Interview guides · Cambia Health Solutions

Cambia Health Solutions Data Scientist Interview Questions & Guide 2026

SQL practice for Cambia Health Solutions data scientist candidates: window functions, funnel and retention queries, joins that quietly drop rows.

The 60-second brief

At Cambia Health Solutions, a Data Scientist plays a pivotal role in transforming healthcare by leveraging data-driven insights to improve clinical outcomes, lower costs, and personalize the member experience. As a family of companies dedicated to making healthcare more consumer-centric, Cambia Health Solutions relies on its data science teams to build predictive models and analytical frameworks that directly impact millions of members. You will be working at the intersection of machine learning, statistical modeling, and healthcare economics to solve some of the industry's most complex challenges.

How much statistics you need depends on the flavour of the seat. Experiment-facing work wants you deep enough to notice that repeated looks at accumulating data inflate the false positive rate of a fixed-sample test; modelling-facing work wants estimation and honest uncertainty intervals.

Focus areas

Correct for claims runout before reporting recent months
Separate censoring from events in time-to-event models
Risk-adjust outcomes before comparing providers or panels

Overview

The impact of this position is felt across multiple business lines, from predicting member health risks and optimizing care management paths to analyzing financial structures like deductibles and claims. By joining this team, you will contribute to products and initiatives that make healthcare simpler, more transparent, and more accessible. Whether you are developing algorithms to detect fraud, waste, and abuse or building recommendation systems for personalized wellness plans, your work will directly drive strategic business decisions.

What makes the Data Scientist role at Cambia Health Solutions particularly compelling is the scale and richness of the data. You will have access to massive, diverse datasets containing longitudinal health records, claims data, and consumer behavioral metrics. Navigating this highly regulated environment requires a unique blend of technical rigor, creative problem-solving, and domain curiosity. It is an inspiring space where your technical solutions translate directly into healthier lives and a more efficient healthcare system.

The Cambia Health Solutions interview process

Cambia Health Solutions candidates report 6 rounds · ≈ 4-6 weeks. The stages below are what candidates describe, not a published process.

Recruiter Screen

A screening call is a matching exercise run by someone who will not evaluate your statistics. They are checking that the work described on your resume is work you personally did, and that its scope matches the level the role is written for. Logistics get settled in the same half hour so nobody spends an interviewer's afternoon on a mismatch. The answer that fails is the one narrated in the plural. If every sentence is 'we built' and 'the team decided', there is nothing specific to write down about you. Name the piece that was yours, the decision you made inside it, and what changed after.

What to demonstrate

Whether the ownership implied by your resume survives one round of follow-up about who actually did which part
Whether your described scope (data size, stakeholders, what shipped) matches the seniority the role is written at
Whether timeline, location and compensation expectations make the rest of the loop worth scheduling

How to prepare

Rewrite your top three resume bullets in the first person singular, each with the decision you made and what moved afterwards, then say them out loud once so the 'we' does not return under pressure
Attach one number to each project: the baseline, the change, and the window it was measured over. Where impact was never measured, say that plainly rather than inventing a figure
Settle your compensation range before the call and give it as a range with a reason behind it, such as current total comp or a competing timeline, instead of deflecting the question twice

Technical Discussions

Before anything else, this round is a reading test. You are given a small schema and a question phrased in business language, and most of the difficulty sits in the gap between them. Who counts as an active user, does a refunded order still count as an order, is that date column an event time or a load time. Weak answers start typing immediately and compute something precise about the wrong population. Strong ones pin the definition in one sentence, name the column that encodes it, then write the query. On a timed assessment with nobody to tell, write the definition in a comment anyway.

What to demonstrate

Whether an ambiguous term becomes a specific column and filter before any computation happens
Whether you read the schema for keys and cardinality rather than only for column names
Whether the result answers the question at the grain it was asked at, per user or per session or per day

How to prepare

Take three metrics you already use and write down the exact filter and exact grain behind each, then practise stating one of them in a single sentence out loud
On a schema you have never seen, spend the first minute writing what one row of each table means and which key it is unique on, then predict which joins can duplicate rows
Rehearse a version where the definition changes halfway through, and edit the query you have instead of starting over

Practical Assessments

This round decides whether someone can hand you a schema and a question and trust the number that comes back. Correctness under a clock is the bar, not clever syntax. The habit that separates strong from weak answers is checking the grain: after every join, know how many rows you expect and whether the count moved. Most wrong answers in this format are not wrong logic, they are a fan-out from a key that turned out not to be unique, or a filter applied before an aggregate when it belonged after. Say what you expect before you run it.

