Data Scientist II

SmartLight Analytics is seeking a Machine Learning Data Scientist with deep expertise in healthcare claims data. In this role, you will design, build, and deploy advanced analytics and machine learning modeling solutions to transform complex datasets into actionable insights that improve cost efficiency and care quality in the healthcare ecosystem. Responsibilities: Develop, train, and deploy ML models for use cases such as: Claims cost prediction and utilization forecasting; Fraud, waste, and abuse detection; Risk adjustment and member stratification; Provider performance and network optimization; Apply modern ML techniques including gradient boosting, deep learning, NLP, and probabilistic modeling; Capable of applying advanced predictive analytics to correlate disparate datasets and events and derive business value; Build scalable pipelines for feature engineering, model training, validation, and monitoring; Analyze and interpret medical, pharmacy, and dental claims (CPT/HCPCS, ICD‑10, DRG, NDC); Translate domain knowledge into meaningful features and model strategies; Partner with clinicians, product managers, and business stakeholders to define problems and measure outcomes; Communicate complex analytical findings in clear, actionable terms Qualifications: Strong proficiency in Python and ML libraries (scikit‑learn, XGBoost, TensorFlow/PyTorch); Hands‑on experience with healthcare claims datasets and coding systems; Solid understanding of statistical modeling, machine learning algorithms, and data mining techniques; Strong knowledge and expertise working with SQL; Ability to translate business needs into analytical solutions; Must have demonstrated the ability to solve complex problems with minimal direction Required Skills: Python, Machine learning, Healthcare claims data, Statistical modeling, Data mining, SQL, Scikit-learn, XGBoost, TensorFlow, PyTorch, Problem solving, Communication