Clarity on the Role:
Wellvana is looking for a Sr. Director of Data Science to lead the development of data science capabilities that deliver actionable models to drive informed decision making by both internal and external partners in our value-based care contracts. This role requires expertise in identification and risk stratification, population health, value-based care, risk adjustment methodologies, and data analytics, as well as strong leadership, communication, and cross-functional collaboration.
The Sr. Director of Data Science serves as the strategic and technical leader for all predictive modeling and advanced analytics supporting Medicare physician value-based care programs and will be instrumental in building an onshore and offshore team as we expand our business.
Primary Job Duties & Responsibilities:
- Lead and execute the data science strategy for Medicare value-based care, focusing on risk identification, stratification, and predictive modeling
- Build, maintain and evaluate models for high-risk/rising-risk identification, avoidable utilization, chronic condition progression, and care-management prioritization
- Collaborate with clinical and operations teams to embed predictive insights into workflows and provider platforms.
- Oversee model governance, monitoring, and ML Ops pipelines to ensure reliability and scalability
- Manage data science talent, establish best practices, and guide execution across projects
- Work cross-functionally with clinical, analytics, actuarial, engineering, and partner success teams to support organizational goals
- Defines data science strategies and methodologies for specific projects, applying domain knowledge and expertise to drive impactful outcomes
- Conducts assessments for data science initiatives, such as identifying potential vulnerabilities, proposing mitigation strategies, and rationalization and selection of preferred AI/ML technology
- Manage team performance through regular, timely feedback as well as the formal performance review process to ensure delivery of exceptional services and engagement, motivation, and team development
- Stays abreast of industry trends and emerging technologies, continuously enhancing skills and knowledge to contribute effectively as an independent contributor in the field of data science
What’s Required:
- Integrity: The right way is the only way.
- Dependability: You do what you say you’re going to do.
- Advocacy: You fight for the best possible outcome for providers and their patients.
- Clarity: You make it all understandable.
- Bachelor's degree in a quantitative field such as Actuarial Science, Statistics, Economics, or Mathematics. Advanced degree is a plus.
- 15+ years of experience in healthcare data science with deep knowledge of Medicare Advantage and value-based care.
- Proven success developing and operationalizing risk models.
- Strong leadership, communication, and stakeholder management skills.
- Expertise in Python or R, cloud-based ML platforms, and modern ML Ops practices.
- Extensive experience in healthcare analytics (10+ years), with a focus on population health management, value-based care, and risk adjustment
- The ideal candidate has worked previously with a healthcare payer or risk bearing entity
- Strong knowledge of healthcare data sources, including electronic health records (EHRs), claims data, social determinants of health (SDOH), CMS Virtual Research Data Center (VRDC) and other relevant data sets
- Deep understanding of value-based care models, including risk adjustment methodologies (e.g., HCC)
- Experience with healthcare analytics platforms and technologies, such as data warehouses, business intelligence tools, and machine learning frameworks
- Proven track record of driving successful analytics initiatives and achieving measurable outcomes in population health management and value-based care
- Strong leadership skills with the ability to effectively communicate complex analytics concepts to diverse audiences, including executive leadership, clinicians, and non-technical stakeholders
- Excellent problem-solving and critical thinking abilities
- Familiarity with healthcare regulatory and related requirements, such as HIPAA, PHI, HCC, ICD-10, etc. and a commitment to maintaining data privacy and security
- Familiarity with claims grouping software and output such as Optum Symmetry Groupers or Milliman HCG Groupers
- Preference given to Nashville based candidates or those open to relocating to Nashville