Data Scientist

Alignment Healthcare is a data and technology-driven healthcare company focused on partnering with health systems, health plans, and provider groups to provide care delivery that is preventive, convenient, and coordinated, resulting in improved clinical outcomes for seniors. We are seeking a mission-driven Data Scientist to join our growing team and support risk adjustment strategy within our Medicare Advantage line of business. This role focuses on enhancing risk score accuracy, CMS audit preparedness (RADV), and building AI-powered tools that improve clinical documentation review and integrity. You will play a key role in advancing AVA, our proprietary clinical intelligence platform, by developing next-generation models that support autonomous chart review and NLP/GenAI-driven documentation analytics. This is a unique opportunity to work at the intersection of healthcare, compliance, and machine learning—transforming how we ensure both quality and regulatory alignment. Job Duties/Responsibilities: Collaborate with key business leaders to understand their problems and develop analytical solutions. Apply coding skills and knowledge of data structures to develop projects in partnership with other scientists and engineers. Build customer segmentation models to better understand our customers and tailor clinical outcomes and healthcare experiences. Build and fine-tune models for LLMs and OCR-based document understanding, enabling accurate extraction from scanned or low-quality medical charts. Develop scalable model pipelines that integrate NLP, computer vision, and unstructured data, leveraging cloud infrastructure (Azure) and containerized environments. Collaborate with engineering teams to version, test, and deploy models using Git, CI/CD pipelines, and VMs. Design algorithms to predict audit risk and detect documentation anomalies across cohorts and markets. Partner with Coding, Compliance, CDI, Clinical, and Legal teams to ensure data outputs align with CMS guidance. Standardize definitions, documentation logic, and reporting workflows to scale enterprise-wide AI-readiness. Support CMS Risk Adjustment Data Validation (RADV) audits, including audit sampling validation, error pattern identification, and root cause analysis. Minimum Requirements: 2+ years of relevant experience in predictive modeling and analysis. PhD in Computer Science, Engineering, Mathematics, Statistics, or related field. Excellent communication, analytical, and collaborative problem-solving skills. Experience in building end-to-end data science solutions and applying machine learning methods. Deep understanding of machine learning algorithms, NLP, and LLMs. Strong programming skills in Python, Java, R, Scala, or C++. Proficiency in SQL and relational databases. Experience with data visualization and turning analysis into insights. Understanding of statistical measures and analysis frameworks. Experience with complex, high-volume, unstructured data. Preferred Qualifications: Healthcare experience. Experience with Big Data technologies: Hadoop, Spark, Cosmos. Experience with cloud platforms: Azure, AWS. Experience with NoSQL databases. Published work or industry recognition. Ability to work with ambiguity and deliver results in a dynamic environment. Knowledge of CMS RADV audits. Work Environment & Physical Functions: Standard office environment with physical activities including talking, hearing, sitting, standing, walking, and lifting up to 10 pounds. Accommodations available for disabilities. Alignment Healthcare is an Equal Opportunity/Affirmative Action Employer. We value diversity and encourage all qualified candidates to apply. If you require accommodations during the application process, please contact careers@ahcusa.com. Pay Range: $149,882.00 - $224,823.00. Compensation may vary based on factors like location, experience, and education. Beware of recruitment scams. Alignment Health will never ask for payment or sensitive information during the hiring process. Report scams to the FTC and verify communications through official channels. Join us in transforming senior care and making a difference in people's lives. Be part of a team that is changing healthcare — one person at a time.

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