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Lead Data Scientist - Utilization Management
Lead Data Scientist - Utilization Management-May 2024
Wellesley
May 4, 2025
ABOUT CVS HEALTH
CVS Health is a healthcare innovation company. Together, we are helping people on their path to better health.
10,000+ employees
Healthcare
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About 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

  CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

  You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

  CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.

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