The FWA Data Science team is focused on transforming validated fraud, waste, and abuse (FWA) analytical prototypes into robust, scalable detection models for production implementation. This role includes ownership of model enhancement, feature engineering, calibration, validation, explainability, performance assessment, and continuous improvement throughout the solution lifecycle. The position involves close collaboration with Actuarial, Claims Integrity, and FWA AI Engineering teams to ensure FWA detection models are effective, relevant, and responsive to evolving fraud patterns post-deployment.
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Key Accountabilities:
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Model Industrialization Readiness:
- Assess AI/ML prototypes from Actuarial teams.
- Refine model logic and improve statistical rigor.
- Enhance feature engineering methodologies.
- Validate and clarify prototype assumptions.
- Develop explainable detection methodologies.
- Support migration of approved analytical models to cloud-based solutions.
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Detection Model Development & Enhancement:
- Improve and retrain FWA models using new data and investigation outcomes.
- Develop advanced fraud detection features and improve operational effectiveness.
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Model Validation & Performance Science:
- Define and monitor model success metrics and perform false-positive and false-negative analysis post-deployment.
- Validate model outputs with investigators.
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Fraud Intelligence & Pattern Evolution:
- Analyze investigation outcomes and identify emerging fraud behaviors.
- Design new detection features and recommend model modifications.
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Continuous Model Optimization:
- Monitor business effectiveness of deployed models and recommend retraining activities.
Skills Required:
- Proficiency in Python, SQL, and SAS
- Knowledge of Machine Learning, Statistical Analysis, Feature Engineering, and Model Validation
- Experience in FWA/Fraud Analytics and Healthcare Claims Analytics
- Familiarity with Google Cloud Platform (GCP) and Power BI for data visualization
- Strong problem-solving, stakeholder management, and communication skills
Education:
Bachelor’s Degree in Computer Science, Data Science, Artificial Intelligence, or a related field
Location:
Jiddah, Makkah, Saudi Arabia
Work Conditions:
On-site, Full-time
Language Requirements:
(Any language requirements were not specified in the job listing.)
Benefits:
