CGI Group, LLC
HealthCare Claims Intelligence Engineer
CGI Group, LLC, Knoxville, Tennessee, United States, 37955
HealthCare Claims Intelligence Engineer
Position Description CGI is seeking a highly motivated, self learner, creative and passionate Junior Engineer to Support Claim Intelligence and Healthcare Analytics. This Claim Intelligence Engineer is responsible for leveraging advanced technologies such as API Development, Python Programming, machine learning (ML), data analysis, Business Intelligence and Data Visualizations to streamline the claims processing, Payment Integrity and healthcare analytics systems. This role focuses on developing, implementing, and improving Advance Analytics solution that aims to perform claims analysis, fraud detection, and overall operational efficiency.
Your future duties and responsibilities AI/ML Model Development: Design, develop, and deploy AI/ML models to analyze claims data, predict outcomes, and detect anomalies. Build models for claims automation, fraud detection, risk assessment, and claims validation.
Data Engineering: Use of Python, PySpark or ADF to ingest and transform dataset needed for analytics purpose.
Advance Analytics and Visualization: Analyze large volumes of claims and health care data to identify trends, patterns, and identify missing edit opportunities. Collaborate with data scientists to extract insights that help optimize claims processing and reduce time to settlement. Develop Power BI visualization to show operational and prescriptive analytics.
Backend Development: Responsible for developing APIs for data consumption and support microservice based orchestrations.
Run & Maintain : Continuously monitor the performance of AI/ML models and make necessary adjustments to improve accuracy and efficiency. Operation support of all data ingestions, engineering and APIs.
Compliance and Data Security: Responsible to understand data security and Industry compliance and ensure that all development is comply with relevant industry regulations and data privacy laws.
Required qualifications to be successful in this role Bachelor's degree with 5 years of experience or master's degree in computer science or Equivalent Excellent ability to analyze complex data sets and identify actionable insights. Strong critical thinking to develop intelligent solutions for claims processing and Edit detection. Strong proficiency in AI/ML frameworks (e.g., TensorFlow, PyTorch) and data analytics tools like Power BI/Tableau Strong hands-on knowledge with data processing tools such as Python, Databricks, R, SAS, SQL, or similar ETL tools. Should be able to work on Azure/AWS/GCP Platform Should be able to do backend API development Understand CI/CD and DevOps process. Knowledge of claims processing systems and insurance-related software is an advantage.
*CGI is required by law in some jurisdictions to include a reasonable estimate of the compensation range for this role. The determination of this range includes various factors not limited to: skill set level; experience and training; and licensure and certifications. CGI typically does not hire individuals at or near the top of the range for their role. Compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $50,000 -$91,700.
At CGI we call our professionals CGI Partners to reinforce that all who join our team are, as owners, empowered to participate in the challenges and rewards that come from building a world-class company. CGIs benefits include:
CGI's benefits are offered to eligible professionals on their first day of employment to include: Competitive compensation Comprehensive insurance options Matching contributions through the 401(k) plan and the share purchase plan Paid time off for vacation, holidays, and sick time Paid parental leave Learning opportunities and tuition assistance My Assistance Program & other wellness programs
#CSG-TMC-F24 #LI-KB5
Together, as owners, let's turn meaningful insights into action.
Life at CGI is rooted in ownership, teamwork, respect and belonging. Here, you'll reach your full potential because...
You are invited to be an owner from day 1 as we work together to bring our Dream to life. That's why we call ourselves CGI Partners rather than employees. We benefit from our collective success and actively shape our company's strategy and direction.
Your work creates value. You'll develop innovative solutions and build relationships with teammates and clients while accessing global capabilities to scale your ideas, embrace new opportunities, and benefit from expansive industry and technology expertise.
You'll shape your career by joining a company built to grow and last. You'll be supported by leaders who care about your health and well-being and provide you with opportunities to deepen your skills and broaden your horizons.
Come join our team-one of the largest IT and business consulting services firms in the world.
Qualified applicants will receive consideration for employment without regard to their race, ethnicity, ancestry, color, sex, religion, creed, age, national origin, citizenship status, disability, pregnancy, medical condition, military and veteran status, marital status, sexual orientation or perceived sexual orientation, gender, gender identity, and gender expression, familial status or responsibilities, reproductive health decisions, political affiliation, genetic information, height, weight, or any other legally protected status or characteristics.
CGI provides reasonable accommodations to qualified individuals with disabilities. If you need an accommodation to apply for a job in the U.S., please email the CGI U.S. Employment Compliance mailbox at US_Employment_Compliance@cgi.com . You will need to reference the Position ID of the position in which you are interested. Your message will be routed to the appropriate recruiter who will assist you. Please note, this email address is only to be used for those individuals who need an accommodation to apply for a job. Emails for any other reason or those that do not include a Position ID will not be returned.
We make it easy to translate military experience and skills! Click here to be directed to our site that is dedicated to veterans and transitioning service members.
All CGI offers of employment in the U.S. are contingent upon the ability to successfully complete a background investigation. Background investigation components can vary dependent upon specific assignment and/or level of US government security clearance held. Dependent upon role and/or federal government security clearance requirements, and in accordance with applicable laws, some background investigations may include a credit check. CGI will consider for employment qualified applicants with arrests and conviction records in accordance with all local regulations and ordinances.
