Overview :

Cotiviti is seeking a Data Scientist to lead the development of advanced classification and predictive systems for healthcare risk adjustment and ICD-10 code classification.

This role will focus on building intelligent NLP systems that analyze clinical charts and encounters to accurately identify and classify ICD-10 codes through sophisticated pattern recognition, machine learning, and natural language processing techniques.

Responsibilities :

- Lead development of NLP-based classification systems for ICD-10 code identification from clinical charts and encounters.

- Design and implement deep learning models using PyTorch and transformer architectures for medical text analysis.

- Build and optimize machine learning models for accurate risk adjustment coding and HCC classification.

- Develop decision support systems for automated ICD-10 code suggestion and validation.

- Create and maintain feature engineering pipelines for clinical text processing and model training.

- Implement model evaluation metrics and performance optimization strategies for healthcare coding accuracy.

- Produce comprehensive technical documentation and training materials for NLP models.

- Conduct system health checks and performance monitoring for deployed coding models.

- Collaborate with engineering teams to integrate ML/NLP solutions into production systems.

- Provide technical guidance on statistical modeling, transformer architectures, and algorithm selection.

- Support data pipeline design and implementation for clinical text analytical workflows.

- Participate in code reviews and maintain high standards for code quality.

- Experience with distributed computing frameworks and big data technologies for processing large volumes of clinical data.

- Mentor junior scientists and analysts in machine learning, NLP, and artificial intelligence best practices.

- Track record of using assistive AI technology to improve quality and efficiency of modeling and analytics.

- Complete all responsibilities as outlined in the annual performance review and/or goal setting.

- Complete all special projects and other duties as assigned.

Required :

Must be able to perform duties with or without reasonable accommodation.

Qualifications :

- Bachelor's degree in Computer Science, Statistics, Mathematics, Data Science, or related field; Master's in Data Science or related field preferred.

- 3+ years of experience in machine learning and AI with focus on NLP, classification, and predictive systems.

- Strong expertise in PyTorch and transformer architectures (BERT, RoBERTa, etc.) for text classification.

- Advanced Python programming skills with experience in NLP frameworks and libraries.

- Experience with healthcare claims data, clinical text processing, and ICD-10 coding systems preferred.

- Knowledge of risk adjustment methodologies and HCC (Hierarchical Condition Categories) coding.

- Experience with feature engineering techniques for clinical text and model evaluation methodologies.

- Experience with model deployment and monitoring in production environments.

- Understanding of data quality frameworks and error detection methodologies for healthcare coding.

- Strong analytical and problem-solving skills with focus on clinical data challenges.

- Excellent communication skills with ability to explain technical NLP concepts clearly.

- Experience with version control systems and collaborative development practices.

- Expertise with SQL and data manipulation tools for healthcare datasets.