What to demonstrate

Whether your row counts survive each join, and whether you notice on your own when they do not
Deliberate handling of rows that fail to match, including whether the question needs an inner join or a left join with the non-matches kept and counted
Whether NULLs are treated on purpose, given that a NULL compares equal to nothing and that COUNT of a column skips it
Reaching a defensible answer inside the window instead of a refined one after it

How to prepare

Take a two-table schema, write a join that fans out on purpose, then fix it by collapsing the many-side to one row per key before joining. Repeat until the fix is reflex rather than recall.
Write a funnel as one query and print the distinct user count at each stage, then confirm each stage is a subset of the one above it rather than assuming it
Do a few timed runs in a plain text box with no autocomplete and no formatter, since assessment editors often have neither

Team Interactions

An added round often puts you in front of someone outside the core hiring team: a partner engineer, a product owner, a domain expert, sometimes a more senior manager. The question they are really asking is not whether you can do the work but whether they would trust a number that came from you. That changes what a good answer looks like. Lead with what the decision cost and what it changed, keep the method available but not central, and be plain about the limits of your evidence. Overstating a result is the fastest way to lose this round.

What to demonstrate

Whether you can explain a technical choice to someone who will never read your code, without either flattening it into nothing or hiding inside jargon
Honesty about evidence strength: what the analysis establishes, what it only suggests, and what it cannot say at all
How you take disagreement, specifically whether you update on a good objection, hold your position with reasons, or fold on contact

How to prepare

Write the two-sentence version of your most technical project for a non-specialist, then check that neither sentence needs a method name to make sense.
For one result you are proud of, write the strongest objection someone could raise and a response that concedes the part of it that is correct.
Prepare one decision that turned out to be wrong: how you found out, what it cost, and what you changed afterwards. A senior cross-functional interviewer asks for this more often than a technical one does.

Take-Home Assignment

Your submission is read asynchronously by someone who cannot ask you a clarifying question, and who will usually skim it before reading it properly. That changes what good looks like. The conclusion belongs near the top with the supporting analysis beneath it, and the code should run start to finish on a clean machine without a manual step you forgot to document. A reviewer forced to reconstruct your reasoning from the order of notebook cells is already discounting the work. The submissions that land are the ones where a busy reader gets the answer immediately and can verify it if they want to.

What to demonstrate

Whether the answer arrives before the methodology, so a reader who stops after the first page still has the recommendation
Whether the code runs end to end from the submitted files, with dependencies and data paths declared rather than assumed
Whether each chart is legible on its own, carrying axis labels and units, and exists to support a claim made in the text

How to prepare

Restructure a past analysis so the opening paragraph holds the recommendation and the number behind it, then check that nothing later in the document quietly contradicts it
Copy your own submission into an empty directory, run it in a clean environment, and fix everything that breaks; hidden local state is caught here or by the reviewer
For every chart, write the one sentence it is meant to prove, and delete the chart if you cannot write that sentence

Final Offer

A loop is not scored one interview at a time. The people you meet compare notes afterwards, usually in a meeting you are not in, and the outcome turns on what each of them can say about you when asked. That rewards something other than survival: every room needs one specific thing worth repeating, and none of them can contradict another. The common way to lose is to tell the same project four times with different numbers in it, or to be uniformly fine in a way that leaves nobody with anything to argue for.

What to demonstrate

Whether your account of a project survives being told twice, with the same scale, the same metric definition and the same numbers each time
Whether each interviewer leaves with one concrete claim they could make on your behalf later, rather than an absence of complaints
Whether a question you already answered in an earlier room gets the same answer at the same depth, without visible impatience

How to prepare

Write a one-page fact sheet for your two or three main projects that fixes the numbers you will quote: rows of data, the metric as a single sentence, the effect you measured and how long the work took. Say them aloud from the sheet until they come out identical every time
For each kind of room you expect, decide the one sentence you want that interviewer repeating in a debrief, then check during the mock that you said it outright instead of implying it
Rehearse answering the same project question twice in one sitting, the second time as though you had not just answered it, because the thing that needs fixing is the flatness that creeps into a repeated story

Where candidates lose points

Treating clinical measurements as missing at random

A lab result, a vital sign, or a screening exists because someone ordered it, and ordering tracks suspicion of disease, visit frequency, and site workflow. Imputing the mean or dropping incomplete rows biases the population estimate and can flip the sign of an association, because the untested are systematically healthier or systematically disengaged. The presence indicator is often more predictive than the value, which is a warning sign rather than a feature win: a model that learns test ordering will not transfer to a site with different protocols.

