Data Scientist-Medicare Part D & Market Access

Summary

ADVI Health is a healthcare and life sciences consulting and advisory firm focused on data-informed commercialization, market access, policy, and healthcare strategy. The Data Scientist will apply real-world data, advanced statistical modeling, machine learning, and healthcare analytics to evaluate Medicare Part D, utilization, drug spending, reimbursement, pricing, and market access strategies, while translating findings into client recommendations and deliverables.

Responsibilities

• Advanced Analytics & Modeling: Develop, validate, and deploy predictive and statistical models in Python or R to forecast prescription drug spending, patient utilization, and market shifts
• Medicare Part D Optimization: Analyze Prescription Drug Event (PDE) claims, formulary tier structures, and beneficiary out-of-pocket costs to optimize plan performance and market positioning
• Large-Scale Data Engineering: Query, clean, and synthesize massive, unstructured administrative healthcare datasets, including public and restricted CMS data files, using SQL and cloud data platforms
• Fraud & Risk Assessment: Build data-mining algorithms to identify market anomalies, track attrition rates, and detect potential fraud, waste, or abuse
• Cross-Functional Collaboration: Partner closely with market access professionals, health economists, and consulting associates to translate analytical findings into strategic reports for pharmaceutical and precision medicine clients
• Regulatory Alignment: Continuously adapt existing data models to reflect changing federal healthcare regulations, benefit redesigns, and modern payment structures
• Design and conduct analyses using Medicare, Medicaid, commercial claims, pharmacy, EHR, and other real-world healthcare data
• Work extensively with CMS data, including PDE data, CCW, VRDC, and other Medicare and Medicaid data sources
• Develop and maintain analytical programs using SAS, with additional experience in SQL, R, or Python valued
• Contribute to observational research and real-world evidence studies supporting life sciences clients
• Partner with consultants and subject-matter experts to translate analytical findings into clear, actionable insights
• Support the development of client-facing presentations, reports, exhibits, and other deliverables
• Communicate complex analytical concepts and findings to both technical and non-technical audiences
• Apply rigorous programming, documentation, validation, and quality assurance practices to ensure analytical integrity
• Contribute to projects spanning market access, reimbursement, pricing, healthcare policy, and value strategy

Skills

• • Candidates must be legally authorized to work full time in the United States at the time of their hire
• • Bachelor's degree in Computer Science, Data Science, Biostatistics, Epidemiology, Public Health, Health Economics, or another quantitative discipline
• • Hands-on experience working with Medicare PDE data is required
• • Professional experience using SAS
• • Experience in healthcare analytics, HEOR, RWE, observational research, or a related field
• • Experience working with healthcare claims and pharmacy data
• • Familiarity with Medicare and Medicaid data, reimbursement, and healthcare policy
• • Experience with CMS Chronic Conditions Warehouse (CCW), Virtual Research Data Center (VRDC), T-MSIS, or similar healthcare data environments
• • Strong analytical, problem-solving, and communication skills
• • Ability to work collaboratively in a consulting environment and manage multiple project priorities
• Candidates can be based anywhere in the U.S
• With a preference for those operating in the Eastern or Central Standard Time Zone

Qualifications

Must Haves

• • Candidates must be legally authorized to work full time in the United States at the time of their hire
• • Bachelor's degree in Computer Science, Data Science, Biostatistics, Epidemiology, Public Health, Health Economics, or another quantitative discipline
• • Hands-on experience working with Medicare PDE data is required
• • Professional experience using SAS
• • Experience in healthcare analytics, HEOR, RWE, observational research, or a related field
• • Experience working with healthcare claims and pharmacy data
• • Familiarity with Medicare and Medicaid data, reimbursement, and healthcare policy
• • Experience with CMS Chronic Conditions Warehouse (CCW), Virtual Research Data Center (VRDC), T-MSIS, or similar healthcare data environments
• • Strong analytical, problem-solving, and communication skills
• • Ability to work collaboratively in a consulting environment and manage multiple project priorities
• Candidates can be based anywhere in the U.S

Nice to Haves

• with a preference for those operating in the Eastern or Central Standard Time Zone

Benefits

• Bonus plan
• Medical, dental, and vision
• 8 paid holidays, including one ADVI Anniversary Day per calendar year
• 401(k) retirement contribution match, with a safe harbor company contribution
• Health Reimbursement Account
• Life and short-term and long-term disability insurance
• Paid vacation and sick leave
• Candidates based in Washington, DC or Austin, TX, will have the option of hybrid work arrangements.