Decision Scientist - Utilization Management

9025 CVS Shared Services Resources LLC; Wellesley (MA); On-site; USD 87,000 - 173,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health in Massachusetts is seeking a Decision Scientist to join the Analytics & Behavior Change team, focusing on Utilization Management. You will build analytics, data pipelines, and AI-enabled solutions to optimize care pathways and provider/member experiences.

Responsibilities include analyzing large datasets, developing models, and communicating insights to cross-functional partners. 1+ year of analytics experience, SQL, and Python or R required.

Qualifications

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

Responsibilities

• Develop analytic solutions to optimize Utilization Management in healthcare.
• Explores, examines and interprets large volumes of data in various forms.
• Performs 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.
• Uses data visualization techniques to effectively communicate analytical results and support business decisions.

Skills

SQL

R or Python

Education

Bachelor's degree or equivalent

Tools

Google Cloud Platform

BigQuery

Job description

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 At CVS/Aetna, we're pioneering a total approach to health and wellness. As a Decision 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 leverage data, analytics and AI solutions to transform UM operations and optimize provider and member experience.

Develop analytic solutions to optimize Utilization Management in healthcare Explores, examines and interprets large volumes of data in various forms Performs 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 Uses data visualization techniques to effectively communicate analytical results and support business decisions Creates and evaluates the data needs of assigned projects and assures the integrity of the data Explores existing data and recommends additional sources of data for improvements Documents projects including business objectives, data gathering and processing, detailed set of results and analytical metrics

Required Qualifications 1+ years of relevant analytic experience Experience in SQL Experience programming using R or Python

Preferred Qualifications Experience with Google Cloud Platform, big query, and other tools in cloud Demonstrates good written and verbal communication skills. Able to present information to various audiences Effectively resolves problems and roadblocks as they occur Demonstrates interests in several areas of statistical analysis, data engineering and data visualization Ability to work with large data sets from multiple data sources

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

Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $86,520.00 - $173,040.00 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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people 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.

We anticipate the application window for this opening will close on: 12/04/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.