Senior Decision 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.

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.
 

Position Summary

The Analyst, Medical Cost Analytics / Utilization Management role will analytics to evaluate scenarios and make predictions on future outcomes to solve highly complex business problems and support decision making. The Analyst will be regarded as a specialist, analyzing large data sets in real-time databases and developing mathematical approaches to save medical costs. This role will share ideas and drive initiatives for medical cost savings.

Responsibilities include:

• Consulting on the creation of analytics solutions that effectively weigh business and technical tradeoffs using an advanced understanding of business strategy as well as relevant big data environment topics.

• Translating business needs into analytics projects and actions.

• Collaborating with business partners to understand their problems and goals, performing statistical analysis, developing data reports and performance metrics.

• Consulting with internal clients to identify opportunities to implement data science solutions to business problems.

• Structuring data analysis, driving analytics insights and analytical solutions to help data scientists determine the best analytical solution.

• Understanding key drivers of business value.

• Translating business problems into analytical solutions by knowing appropriate models to suggest to data scientists.

• Presenting recommendations to senior staff and internal clients.

Required Qualifications

• 5+ years' experience consulting with internal clients, identifying opportunities to implement data science and analytics solutions to make a business impact

• 4+ years' experience using SQL to extract, manipulate and analyze large datasets

• 3+ years experience working in Healthcare industry, with Healthcare data

• 3+ years' experience in strategic consulting or on strategy teams in a large company, providing actionable insights and recommendations to senior leaders and stakeholders to support strategic decision making

• 3+ years' experience with the Microsoft Office Suite including MS Excel and PowerPoint

• 2+ years' experience identifying trends and opportunities for cost savings initiatives and evaluating the effectiveness of programs

• 2+ year experience communicating and presenting complex data findings to a variety of stakeholders

• 2+ year experience organizing and managing multiple projects simultaneously

Preferred Qualifications

• Collaborative with a growth mindset and excellent interpersonal skills

• Demonstrated ability to communicate technical concepts and implications to business partners

• Knowledge of healthcare industry trends and regulatory changes

• Demonstrated proficiency in most areas of mathematical analysis methods, machine learning, statistical analyses, and predictive modeling and in-depth specialization in some areas

• Anticipates and prevents problems and roadblocks before they occur

Education

• Bachelor's degree in Finance, Economics, Medical Economics, Math, Actuarial Science, Data Science or related field required
• Master's degree in quantitative field or MBA strongly preferred

Anticipated Weekly Hours

Time Type

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. 
 

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.