Principal Data Scientist

Benefits:

401(k)

401(k) matching

Competitive salary

Dental insurance

Health insurance

Paid time off

Tuition assistance

Vision insurance

About the Role

We are seeking a Principal Data Scientist to lead the design, maintenance, and annual evolution of risk assessment and compliance analytics solutions supporting CMS Marketplace oversight programs. This role sits at the intersection of regulatory data science, risk modeling, and federal program oversight driving the analytical frameworks used to evaluate and prioritize compliance risk across QHP issuers, web brokers, agents/brokers, and Direct Enrollment (DE/EDE) entities.

What You Will Do

· Lead development and ongoing refinement of structured risk assessment methodologies, including changes to data sources, measure design, risk attribution logic, and scoring calculations.

· Design and develop compliance risk dashboards and performance monitoring tools adopted by CMS policy and audit stakeholders for operational decision-making, leveraging data visualization platforms such as Power BI, Tableau, or MS Excel.

· Design data-driven methodologies to identify and quantify compliance risk using multi-source datasets, including the preparation and maintenance of composite measure frameworks and multi-stage risk scoring pipelines.

· Support issuer compliance reviews, DE/EDE audits, and agent/broker oversight activities by translating regulatory requirements into technical specifications and testable data logic.

· Develop AI and machine learning solutions with explainability to prioritize and detect noncompliance, and implement agentic AI workflows that automate ingestion, validation, and normalization of compliance data.

· Support development and maintenance of machine-readable public use files (PUFs) and associated validation logic.

· Integrate and harmonize CMS data systems to produce actionable insights and executive reporting, ensuring risk scoring outputs are clearly communicated to non-technical and senior stakeholders.

· Collaborate with CMS policy, audit, and IT teams to continuously enhance oversight systems and analytical processes.

What We Are Looking For

· Bachelor’s degree (Master’s preferred) in Data Science, Computer Science, Information Systems, Statistics, Public Health, Health Informatics, or related field.

· 5+ years of hands-on experience in advanced analytics or data science within regulated environments such as healthcare, insurance, government, or financial services.

· 3+ years of experience leading technical or cross-functional teams.

· Proven experience building risk scoring methodologies, predictive models, or compliance analytics frameworks involving multi-source datasets.

· Proficiency in Python and/or R, SQL, and structured data analysis (SAS experience a plus) and experience using Databricks.

· Experience working with large, complex, multi-source datasets.

· Expert-level proficiency in data visualization platforms (Power BI, Tableau, or MS Excel) with demonstrated experience producing dashboards for senior and non-technical stakeholders in a regulatory or federal program environment.

· Strong ability to communicate technical methodology and findings clearly to non-technical and executive stakeholders.

· Ability to pass a background investigation or federal security clearance for contracted project work; holding an active CMS Enterprise User Administration (EUA) ID is desired.

Preferred Experience

· Experience supporting CMS, CCIIO, ACA Marketplace, or other federal oversight programs.

· Familiarity with QHP compliance reviews, DE/EDE, or agent/broker oversight, agent/broker oversight, or the ACA regulatory framework.

· Experience developing explainable AI or human-in-the-loop decision support tools.

· Experience with methodology documentation, SOP development, or audit-ready analytical frameworks

This is a remote position.