Data Scientist, Pharmacy (Part D Stars)

Summary

Alignment Healthcare is a data and technology driven healthcare company focused on providing preventive, convenient, coordinated care and improved clinical outcomes for seniors. The Data Scientist will develop and enhance analytics, predictive models, dashboards, simulations, and prioritization tools supporting pharmacy data and Part D Star measures within the Medicare Advantage business. The role also manages analytical projects end to end and collaborates with data and engineering teams on production deployment and monitoring.

Responsibilities

• Partner with Pharmacy leadership to understand business problems, propose analytical solutions, and turn findings into clear, actionable takeaways for stakeholders
• Convert analytical models and business rules into scalable, production-ready tools
• Design dashboards and reporting that track Stars measure trajectories and intervention impact
• Build cut-point projection and simulation models to forecast Star Rating outcomes under varying performance and CMS methodology scenarios
• Build out prioritization rules, measure improvement models, and next-best-action (NBA) logic
• Analyze the financial impact of pharmacy and Star performance to help leadership prioritize investment and interventions
• Manage projects end to end – from problem definition through analysis, model building, validation, deployment support, and ongoing monitoring
• Collaborate with data and engineering teams to version, test, and deploy models using Git, CI/CD pipelines, and virtual machine (VM) environments
• Help standardize definitions, documentation logic, and reporting workflows to scale enterprise-wide AI-readiness
• Bring in new data sources, techniques, and emerging tools to continuously improve analytical capabilities
• Other duties as assigned by your manager

Skills

• 2+ years of relevant experience in predictive modeling and data analysis
• Excellent communication, analytical and collaborative problem-solving skills
• Experience in building data science solutions and applying machine learning methods to real world problems with measurable outcomes
• Familiarity with time-series analysis or forecasting methods
• Solid data structures & algorithms background
• Strong programming skills in one of the following: Python, Java, R, Scala or C++
• Demonstrated proficiency in SQL and relational databases
• Experience with data visualization and presentation, turning complex analysis into insight
• Experience in setting experimental analytics frameworks or strategies for complex scenarios
• Understanding of relevant statistical measures such as confidence intervals, significance of error measurements, development, and evaluation data sets, etc
• Experience with manipulating and analyzing complex, high-volume, high-dimensionality and unstructured data from varying sources
• While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms
• The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus
• Prior healthcare experience, ideally supporting Stars or Part D analytics
• Experience in Big Data processing technologies: Hadoop, Spark, Cosmos
• Experience in Azure, AWS or other cloud ecosystems
• Strong understanding of CMS Stars rating measures and methodology
• Published work in academic conferences or industry circles
• Demonstrated track record in navigating ambiguity, shifting priorities, and delivering results in an agile environment
• Bachelor or Master's in Computer Science, Engineering, Mathematics, Statistics, or related field (PhD a plus), or equivalent related experience

Qualifications

Must Haves

• 2+ years of relevant experience in predictive modeling and data analysis
• Excellent communication, analytical and collaborative problem-solving skills
• Experience in building data science solutions and applying machine learning methods to real world problems with measurable outcomes
• Familiarity with time-series analysis or forecasting methods
• Solid data structures & algorithms background
• Strong programming skills in one of the following: Python, Java, R, Scala or C++
• Demonstrated proficiency in SQL and relational databases
• Experience with data visualization and presentation, turning complex analysis into insight
• Experience in setting experimental analytics frameworks or strategies for complex scenarios
• Understanding of relevant statistical measures such as confidence intervals, significance of error measurements, development, and evaluation data sets, etc
• Experience with manipulating and analyzing complex, high-volume, high-dimensionality and unstructured data from varying sources
• While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms
• The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus

Nice to Haves

• Prior healthcare experience, ideally supporting Stars or Part D analytics
• Experience in Big Data processing technologies: Hadoop, Spark, Cosmos
• Experience in Azure, AWS or other cloud ecosystems
• Strong understanding of CMS Stars rating measures and methodology
• Published work in academic conferences or industry circles
• Demonstrated track record in navigating ambiguity, shifting priorities, and delivering results in an agile environment
• Bachelor or Master's in Computer Science, Engineering, Mathematics, Statistics, or related field (PhD a plus), or equivalent related experience

Benefits

• Fully Remote
• Ample room for growth and innovation