Reading the most recent months of a claims-based series as real

Claims incur before they are reported and paid, so recent incurred months are systematically undercounted until runout completes. The lag is not uniform: pharmacy adjudicates in days, professional claims in weeks, inpatient facility claims in months. That means recent data is both too low and mix-shifted toward cheap services, which reads as a cost improvement and a utilisation drop at once. The fix is to hold the last three incurred months back or apply completion factors, and to state the paid-through date on every chart.

Analysing at a different unit than the one randomised

Say out loud what was randomised (user, device, account, cluster) and make the analysis unit match, or account for the clustering with cluster-robust standard errors, the delta method, or aggregation up to the randomised unit. Randomising users and then running a test over sessions understates variance and inflates the false-positive rate.

Answering a product-sense question with a list of features

Answer with a decision and the measurement that would settle it: the hypothesis, the primary metric, the guardrails, and the result that would make you not ship. A feature brainstorm cannot be wrong, which is exactly why it earns no points.

Questions & practice

Explain the difference between supervised and unsupervised learning, and provide a real-world healthcare scenario where you would use each.

Medium · statistics and probability

Approach

Sanity-check the answer against a simple bound or a simulated case.
Write down the assumption the method needs before you use the method.
Quantify uncertainty explicitly rather than reporting a point estimate alone.

Follow-up

Which assumption here is most likely to be violated in practice?
What sample size would you need to detect an effect half this size?

Walk me through a probability problem involving conditional probability. How would you apply Bayes' theorem to diagnostic testing?

Medium · statistics and probability

Approach

Write down the assumption the method needs before you use the method.
Translate the result into the decision it informs, in one plain sentence.
Sanity-check the answer against a simple bound or a simulated case.

Follow-up

Which assumption here is most likely to be violated in practice?
How would you explain this result to someone who does not know statistics?

How do neural networks learn, and how do you determine when a deep learning approach is appropriate versus a traditional machine learning model?

Medium · machine learning and modelling

Approach

Pick an evaluation metric that matches the cost of each error type, not a default.
Frame the prediction: the label, the moment of prediction, and the action it triggers.
Check what information would not exist at prediction time, and exclude it.

Follow-up

What would you monitor after launch to know the model is still valid?
Where could label leakage enter this setup?

Proportion of days covered with shifted, truncated refill intervals

Hard · interval merging · adherence · path dependence

pharmacy_claim has fill_id, member_id, therapeutic_class_code, fill_date, days_supply, reversal_flag, reversed_fill_id. For one therapeutic class and a fixed 12-month window, compute proportion of days covered per member: distinct days on which a dispensed days_supply covers the day, divided by days from the member's first in-window fill through the window end. An early refill shifts coverage forward rather than stacking, and coverage is truncated at the window end. Drop both rows of every reversed pair. Return member_id, pdc, and the share at pdc >= 0.80 among members with at least 2 fills and at least 91 days of follow-up.

Approach

Remove reversals as pairs first. Drop every row with reversal_flag true, and also drop the fill_ids those rows point at through reversed_fill_id. Dropping only the flagged row leaves a dispense that was never collected in the exposure.
Walk fills per member in fill_date order carrying a cursor: start = max(fill_date, previous_end + 1 day), end = start + days_supply - 1. The shift is path dependent, so a plain cumsum over days_supply does not reproduce it. Use itertools.accumulate or a per-member loop over numpy arrays, not a row-wise apply over the whole frame.
Truncate the last interval at the window end before measuring. Without truncation a 90-day fill dispensed on the final day pushes the covered-day count past the denominator and PDC above 1.0.
Use the denominator the definition states: first in-window fill_date through window end, inclusive. Not a flat 365, and not first fill to last fill, which is a different metric that rewards early discontinuation.
Apply the eligibility filter before computing the >= 0.80 share, and report the size of that denominator next to the share. A share without its denominator is not reviewable.

