience in advisory settings
- Applying statistical modeling to member, claims, or utilization data
- Translating complex findings into clear client-ready narratives
- Leading analytical teams through ambiguous, multi-stakeholder projects
- Using Python, R, SQL, or visualization tools for insights
The salary range for this position is: $124,000 - $280,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glance
As PwC is an equal opportunity employer, all qualified applicants will receive consideration for employment at PwC without regard to race; color; religion; national origin; sex (including pregnancy, sexual orientation, and gender identity); age; disability; genetic information (including family medical history); veteran, marital, or citizenship status; or, any other status protected by law.
PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.
Learn more about how we work: https://pwc.to/how-we-work
For only those qualified applicants that are impacted by the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, San Diego County Fair Chance Ordinance, and the California Fair Chance Act, where applicable, arrest or conviction records will be considered for Employment in accordance with these laws. At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members. We evaluate these factors thoughtfully to establish a secure and trusted workplace for all.
Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: https://pwc.to/us-application-deadlines
PwC Boston, Massachusetts, USA Office
101 Seaport Boulevard, Boston, MA, United States, 02210
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