Sr. Data Scientist - Cost & Operations Analytics

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. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary: At CVS/Aetna, we're pioneering a total approach to health and wellness. As a Senior Data Scientist on the Analytics & Behavior Change team, you'll build industry-leading analytics, data, and technology platforms to help re-imagine health care. This position will play a critical role within a cross-functional team, delivering powerful solutions. This role will be working with Cost and Operations Analytics that focuses on improving automation, unit cost, operational efficiency and provider experience. You will be working on:

• Leveraging AI and analytics to drive efficiency and automation for Appeals and Grievances
• Analyzing large amounts of data to evaluate competitive cost positioning
• Implementing models, developing tool and algorithms to augment processes related to Claims, Appeals and Grievances ecosystem
• Identifying and sizing opportunities for analytics to improve efficiency and increase automation in claim adjudication, and claim rework
• Developing, validating and executing algorithms and predictive models to investigate problems, detect patterns and recommend solutions
• Exploring, examining and interpreting large volumes of data in various forms
• Performing analyses of structured and unstructured data to solve moderately complex business problems
• Utilizing advanced statistical techniques and mathematical analyses develops data structures and pipelines to organize, collect and standardize data that helps generate insights and addresses reporting needs
• Using data visualization techniques to effectively communicate analytical results and support business decisions
• Creating and evaluating the data needs of assigned projects and assures the integrity of the data
• Exploring existing data and recommends additional sources of data for improvements
• Documenting projects including business objectives, data gathering and processing, detailed set of results and analytical metrics
• Building solutions that help with tracking of operational processes and policies and identify opportunities for improvements

Required Qualifications:

• 3+ years of relevant Data Science experience
• 3+ years' experience programming in Python
• 3+ years' experience programming in SQL
• 1+ year experience working with Cloud Technology (GCP, AWS or Azure)
• 1+ year experience building solutions using Generative AI (GenAI) or Machine Learning

Preferred Qualifications:

• Experience in Google Cloud/BigQuery
• Strong problem solving experience with a history of making business impact

Education:

• Master's degree or equivalent work experience in Mathematics, Statistics, Computer Science, Business Analytics, Economics, Physics, Engineering, or related discipline

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 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | CVS Health We anticipate the application window for this opening will close on: 10/09/2024 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Apply tot his job Apply To this Job