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Data Scientist IV - Medicare, ACA, Risk Adjustment

Kaiser Permanente

Software and Technology Jobs

Data Scientist IV - Medicare, ACA, Risk Adjustment

full-timePosted: Jan 13, 2026

Job Description

Remote from any KP location in CA, OR, CO, WA, GA, MD, VA, HI or D.C. Only. 
** PLEASE NOTE: Salary ranges are geographically based and the posted range reflects the Northen CA region. Lower salary ranges will apply for other labor markets outside of NCAL

 

Overview:

The Prospective Risk Adjustment Operations team is seeking a Data Scientist to support scoping, deploying, and reporting out on projects to support prospective risk adjustment projects. This pivotal role will support the development of foundational reporting and analytical frameworks crucial for identifying and prioritizing prospective risk initiatives, developing and supporting comprehensive reporting and insightful visualization of opportunities and outcomes, and directly supporting strategic decision-making and operational excellence. Ideal candidates will possess robust analytical skills and a proven ability to translate complex data into actionable business intelligence within a dynamic healthcare environment. This position offers a significant opportunity to contribute to the organization's continued success in risk adjustment.

This role requires a background in technical coding (i.e SQL, Python, R etc.) or other statistical modeling programs.  Familiarity with data science disciplines (i.e machine learning, predictive analytics, data visualization etc.), data modeling is preferred.

Job Summary:

This individual contributor is primarily responsible for designing and developing data pipelines and automation for data acquisition and ingestion of raw data from multiple data sources and data formats by transforming, cleansing, and storing data for consumption. This role is also responsible for developing detailed problem statements outlining hypotheses and their effect on target clients/customers, analyzing and investigating complex data sets and summarizing key characteristics, selecting, manipulating and transforming data into features used in machine learning algorithms, training statistical models, deploying and maintaining reliable and efficient models through production, verifying model performance, and collaborating with internal and external stakeholders across domains to develop and deliver statistical driven outcomes.


Essential Responsibilities:
  • Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome.
  • Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions.
  • Develops detailed problem statements outlining hypotheses and their effect on target clients/customers by defining scope, objectives, outcome statements and metrics.
  • Designs and develops data pipelines and automation for data acquisition and ingestion of raw data from multiple data sources and data formats by transforming, cleansing, and storing data for consumption by downstream processes; writing and optimizing diverse SQL queries; and demonstrating advanced knowledge of database fundamentals.
  • Analyzes and investigates complex data sets and summarizes key characteristics by employing data visualization methods; and determining how best to manipulate data sources to discover patterns, spot anomalies, test hypotheses, and/or check assumptions.
  • Selects, manipulates, and transforms data into features used in machine learning algorithms by leveraging techniques to conduct dimensionality reduction, feature importance, and feature selection.
  • Trains statistical models by using algorithms and data mining techniques; testing models with various algorithms to assess the input dataset and related features; and applying techniques to prevent overfitting such as cross-validation.
  • Deploys and maintains reliable and efficient models through production.
  • Verifies model performance by demonstrating expertise in the practice of a variety of model validation techniques to assess and discriminate the goodness of model fit; and leveraging feedback and output to manage and strengthen model performance.
  • Collaborates with internal and external stakeholders across domains to develop and deliver statistical driven outcomes by delivering insights and values from heterogeneous data to investigate complex problems for multiple use cases; driving informed decision-making; and presenting findings to both technical and non-technical audiences.

Locations

  • Oakland, California, United States

Salary

Estimated Salary Rangemedium confidence

90,000 - 150,000 USD / yearly

Source: ai estimated

* This is an estimated range based on market data and may vary based on experience and qualifications.

Skills Required

  • SQLintermediate
  • Pythonintermediate
  • Rintermediate
  • statistical modelingintermediate
  • machine learningintermediate
  • predictive analyticsintermediate
  • data visualizationintermediate
  • data modelingintermediate

Required Qualifications

  • background in technical coding (experience)
  • familiarity with data science disciplines (experience)

Responsibilities

  • designing and developing data pipelines
  • automation for data acquisition and ingestion
  • transforming, cleansing, and storing data
  • developing detailed problem statements
  • analyzing complex data sets
  • selecting, manipulating and transforming data into features for machine learning

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SQLPythonRstatistical modelingmachine learningpredictive analyticsdata visualizationdata modelingHealthcare

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Kaiser Permanente logo

Data Scientist IV - Medicare, ACA, Risk Adjustment

Kaiser Permanente

Software and Technology Jobs

Data Scientist IV - Medicare, ACA, Risk Adjustment

full-timePosted: Jan 13, 2026

Job Description

Remote from any KP location in CA, OR, CO, WA, GA, MD, VA, HI or D.C. Only. 
** PLEASE NOTE: Salary ranges are geographically based and the posted range reflects the Northen CA region. Lower salary ranges will apply for other labor markets outside of NCAL

 

Overview:

The Prospective Risk Adjustment Operations team is seeking a Data Scientist to support scoping, deploying, and reporting out on projects to support prospective risk adjustment projects. This pivotal role will support the development of foundational reporting and analytical frameworks crucial for identifying and prioritizing prospective risk initiatives, developing and supporting comprehensive reporting and insightful visualization of opportunities and outcomes, and directly supporting strategic decision-making and operational excellence. Ideal candidates will possess robust analytical skills and a proven ability to translate complex data into actionable business intelligence within a dynamic healthcare environment. This position offers a significant opportunity to contribute to the organization's continued success in risk adjustment.

