Decision Scientist - Utilization Management

CVS Health Corporation; Wellesley, Northern (MA, KY); Hybrid; USD 87,000 - 173,000; Full time

Benefits offered by this job

Bonus potential

Comprehensive benefits

Retirement options

Job summary

CVS Health Corporation is seeking a Decision Scientist in Utilization Management to develop analytics, data platforms, and AI solutions that optimize UM operations and provider/member experiences.

The role emphasizes cross-functional collaboration, data exploration, and communicating findings with diverse audiences. Ideal candidates have 1+ years of analytics, SQL, and Python/R experience, with cloud familiarity and strong problem-solving skills.

Qualifications

• Bachelor's degree or equivalent in a relevant field.
• Experience with structured and unstructured data analyses.
• Strong written and verbal communication skills.

Responsibilities

• Develop analytic solutions to optimize Utilization Management in healthcare.
• Explore, examine, and interpret large volumes of data.
• Build data structures and pipelines to organize and standardize data for insights.

Skills

SQL

Python/R

Statistical analysis

Data visualization

Education

Bachelor's degree in Business Analytics / Economics / STEM

Tools

Google Cloud Platform

BigQuery

Job description

## Decision Scientist - Utilization ManagementApply: Remote: MA - Wellesley: Work At Home-New York: NY - New York: Full time: Posted Today: End Date: December 4, 2026 (30+ days left to apply): R1050866We’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 - $173,040.00This 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