Senior Data Scientist - Utilization Management

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

At CVS/Aetna, we're pioneering a total approach to health and wellness. As a Data Scientist on the Analytics & Behavior Change team, you'll build industry-leading analytics, data, and technology platforms to help reimagine health care. This position will play a critical role within a cross-functional team, delivering powerful solutions.

Utilization Management (UM) ensures consistent delivery of the right care, in the right setting, by the right people.  The UM Data Science team leverage data, analytics and AI solutions to transform UM operations and optimize provider and member experience.

• Collaborates with business partners to shape the analytics approach to address business priorities (through predictive modeling, statistical analysis, or metric evaluation) as a thought leader
• Owns and manages an analytics workstream, leading other analysts and data scientists to build end to end analytical products.
• Uses strong knowledge in algorithms and predictive models to propose approaches, investigate problems, detect patterns and recommend solutions
• Performs analyses of structured and unstructured data to solve multiple and/or complex business problems utilizing advanced statistical techniques and mathematical analyses and broad knowledge of the organization and/or industry
• Develops and participates in presentations and consultations to existing and prospective constituents on analytics results and solutions
• Use strong programming skills to explore, examine and interpret large volumes of data in various forms

Required Qualifications

• 3+ years of relevant analytic experience
• Experience programming using R or Python
• Experience in SQL

Preferred Qualifications

• Demonstrates strong ability to communicate technical concepts and implications to business partners
• Anticipates and prevents problems and roadblocks before they occur
• Strong knowledge of advanced analytics tools and languages to analyze large data sets from multiple data sources
• Demonstrates proficiency in most areas of mathematical analysis methods, machine learning, statistical analyses, and predictive modeling and in-depth specialization in some areas
• Hand on experience with LLMs and Generative AI strongly preferred.
• Healthcare experience a plus.

Education

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

Pay Range

The typical pay range for this role is:

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

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