Worked solution (40 min)

Filter to the therapeutic class and the window, then remove reversed pairs by dropping flagged rows and the fill_ids in reversed_fill_id.
Sort by member_id, fill_date. Per member, accumulate start = max(fill_date, prior_end + 1 day) and end = start + days_supply - 1.
Clip every interval's end at the window end and drop intervals whose start is past it.
Covered days per member = sum of (end - start + 1) over the shifted intervals, which are disjoint by construction.
Denominator = (window_end - first_fill_date).days + 1. Divide, then filter to members with >= 2 fills and denominator >= 91 and compute the share at or above 0.80.

Expected result: Per-member PDC in [0, 1], plus one share. Worked case: fills at day 0 (30 days), day 20 (30 days) and day 55 (30 days) in a 180-day denominator give intervals 0-29, 30-59 and 60-89, so 90 covered days and PDC = 0.50. Change the window to 60 days with fills at days 0, 20 and 40 and the shifted intervals truncate to 0-59, giving PDC = 1.00 while a days-supply sum would report 90/60 = 1.50.

Verify it yourself

No member has PDC above 1.0. Any value above 1.0 means intervals stacked instead of shifting, or the final interval was not truncated.
A member with a single 30-day fill at the start of a 180-day denominator scores 30/180 = 0.167 and is excluded from the share by the two-fill rule.
For one member, rebuild covered days as the size of a Python set of date ordinals over the raw fills and confirm it matches the interval arithmetic.
Shifting every fill_date forward by the same number of days changes each denominator but leaves the covered-day counts unchanged except at the truncation boundary.

Follow-up

How does PDC differ from medication possession ratio, and which of the two can exceed 1.0?
A member switches to a different ingredient inside the same therapeutic class mid-window. Should the intervals chain, and what does that do to the class-level number?
Members who die or lose coverage mid-window get a short denominator and often a high PDC. If you then compare mortality by adherence category, what bias have you built in and how do you remove it?

Write a function to merge two sorted arrays of patient records while maintaining chronological order.

Medium · sql and data manipulation

Approach

State the window function and its partition and ordering out loud before writing it.
Compute rates by summing numerator and denominator separately, never by averaging rates.
Handle the rows that do not match: a LEFT JOIN with a NULL check is usually the question.

Follow-up

How does the query change if the join becomes one-to-many?
How would you verify this result without re-running the same query?

Given a dataset of member claims, write a script in Python or SQL to find the top three most common diagnoses per demographic group.

Medium · sql and data manipulation

Approach

Check whether any join is one-to-many before aggregating, or the sums inflate.
State the window function and its partition and ordering out loud before writing it.
Compute rates by summing numerator and denominator separately, never by averaging rates.

Follow-up

How does the query change if the join becomes one-to-many?
What breaks if events arrive late or out of order?

Measure ninety-day primary care contact for an enrollment cohort

Easy · cohort analysis · conversion rate · date windows

member_enrollment gives span_id, member_id, product_type, effective_date and termination_date, which is NULL while a span is active. medical_claim_line gives member_id, service_start_date, procedure_code and claim_status. The cohort is members whose earliest 2025 span has effective_date in January 2025 and who stay covered at least 90 days from it. Return, by product_type, cohort size and the share with at least one paid claim line whose procedure_code is in a supplied list of evaluation-and-management office visit codes and whose service_start_date falls in the half-open window from effective_date to effective_date plus 90 days.

Approach

Build the cohort as one row per member before touching claims. Take the earliest 2025 span per member, require its effective_date in January, and require coverage to effective_date + 90 days, which means termination_date IS NULL OR termination_date >= effective_date + 89.
Use EXISTS for the numerator rather than a join. A member with four office visits must count once; joining and counting rows inflates the numerator and can push the rate above 1.
Keep the window half-open and anchored per member. Every member has a different effective_date, so a single fixed calendar window is a different metric and will not match the cohort definition.
Aggregate numerator and denominator in one pass with a conditional sum grouped by product_type, and carry the raw counts alongside the rate so the reader can see the denominator.
State the reportability rule on the output: the January cohort is not final until 90 days plus professional-claims runout have passed, so label the paid-through date.

Worked solution (15 min)

CTE first_span: per member, the 2025 span with the minimum effective_date, filtered to January effective dates.
Add the continuous-coverage requirement to that CTE using COALESCE(termination_date, DATE '9999-12-31').
Add an EXISTS subquery on medical_claim_line correlated on member_id, restricted to the code list, claim_status = 'paid', and service_start_date >= effective_date AND < effective_date + 90.
Group by product_type: COUNT(*) as cohort_size, SUM(CASE WHEN contacted THEN 1 ELSE 0 END) as contacted, and their quotient.
Print the paid-through date used, and re-run at a 30-day window to confirm the rate falls.

