Senior Data 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.

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 leverages data, analytics and AI solutions to transform UM operations and optimize provider and member experience.

• Collaborate with business partners to shape the analytics approach to address business priorities (through predictive modeling, statistical analysis, or metric evaluation) as a thought leader.
• Own and manage an analytics workstream, leading other analysts and data scientists to build end‑to‑end analytical products.
• Use strong knowledge in algorithms and predictive models to propose approaches, investigate problems, detect patterns and recommend solutions.
• Perform 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.
• Develop and participate in presentations and consultations with 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.

• 3+ years of relevant analytic experience.
• Experience programming using R or Python.
• Experience in SQL.

• 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.
• Hands‑on experience with LLMs and Generative AI.

• 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.

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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.

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

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

The application window for this opening will close on: 08/31/2026.