HC Quality & Population Health Data Scientist

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Applies rigorous data science principles and methods to continuous quality improvement and methodical evaluation of HEDIS and Population Health interventions. Synthesizes salient data analytics to craft actionable data stories that highlight successes, opportunities, and recommendations for performance improvement by HEDIS measure and subpopulation level. Leads data science infrastructure development and automation via SQL, Python, Excel, R, Power BI, and additional tools. Leads development of custom analytics to meet regulatory requirements (e.g., Quarterly Business Reports, Annual Reports, RFP).

Primary Job Duties & Responsibilities

• Leads rigorous evaluation research into prioritized Medicaid population health interventions from end-to-end (e.g., research design, methodology, analysis, presentation, continuous improvement cycle)
• Leads the development of fact/dimensional data models within Power BI that serve evaluation research effort
• Leads all data science efforts to continuously monitor our HEDIS and population health performance metrics by applying data-appropriate methodologies and techniques that are rigorous and actionable
• Leads KPI design, Power BI data modeling, custom algorithms, machine learning, and continuous quality improvement techniques that are guided by sound data science principles and reasoning
• Leads project management and communication of multi-month, cross-functional data science infrastructure projects
• Leads in-depth program evaluation analytics to understand the successes and opportunities within the Population Health Management Programs offered by Aetna Better Health of Illinois
• Leads custom data insights generation for senior leadership and regulatory/accreditation reporting (e.g., Illinois Department of Healthcare and Family Services, NCQA)
• Leads the iterative development of actionable, custom-built Power BI solutions that can be used by frontline staff as well as senior leadership
• Transforms data intake and reporting efforts that are highly manual into standardized, automated processes that monitor and flag any data validity, accuracy, and completeness issues
• Effectively communicates data insights to key stakeholders with varying data skills
• Trains fellow analysts in advanced data science principles, Power BI, SQL, python, R, Hadoop, data visualizations, and other essential data science skills
• Trains colleagues on how to use and interpret custom-built Power BI solutions
• Other duties as needed

Required Qualifications

• At least 5 years of experience within the analytics industry
• At least 3 years of demonstrated healthcare analytics experience within Medicaid/Medicare space
• Advanced knowledge of data science principles and techniques (e.g., inferential statistics, machine learning, algorithms, data modeling, statistical significance testing, forecasting)
• Advanced knowledge of identifying appropriate data science methods based upon the existing data and research questions
• Advanced knowledge of evaluation research, longitudinal trending (e.g., YoY, MoM, QoQ), and population monitoring to demonstrate effectiveness, opportunities, and successes of care management, HEDIS, and population health interventions
• Advanced knowledge of effectively communicating data verbally and visually to data experts as well as non-data experts
• Advanced knowledge of data-appropriate visualization techniques (e.g., bar, line, scatter, boxplot, choropleth map, heatmap, matrix table, decomposition tree, pareto, histograms)
• In-depth experience in RFP work and generating evidence-based data stories for quarterly/monthly reporting
• Advanced knowledge of healthcare data types (e.g., qualitative, quantitative, geospatial)
• Advanced knowledge of SQL and writing SQL code within SQL Server Management Studio
• Advanced knowledge of relational database design including fact-dimensional data modeling
• Advanced knowledge of Power BI (e.g., DAX)
• Advanced knowledge of Microsoft Excel (e.g., formulas, pivot tables/graphs, data slicers, statistical toolkit)
• Advanced knowledge of designing and evaluating KPIs, outcome measures, and other custom-built metrics