Healthcare Data Scientist

Brillfy Technology Inc is seeking a Healthcare Data Scientist to analyze healthcare payer and provider data. The role focuses on building predictive, anomaly detection, pattern recognition, and classification models using Databricks, Python, and SQL, and translating healthcare data into actionable business insights for operational decision-making.

Requirements:

• Deep understanding of healthcare payer/provider data, claims, DRG, ICD, CPT/HCC, risk adjustment, and coding patterns
• Strong experience building predictive, probabilistic, anomaly detection, and pattern recognition models
• Hands-on experience with Databricks, large-scale data processing, feature engineering, and model development
• Ability to identify trends, explain anomalies, convert analytical findings into actionable business recommendations
• Python, SQL, ML libraries, experimentation, model validation
• Experience in fraud, waste & abuse, payment integrity, claims auditing, utilization management, or coding intensity programs
• Knowledge of model operationalization, monitoring, governance, and performance measurement
• Ability to work closely with engineering, product, and healthcare domain experts
• 5+ years of experience as a Data Scientist with strong statistical and predictive modeling background
• Demonstrated experience working with healthcare claims or payer data
• Demonstrated ability to build anomaly detection, pattern recognition, or classification models
• Strong Databricks, Python, and SQL skills
• Ability to translate complex healthcare data into business insights and investigative "stories."
• Experience working in production environments where models support real operational decisions
• Experienced in working on proprietary algorithms and extremely sensitive intellectual property