Expected result: One row per product_type with cohort_size, contacted_members and contact_rate = contacted_members / cohort_size, where contacted_members never exceeds cohort_size.

Verify it yourself

contact_rate lies in [0, 1] for every product_type. Above 1 proves the numerator was counted on rows rather than members.
SUM(cohort_size) across product_types equals COUNT(DISTINCT member_id) in the cohort CTE. A larger value means a member with two January spans was counted twice.
A 0-day window returns a rate at or near zero, and a 365-day window returns a rate no lower than the 90-day one.

Follow-up

A member changes plan on day 40, closing one span and opening another. Is she still in the cohort, and which product_type does she report under?
What moves if denied lines are allowed into the numerator, and which definition is right for an access metric?
How would you show this as a cumulative curve by day since effective_date instead of one 90-day point?

Explain the difference between a list and a dictionary in Python. In what scenarios would you prioritize one over the other for memory or time complexity?

Medium · product sense and metrics

Approach

Restate the decision this analysis has to support, and who acts on the answer.
Decompose the metric into the rates that drive it, and say which one you would check first.
State what result would change your recommendation, so the answer is falsifiable.

Follow-up

What would you do if the primary metric and the guardrail moved in opposite directions?
How would you detect that the metric is being gamed rather than genuinely improving?

How do deductibles, copays, and out-of-pocket maximums influence patient behavior and claims data?

Medium · product sense and metrics

Approach

State what result would change your recommendation, so the answer is falsifiable.
Name one primary metric, then the guardrail that stops it being gamed.
Decompose the metric into the rates that drive it, and say which one you would check first.

Follow-up

What would you do if the primary metric and the guardrail moved in opposite directions?
How would you detect that the metric is being gamed rather than genuinely improving?

How would you measure the financial and clinical impact of a new preventive care program introduced to our members?

Medium · product sense and metrics

Approach

Fix the population and the time window before naming any metric.
Name one primary metric, then the guardrail that stops it being gamed.
State what result would change your recommendation, so the answer is falsifiable.

Follow-up

What would you do if the primary metric and the guardrail moved in opposite directions?
How would you detect that the metric is being gamed rather than genuinely improving?

Explain how you would clean and preprocess messy, unstructured electronic health records (EHR) or claims data before modeling.

Medium · product sense and metrics

Approach

Fix the population and the time window before naming any metric.
Name one primary metric, then the guardrail that stops it being gamed.
Restate the decision this analysis has to support, and who acts on the answer.

Follow-up

How would you detect that the metric is being gamed rather than genuinely improving?
Which segment would you cut first, and what would that rule out?

Size a clinic-randomised trial when the intracluster correlation binds

Medium · cluster randomisation · design effect · stepped wedge

A care-coordination change is delivered at the clinic level and cannot be withheld from some members of a participating clinic. Forty-eight clinics are available for 1:1 randomisation. The primary outcome is the 90-day primary care contact rate among newly enrolled members, baseline 0.62, with a target of plus 5 percentage points. Each clinic contributes about 60 eligible members a year, and the intracluster correlation on this outcome is 0.02. Two-sided alpha 0.05, 80 percent power. Give clinics required per arm, say whether 48 suffices, and what you would do.

Approach

Compute the individually randomised sample size first, then inflate it by the design effect 1 + (m - 1) x ICC, where m is the average cluster size. The design effect is the price of correlation within clinics and is the single largest term in this calculation.
Convert the inflated individual N into clusters by dividing by m, and compare with the 24 clinics available per arm.
Check the ceiling before proposing a longer accrual window. As m grows, effective members per cluster approaches 1 / ICC, here 50, so 24 clinics can never contribute more than 1,200 effective members per arm no matter how many members each one enrols. If the required effective N exceeds that, no amount of accrual rescues the parallel design.
Propose the designs that actually change the arithmetic: a stepped wedge in which every clinic crosses over so each contributes a within-cluster comparison, or a smaller randomisation unit (provider pod) if the intervention can be delivered at that level without contamination.
Add the two refinements a reviewer will ask for: use a t-distribution with roughly 2k - 2 degrees of freedom rather than z when k is small (here about 46 df, which raises N by about 4 percent), and use covariate-constrained randomisation on baseline contact rate so 48 clinics do not land badly imbalanced by chance.