CGI will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with CGI's legal duty to furnish information.
Position Description CGI is seeking a highly motivated, self learner, creative and passionate Junior Engineer to Support Claim Intelligence and Healthcare Analytics. This Claim Intelligence Engineer is responsible for leveraging advanced technologies such as API Development, Python Programming, machine learning (ML), data analysis, Business Intelligence and Data Visualizations to streamline the claims processing, Payment Integrity and healthcare analytics systems. This role focuses on developing, implementing, and improving Advance Analytics solution that aims to perform claims analysis, fraud detection, and overall operational efficiency.
Your future duties and responsibilities AI/ML Model Development: Design, develop, and deploy AI/ML models to analyze claims data, predict outcomes, and detect anomalies. Build models for claims automation, fraud detection, risk assessment, and claims validation.
Data Engineering: Use of Python, PySpark or ADF to ingest and transform dataset needed for analytics purpose.
Advance Analytics and Visualization: Analyze large volumes of claims and health care data to identify trends, patterns, and identify missing edit opportunities. Collaborate with data scientists to extract insights that help optimize claims processing and reduce time to settlement. Develop Power BI visualization to show operational and prescriptive analytics.
Backend Development: Responsible for developing APIs for data consumption and support microservice based orchestrations.
Run & Maintain : Continuously monitor the performance of AI/ML models and make necessary adjustments to improve accuracy and efficiency. Operation support of all data ingestions, engineering and APIs.
Compliance and Data Security: Responsible to understand data security and Industry compliance and ensure that all development is comply with relevant industry regulations and data privacy laws.
Required qualifications to be successful in this role Bachelor's degree with 5 years of experience or master's degree in computer science or Equivalent Excellent ability to analyze complex data sets and identify actionable insights. Strong critical thinking to develop intelligent solutions for claims processing and Edit detection. Strong proficiency in AI/ML frameworks (e.g., TensorFlow, PyTorch) and data analytics tools like Power BI/Tableau Strong hands-on knowledge with data processing tools such as Python, Databricks, R, SAS, SQL, or similar ETL tools. Should be able to work on Azure/AWS/GCP Platform Should be able to do backend API development Understand CI/CD and DevOps process. Knowledge of claims processing systems and insurance-related software is an advantage.
*CGI is required by law in some jurisdictions to include a reasonable estimate of the compensation range for this role. The determination of this range includes various factors not limited to: skill set level; experience and training; and licensure and certifications. CGI typically does not hire individuals at or near the top of the range for their role. Compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $50,000 -$91,700.
At CGI we call our professionals CGI Partners to reinforce that all who join our team are, as owners, empowered to participate in the challenges and rewards that come from building a world-class company. CGIs benefits include:
CGI's benefits are offered to eligible professionals on their first day of employment to include: Competitive compensation Comprehensive insurance options Matching contributions through the 401(k) plan and the share purchase plan Paid time off for vacation, holidays, and sick time Paid parental leave Learning opportunities and tuition assistance My Assistance Program & other wellness programs
#CSG-TMC-F24 #LI-KB5
Together, as owners, let's turn meaningful insights into action.
Life at CGI is rooted in ownership, teamwork, respect and belonging. Here, you'll reach your full potential because...
You are invited to be an owner from day 1 as we work together to bring our Dream to life. That's why we call ourselves CGI Partners rather than employees. We benefit from our collective success and actively shape our company's strategy and direction.
Your work creates value. You'll develop innovative solutions and build relationships with teammates and clients while accessing global capabilities to scale your ideas, embrace new opportunities, and benefit from expansive industry and technology expertise.
You'll shape your career by joining a company built to grow and last. You'll be supported by leaders who care about your health and well-being and provide you with opportunities to deepen your skills and broaden your horizons.
Come join our team-one of the largest IT and business consulting services firms in the world.
Qualified applicants will receive consideration for employment without regard to their race, ethnicity, ancestry, color, sex, religion, creed, age, national origin, citizenship status, disability, pregnancy, medical condition, military and veteran status, marital status, sexual orientation or perceived sexual orientation, gender, gender identity, and gender expression, familial status or responsibilities, reproductive health decisions, political affiliation, genetic information, height, weight, or any other legally protected status or characteristics.
CGI provides reasonable accommodations to qualified individuals with disabilities. If you need an accommodation to apply for a job in the U.S., please email the CGI U.S. Employment Compliance mailbox at US_Employment_Compliance@cgi.com . You will need to reference the Position ID of the position in which you are interested. Your message will be routed to the appropriate recruiter who will assist you. Please note, this email address is only to be used for those individuals who need an accommodation to apply for a job. Emails for any other reason or those that do not include a Position ID will not be returned.
We make it easy to translate military experience and skills! Click here to be directed to our site that is dedicated to veterans and transitioning service members.
All CGI offers of employment in the U.S. are contingent upon the ability to successfully complete a background investigation. Background investigation components can vary dependent upon specific assignment and/or level of US government security clearance held. Dependent upon role and/or federal government security clearance requirements, and in accordance with applicable laws, some background investigations may include a credit check. CGI will consider for employment qualified applicants with arrests and conviction records in accordance with all local regulations and ordinances.
CGI will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with CGI's legal duty to furnish information.