Senior Decision Scientist - Medical Cost Analytics / Utilization Management

Remote Full-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.

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.

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

40

Time Type

Full time

Pay Range

The Typical Pay Range For This Role Is

$83,430.00 - $222,480.00

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.

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 Benefits | CVS Health

We anticipate the application window for this opening will close on: 03/17/2025

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

Apply Now

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