Note: The job is a remote job and is open to candidates in USA. Alight Solutions empowers clients to build healthier and more financially secure workforces by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management. The Healthcare Navigation Data Scientist will use healthcare data, analytics, predictive modeling, and machine learning to improve provider search and recommendations, identify cost and utilization insights, and demonstrate client value. The role collaborates with Product, Engineering, Clinical, and Business teams to develop scalable solutions that improve member outcomes, engagement, and healthcare affordability.
Responsibilities
- Analyze healthcare and book-of-business data to identify cost drivers, utilization trends, and opportunities to improve member outcomes and reduce healthcare spend
- Develop and enhance provider scoring, ranking, and recommendation methodologies using factors such as cost, quality, specialty alignment, and provider experience
- Integrate and transform complex healthcare datasets, including claims, provider, pricing, and network data, to support analytics and modeling initiatives
- Build, validate, and optimize statistical, predictive, and machine learning models that improve provider search relevance and personalization
- Evaluate business rules, scoring outputs, and recommendation performance to ensure alignment with clinical and business objectives
- Monitor key performance metrics, identify opportunities for continuous improvement, and recommend enhancements to data sources, models, and processes
- Partner cross-functionally with Product, Engineering, Clinical, and Business teams to translate analytical insights into actionable solutions and measurable business value
Skills
- Experience working with large, complex datasets using **SQL** and **Python** and/or **R**
- Experience developing data models, scoring frameworks, predictive analytics, or machine learning solutions
- Knowledge of healthcare datasets and concepts, including claims data, CPT, ICD, NPI, provider networks, and healthcare pricing
- Understanding of healthcare cost drivers, utilization analytics, quality measures, and provider performance metrics
- Analytical, problem-solving, and communication skills with the ability to translate complex findings into business insights
- Experience with provider search, recommendation systems, ranking models, or personalization algorithms
- Knowledge of clinical quality measures such as HEDIS, CMS, or related healthcare standards
- Experience applying machine learning techniques in healthcare, health technology, or navigation environments
- Bachelor's degree in data science, Statistics, Mathematics, Computer Science, Healthcare Analytics, or a related field
- Applicants must reside in the United States in one of the 50 States or the District of Columbia in order to be considered for this role
- Proof will be required to verify US citizenship status at time of hire
- Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not, now or in the future, require sponsorship of a visa for employment authorization in the Employing Country and with Alight
- Advanced degree preferred
Benefits
- Health, dental and vision coverages starting Day One
- Wellbeing programs
- Retirement plans with contribution matching
- Generous time off
- Parental leave
- Continuing education
- Career growth opportunities
- Flexible working arrangements wherever possible
- Bonus and/or incentive eligibility, determined by role and level
Company Overview