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

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$111,240.00 - $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 vari