Worked solution (30 min)

Individual n per arm = 7.849 x (0.62 x 0.38 + 0.67 x 0.33) / 0.05^2 = 7.849 x 0.4567 / 0.0025 = 1,434.
Design effect = 1 + (60 - 1) x 0.02 = 2.18.
Inflated n per arm = 1,434 x 2.18 = 3,126 members, so clusters per arm = 3,126 / 60 = 52.1, round up to 53.
Compare with 24 clinics available per arm: the study is short by more than a factor of two.
Compute the ceiling: 1 / 0.02 = 50 effective members per clinic, so 24 clinics give at most 1,200 effective members per arm against the 1,434 required.

Expected result: 53 clinics per arm (106 total) against 48 available. The effective-sample ceiling of 1,200 per arm is below the 1,434 needed, so the parallel cluster design is infeasible at any panel size; the answer is a stepped wedge, a smaller randomisation unit, or a pre-registered larger MDE.

Verify it yourself

Verify the design effect directly: 1 + 59 x 0.02 = 2.18.
Verify the diminishing return: doubling m from 60 to 120 raises effective members per cluster only from 27.5 to 35.5, not from 60 to 120.
Recompute with t-based quantiles at 46 df and confirm the requirement moves by a few percent, not by a factor.

Follow-up

Sketch the stepped-wedge analysis model. What does a secular trend do to the estimate if you leave period effects out?
The ICC was estimated from a prior year at 0.02 with a wide interval. How do you size under ICC uncertainty?
Six clinics withdraw after randomisation. What does that do to power compared with losing the same number of members?

Adherence share collapsed the month a feed was added

Easy · pdc · interval sql · identity resolution

The share of members with proportion of days covered at or above 0.80 in one therapeutic class fell from 0.71 to 0.58 in a single month. pharmacy_claim carries fill_id, member_id, ndc_code, therapeutic_class_code, fill_date, days_supply, quantity_dispensed, refill_number, reversal_flag, reversed_fill_id and source_system_code. There is no person-level key above member_id and no enrollment table on hand, so every diagnostic has to run on pharmacy_claim alone. That month the pipeline began ingesting a second pharmacy source. Determine whether adherence actually changed, and hand back a PDC query you would defend line by line.

Approach

Compute controls that depend on neither member identity nor the PDC code: total fills in the class per month, and total days_supply dispensed in the class per month. Both are sums over rows, so neither moves when one person's fills split across two member_ids, which is exactly what a per-member control cannot promise. If both are flat while PDC falls, no dispensing behaviour changed and the computation or the keys did.
Check days_supply for nulls and zeros by source_system_code. If the new source omits days_supply and the code coalesces null to zero, covered days vanish and PDC falls even though the fills are there.
Check for member identity splitting using the columns you actually have. There is no person key above member_id, so the split has to be found by its footprint: distinct member_id in the class jumping at the break while total fills stay flat, and a rise in the share of member_ids whose earliest fill for a given ndc_code carries refill_number above zero, which is a continuation history that lost its beginning. When one person is split, each id may fall below the two-fill denominator requirement and drop out, and the ids that do survive carry artificial gaps.
Check reversals. A reversed fill is two rows, the fill and a row with reversal_flag TRUE pointing at reversed_fill_id, and both must be excluded from exposure. If the new source expresses reversals differently and reversed_fill_id does not link, phantom coverage appears, which pushes PDC up rather than down, so use this to rule the cause in or out.
Verify the denominator and window are unchanged: members with at least two fills in the class and at least 91 days of follow-up, over a stated fixed 12-month window, never a mixture of window lengths.
Write the PDC query so overlapping refills shift the next interval's start to the later of fill_date and the prior interval's end, so a day is covered at most once, and cap at one day per calendar day.

Follow-up

Why is PDC preferred to medication possession ratio when early refills are common?
You want to compare adherent and non-adherent members on hospitalisation. What is wrong with classifying on a 12-month PDC and then following from day zero?
A member switches to a different drug in the same class mid-year. How does your interval logic handle that, and is the class the right grain?

Suggested practice checklist

For a candidate whose interviews will centre on A/B testing, metric movement and causal claims. Design comes before arithmetic, arithmetic before analysis, and the week ends by rehearsing the readout rather than the derivation.

