Lead Data Scientist - Utilization Management

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

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

• 5+ 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

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:

$136,217.50 – $267,800.00

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits