Principal Data Scientist - Utilization Management Analytics

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Overview

CVS Health’s Analytics & Behavior Change (A&BC) is an organization working to solve some of the most challenging problems at the intersection of technology and healthcare. A&BC leverages advanced analytics, machine learning, modeling, and a hypothesis-driven approaches to transform data into actionable, customer-centric insights to drive growth, improve health outcomes and access to health care across all our businesses in CVS Health. Our teams build next generation data and machine learning platforms and software products that help power CVS Health to make healthier happen for 100+ million customers.

The A&BC organization is looking to grow its Utilization Management Analytics team. Join us as we embark on an exciting journey to drive a transformational shift in how CVS Health leverages technology and analytics to become the leader in consumer healthcare in the U.S. In this role you will be tasked with anomaly detection of denial rates and mentoring Data Scientists to improve outcomes across multiple lines of business and use cases.

As a Principal Data Scientist, you will…

• be a subject matter expertise in complex data and how to apply it to solve healthcare problems.

• lead decision scientists, data engineers, and product owners to design and implement analytics solution.

• foster a team cultural of analytical excellence by balancing the pursuit of business value with innovation and continuous improvement.

• identify and translate emerging AI trends in healthcare to better address real world problems with an MVP-first mindset.

• develop, validate, implement, and support decision support tools that investigate problem spaces, identify patterns, support decision-making processes, or anticipate outcomes.

• build queries, dashboards, and data visualizations to effectively communicate analysis results and support decision making processes.

• explore, validate, interpret, and summarize large amounts of data with various types/structures using advanced statistical and mathematical approaches.

• develop end-to-end analytics solutions, from developing problem statements to deployments into production.

• translate problem statements from business partners into conceptual solutions, analyze feasibility, and estimate work efforts for analytical use cases early in their lifecycle.

• create documentation of project details, like problem statements, business outcomes, data exploration, dashboard/report details, and deployment/support instructions.

• develop and participate in presentations and consultations to existing and prospective constituents on analytics opportunities, results, and solutions.

Required Qualifications

• 10+ years of relevant analytics experience.

• 10+ years' experience leading analytics projects from concept to delivery by coordinating across a diverse set of stakeholders.

• 10+ years' experience with SQL and Python.

• 10 + years' experience using Google Cloud Platform (GCP) tools, including BigQuery, Vertex AI, and Cloud Composer to implement scalable analytics solutions.

• 8+ years' experience solving analytics problems in the healthcare domain using data.

• 8+ years' experience anticipating and preventing roadblocks throughout a project lifecycle and drive resolution/mitigation.

• 8+ years' experience solving analytics problems using advanced statistics, machine learning, and mathematical algorithms.

• 8+ years' experience demonstrating strong written and verbal communication skills, including the ability to present complex ideas to various audiences.

Preferred Qualifications

• Experience using natural language processing (NLP), large language models (LLMs), and Generative AI (Gen AI) to extract insights from text data.

• Proven track record of implementing cutting-edge AI solutions in a deadline driven, value oriented environment.

Education Requirements

• Bachelor’s degree or equivalent work experience in Mathematics, Statistics, Computer Science, Business Analytics, Economics, Physics, Engineering, or related discipline.
• Master’s degree preferred.

Pay Range

The typical pay range for this role is:

$144,200.00 - $288,400.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.  This position also includes an award target in the company’s equity award program. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/01/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.