Day 1 — Design one test end to end on paper

Take a single feature change and write the full design: randomization unit, the exact point of exposure, the primary metric with its grain, guardrails, allocation, planned duration, and the decision rule committed before any data exists.
Write why the randomization unit must sit at or above the level where treatment can spill over, and give one case where user-level randomization is still contaminated (shared accounts or devices, or two participants in the same marketplace).
State in advance what you will do if the primary metric is flat while a secondary metric is significant.

Deliverable: A one-page test design with a decision rule written before launch.

Day 2 — Power arithmetic until it is automatic

Compute required sample size per arm for a binary metric with the normal approximation, n is approximately 2 times (z for alpha/2 plus z for power) squared times p(1 minus p) divided by delta squared, for baselines of 2, 10 and 40 percent at a 5 percent relative lift, and note that for a fixed relative lift the requirement falls as the baseline rises because delta grows proportionally with p.
Redo the calculation for a continuous metric using variance in place of p(1 minus p), and show why a heavy-tailed quantity such as revenue per user needs either far more traffic or a capped version with a stated cap.
Convert one of the results into weeks given a weekly eligible traffic figure, then list the two honest ways to shorten it (accept a larger detectable effect, or reduce variance) and write why quietly lowering the power target is a decision to miss more real wins, not a speedup.

Deliverable: A small script or sheet that maps baseline, minimum detectable effect, alpha and power to sample size and weeks, cross-checked against a published calculator.

Day 3 — Variance and the unit-of-analysis problem

Take a ratio metric whose denominator is not the randomization unit (clicks per session, randomized by user) and compute the standard error twice, once naively at session level and once by the delta method or a user-level bootstrap, then record how much the naive version understates it.
Implement CUPED on simulated data: choose a pre-period covariate X measured before assignment, estimate theta as Cov(Y, X) divided by Var(X), and analyse Y minus theta times (X minus its mean) in place of Y. Confirm the variance of the adjusted outcome equals the raw variance multiplied by one minus the squared correlation between Y and X, so a correlation of 0.45 removes about 20 percent of the variance and not 80.
Now run that simulation a few hundred times and confirm the adjusted effect estimate is unbiased for the same effect rather than numerically identical to the raw one. Within any single run the two differ, sometimes by a large fraction of the true effect, because the two arms' pre-period covariate means never coincide exactly in a finite sample; they agree in expectation, which is the property that matters and the one to state out loud.

Deliverable: A notebook showing the adjusted estimator with a measurably smaller variance than the raw one, plus a repeated-simulation table showing the two estimators agreeing on average while differing run by run.

Day 4 — Validity threats you can actually test for

Run a sample ratio mismatch check as a chi-square goodness-of-fit test against the intended allocation, and write the three causes you would chase first (assignment logged before exposure, an arm-specific redirect or load failure, bot filtering applied asymmetrically).
Simulate peeking: generate A/A data, test daily at alpha 0.05 across 14 looks, record the inflated false positive rate, then apply an alpha-spending boundary or commit to a fixed horizon and confirm the rate returns to nominal.
Write how you would separate a novelty effect from a durable lift using the treatment effect plotted against days since first exposure, and what shape would change your recommendation.

Deliverable: One table showing the peeking false positive rate before and after correction, plus a written SRM triage list.

Day 5 — When randomization is not available

Write the identifying assumption for difference-in-differences (parallel trends in the absence of treatment), then plot pre-period trends for two candidate control groups and justify rejecting one of them.
Design a switchback test for a change where user-level randomization would leak across participants, choosing a time-block length against the carryover you expect and saying how you would detect carryover in the data.
List what an interrupted time series or a synthetic control buys you and the one thing neither can rule out: an unobserved shock that coincides with the launch.

Deliverable: A one-page memo recommending a single quasi-experimental design and naming its weakest assumption explicitly.

Day 6 — The readout query

Write the assignment-to-exposure join that returns exactly one row per unit per experiment, and handle units appearing in both arms by excluding and counting them rather than silently keeping one.
Compute the per-arm metric, its variance and the relative lift with a confidence interval in SQL, then reproduce the identical numbers in a notebook as a cross-check.
Add a segment breakdown and write the sentence that keeps it from being p-hacking: segments declared in advance, everything else reported as exploratory and corrected for multiplicity.

Deliverable: A single query that outputs the full readout table, matched to a notebook recomputation.

