Data Scientist - Utilization Management

CVS Health • Wellesley, VT

6d

About The Position

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. Position Summary: If you’re eager to make a real impact in the health care industry through your own meaningful contributions, explore a role in technology with CVS Health. Our journey calls for technical innovators and data visionaries: come help us pave the way. As a Data Scientist, you will collaborate with the data engineering teams to leverage advanced analytics, machine learning models, AI-driven solutions, and strategic problem solving to grow products at CVS Health. A successful candidate will be one which is able to think independently and critically, enjoys ambiguous problems with data, is highly adaptable, and loves to collaborate with both technical and non-technical leaders.

Requirements

• 2+ years of experience in data science and machine learning
• 2+ years of experience in SQL
• 1+ year experience programming using Python (pandas, scikit-learn, PyTorch, etc.)
• 1+ year of business experience leading analyses and initiatives with track record of business impact using data driven insights

Nice To Haves

• Experience with Google Cloud Platform, big query, and other cloud-based tools
• Experience with delivering machine learning models end-to-end
• Experience with building AI solutions on multi-modal data and experiences with RAG, embeddings, or prompt engineering
• Exposure to model deployment (APIs, cloud platforms) and LLM packages such as LangChain, LangGraph, Langfuse
• Strong written and verbal communication skills, experience presenting information to various audiences

Responsibilities

• Build analytic solutions and machine learning models (e.g. classification, ranking) to optimize Utilization Management in healthcare and translate business logic or healthcare workflow into data-driven decisions
• Develop data structures and processing pipelines to organize, collect, and standardize insights from both unstructured data (PDFs, texts, images) and structured data, to address both reporting needs and feature development
• Explore and build LLM-powered pipelines and evaluate performance based on real-world feedback
• Create and evaluates the data needs of assigned projects and assures the integrity of the data
• Explore existing data and recommends additional sources of data for improvements
• Document projects including business objectives, data gathering and processing, detailed set of results and analytical metrics

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees