SIU Healthcare Analytics Business Consultant; SQL​/Python

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.

We are seeking a highly analytical and detail-oriented Data Analyst to join our Special Investigation Unit within a leading health insurance organization. This role is ideal for a data professional with strong skills in SQL and Python who can transform complex healthcare data into actionable insights to support fraud, waste, and abuse (FWA) detection and operational, customer-facing, & compliance reporting. This is an individual contributor role.

• Write robust, efficient code in SQL and Python to extract, manipulate, and analyze large healthcare datasets.
• Design, develop, and maintain complex data analyses to support investigations of potential fraud, waste, and abuse in healthcare claims and provider activity.
• Prepare timely and accurate operational and customer-facing reports in accordance with prescribed guidelines and standards.
• Communicate messages based on data analyses, including preparing easy-to-understand visualizations and other related documents for diverse audiences
• Collaborate with cross-functional teams (SIU Investigators & Leadership, Program Integrity Managers & Compliance) to understand business processes and translate them into actionable data requirements.
• Develop and participate in presentation and consultation with business partners on data, capabilities, and performance results
• Identify data quality issues, perform root cause analysis, and recommend improvements to enhance reporting accuracy and data integrity.
• Document data logic and methodology used in analyses and ensure reproducibility and transparency of results.
• Stay informed about changes in policy, workflows, and FWA detection techniques to ensure ongoing compliance.
• This is a hybrid/remote position in the US. supporting standard east coast business hours.

• 3+ years of experience in data analytics or data science, preferably in healthcare, health insurance, or Medicaid/Medicare programs
• Ability to distill complex data into meaningful insights and present findings to non-technical audiences.
• Solid understanding and experience interpreting medical claim data
• Advanced experience in SQL coding sourcing from a data warehouse
• 3+ years of data interpretation and analysis experience
• 3+ years of project leadership experience
• Strong business as well as systems knowledge
• Excellent problem-solving, critical thinking, and written communication skills
• Advanced experience in Excel

• Experience in healthcare fraud, waste, and abuse
• Proficiency in Python for data analysis (Pandas, Num Py)
• Knowledge of healthcare claims, adjudication & reporting
• Experience with data visualization tools (e.g., Tableau, Power Bl)
• Familiarity with Big Query & Jupyter Notebook

• Bachelor's degree or equivalent experience

40

Full time

The typical pay range for this role is:

$66,330.00 - $

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…