Day 7 — Present it to someone who will not read the appendix

Give a 10-minute readout of a real or simulated experiment in the order decision, number, uncertainty, caveat.
Have your listener ask "can we ship it" in the case where the primary is flat and a guardrail moved, and answer with a recommendation rather than a request for more data.
Rewrite your opening line so the recommendation lands before any methodology.

Deliverable: A one-page readout whose first line is the recommendation.

Ambiguous requests are the test

Most of the questions in this section reduce to one thing: can you be handed a vague request and come back with something useful? Prepare an example where the ask was underspecified, you chose an interpretation, and you said out loud which interpretation you chose. Describing how you narrowed the question matters more than the technique you eventually used.

What are the assumptions of linear regression, and how do you handle violations of these assumptions in a dataset?

Medium · behavioural and stakeholder questions

Approach

Close with what you would do differently, concretely.
State the situation in two sentences and spend the rest on your reasoning.
Pick a story where you drove the decision, not one where you observed it.

Follow-up

What did you decide not to do, and why?
How did you know the outcome was caused by your change?

Push back on an over-broad extract without blocking the work

Hard · minimum necessary · de-identification · governance

A researcher asks for a one-off extract covering 12,000 members: member_id, date of birth, five-digit residential postal code, full lab_result rows including value_text, and clinical note text, held on their laptop for a retrospective analysis of one lab analyte over time. They describe it as de-identified because names are excluded. A flat refusal is not an acceptable answer. Deliverable: the column list you will actually provide with a justification per retained field, the sentence explaining why free text defeats an enumerated-identifier approach, your small-cell rule for the published stratification, and what you deliver this week.

Approach

The probe is whether privacy is a design skill for you or a compliance reflex. Flat refusal and unquestioned fulfilment both fail, for opposite reasons.
Reconstruct the analysis from the research question rather than from the request. A longitudinal trend in one analyte needs a stable pseudonymous subject key, the analyte's loinc_code, value_numeric, units, the reference bounds, and a date. It does not need names, notes, or a precise birth date.
Replace each identifier with the least precise version that still answers the question: a salted per-study pseudonym instead of member_id, age in years or an age band instead of date of birth, a consistent per-subject date offset if only intervals matter, and a coarser geography than five-digit postal code.
Explain the free-text problem in one sentence. Removing an enumerated list of identifier fields does not de-identify a note, because notes carry names, relationships, employers, dates and rare clinical detail in prose, so only a reviewed extraction into structured fields or a formal statistical determination addresses it.
Set the publication rule before the analysis runs. Suppress cells below a stated threshold and suppress complements too, because a reader holding a row total and all but one cell recovers the suppressed count by subtraction.
Keep them moving. Deliver the reduced extract into a controlled environment this week rather than onto a laptop, and offer to derive any note-based variable yourself as a structured flag so they never need the prose.

Follow-up

They say the age band loses resolution their model needs. What do you do?
How do you set the suppression threshold, and who signs off on it?
The analysis later needs linking to a second data source. What changes?

Own an analysis that shipped wrong and was acted on

Easy · retrospective · ownership · data quality

Describe an analysis you delivered that was wrong, where someone acted on it before the error surfaced. Pick something with a mechanism you can name, not a typo. Cover what the number claimed, what was actually true, how much time passed before it was caught, who caught it, and what you told the people who had already acted. Deliverable: a five-minute account that ends with the specific control you added afterwards, plus one occasion since when that control has fired.

Approach

Read the probe: the interviewer is testing whether you detect your own errors and whether the correction was structural. Pick an error with a nameable mechanism (a denominator built from distinct members instead of member-months, a series read before claims runout completed, a cohort selected on the outcome) so the story has a diagnosis rather than a mood.
Open with the decision that was made on your number, not with the bug. The severity of an analytic error is measured in the action it caused: a rate filing, a staffing plan, a programme expansion.
State the counterfactual number. 'The true figure was 14.1 admissions per 1,000 member-years, not 9.8' is a fact; 'it was off by a lot' is not.
Describe the detection path honestly, including whether you found it or somebody else did. Say how long it took, because time to detection is the part you actually control next time.
Close on the control, and make it something that protects a reader who has never met you: a unit test on the denominator, a paid-through date stamped on every chart, a required exclusions block in the spec template. Name one later date it caught something.

Follow-up

What would have had to be true for you to catch this before delivery rather than after?
Did the stakeholder change how much they trust your work, and did you want them to?
Give an example of a control you added that turned out to be the wrong control.