Strong medical coding and clinical domain expertise
Risk adjustment (hcc/raf) and clinical indications
Leveraging claims and clinical notes
Virtix Health LLC is seeking a Senior Data Scientist to support risk adjustment and quality initiatives in Value-Based Care programs, particularly within Medicare Advantage, ACA, and Medicaid. The ideal candidate should possess strong medical coding, clinical domain expertise, and experience in data science, particularly with NLP and AI technologies
Job Summary
Our purpose is to help clients exceed their financial health goals.
We build long-term careers by investing in YOU.
This role focuses primarily on Risk Adjustment (HCC/RAF) and clinical indications, leveraging claims and clinical notes to deliver accurate, explainable, complete, and compliant analytics.
Matching Summary
Match Score: 85
Virtix Health LLC is seeking a Senior Data Scientist to support risk adjustment and quality initiatives in Value-Based Care programs, particularly within Medicare Advantage, ACA, and Medicaid. The ideal candidate should possess strong medical coding, clinical domain expertise, and experience in data science, particularly with NLP and AI technologies.
Skills & Requirements
Must-have
Strong medical coding and clinical domain expertise
Risk Adjustment (HCC/RAF) and clinical indications
Leveraging claims and clinical notes
Advanced Python and SQL
Traditional NLP and modern AI (LLMs, GenAI)
AWS platform experience
Nice-to-have
Experience with ACA health plans and Medicaid
Familiarity with FHIR data
Exposure to quality/HEDIS initiatives
Knowledge of physician workflows
Experience with CDI policies and procedures
Key Requirements
Data science, biostatistics, bioinformatics, or clinical informatics background
Experience applying AI in regulated healthcare environments
Experience delivering explainable models in regulated environments
Clinical background and cross-referencing to medical record documentation