This role requires a background in technical coding (i.e SQL, Python, R etc.) or other statistical modeling programs.  Familiarity with data science disciplines (i.e machine learning, predictive analytics, data visualization etc.), data modeling is preferred.

Job Summary:

This individual contributor is primarily responsible for designing and developing data pipelines and automation for data acquisition and ingestion of raw data from multiple data sources and data formats by transforming, cleansing, and storing data for consumption. This role is also responsible for developing detailed problem statements outlining hypotheses and their effect on target clients/customers, analyzing and investigating complex data sets and summarizing key characteristics, selecting, manipulating and transforming data into features used in machine learning algorithms, training statistical models, deploying and maintaining reliable and efficient models through production, verifying model performance, and collaborating with internal and external stakeholders across domains to develop and deliver statistical driven outcomes.


Essential Responsibilities:
  • Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome.
  • Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions.
  • Develops detailed problem statements outlining hypotheses and their effect on target clients/customers by defining scope, objectives, outcome statements and metrics.
  • Designs and develops data pipelines and automation for data acquisition and ingestion of raw data from multiple data sources and data formats by transforming, cleansing, and storing data for consumption by downstream processes; writing and optimizing diverse SQL queries; and demonstrating advanced knowledge of database fundamentals.
  • Analyzes and investigates complex data sets and summarizes key characteristics by employing data visualization methods; and determining how best to manipulate data sources to discover patterns, spot anomalies, test hypotheses, and/or check assumptions.
  • Selects, manipulates, and transforms data into features used in machine learning algorithms by leveraging techniques to conduct dimensionality reduction, feature importance, and feature selection.
  • Trains statistical models by using algorithms and data mining techniques; testing models with various algorithms to assess the input dataset and related features; and applying techniques to prevent overfitting such as cross-validation.
  • Deploys and maintains reliable and efficient models through production.
  • Verifies model performance by demonstrating expertise in the practice of a variety of model validation techniques to assess and discriminate the goodness of model fit; and leveraging feedback and output to manage and strengthen model performance.
  • Collaborates with internal and external stakeholders across domains to develop and deliver statistical driven outcomes by delivering insights and values from heterogeneous data to investigate complex problems for multiple use cases; driving informed decision-making; and presenting findings to both technical and non-technical audiences.

Locations

  • Oakland, California, United States

Salary

Estimated Salary Rangemedium confidence

90,000 - 150,000 USD / yearly

Source: ai estimated

* This is an estimated range based on market data and may vary based on experience and qualifications.

Skills Required

  • SQLintermediate
  • Pythonintermediate
  • Rintermediate
  • statistical modelingintermediate
  • machine learningintermediate
  • predictive analyticsintermediate
  • data visualizationintermediate
  • data modelingintermediate

Required Qualifications

  • background in technical coding (experience)
  • familiarity with data science disciplines (experience)

Responsibilities

  • designing and developing data pipelines
  • automation for data acquisition and ingestion
  • transforming, cleansing, and storing data
  • developing detailed problem statements
  • analyzing complex data sets
  • selecting, manipulating and transforming data into features for machine learning

Target Your Resume for "Data Scientist IV - Medicare, ACA, Risk Adjustment" , Kaiser Permanente

Get personalized recommendations to optimize your resume specifically for Data Scientist IV - Medicare, ACA, Risk Adjustment. Takes only 15 seconds!

AI-powered keyword optimization
Skills matching & gap analysis
Experience alignment suggestions

Check Your ATS Score for "Data Scientist IV - Medicare, ACA, Risk Adjustment" , Kaiser Permanente

Find out how well your resume matches this job's requirements. Get comprehensive analysis including ATS compatibility, keyword matching, skill gaps, and personalized recommendations.

ATS compatibility check
Keyword optimization analysis
Skill matching & gap identification
Format & readability score

Tags & Categories

SQLPythonRstatistical modelingmachine learningpredictive analyticsdata visualizationdata modelingHealthcare

Answer 10 quick questions to check your fit for Data Scientist IV - Medicare, ACA, Risk Adjustment @ Kaiser Permanente.

Quiz Challenge
10 Questions
~2 Minutes
Instant Score

Related Books and Jobs

No related jobs found at the moment.