Senior Decision Scientist — Affordability & Fraud Analytics

CVS Health; Hartford (CT); On-site; USD 93,000 - 222,000; Full time

Job summary

CVS Health in Hartford, CT is seeking a Lead Decision Scientist to guide analytics for Payment Integrity and FWE/SIU programs. You will lead a team of decision scientists, shape ideation processes, and drive data-driven opportunities that improve affordability and program outcomes.

You will partner with SIU, Analytics & Behavior Change, Medical Economics, and Clinical Policy to define metrics, build datasets, dashboards, and predictive analyses, and present findings to senior leaders.

Qualifications

• 7+ years of experience in healthcare analytics, Payment Integrity, or related fields.
• 5+ years of experience leading analytical projects or technical leadership.
• Experience with healthcare claims platforms (ACAS, QNXT, HRP or similar).
• Proficiency in SAS, SQL, Python, R or equivalent.
• Strong ability to translate analytics into actionable recommendations.

Responsibilities

• Provide day-to-day leadership, coaching, and mentorship to Decision Scientists.
• Lead ideation sessions and governance of affordability opportunities.
• Develop analytics datasets, dashboards, reports, and predictive analyses.
• Present analyses to leaders and stakeholders.
• Collaborate with SIU, Analytics & Behavior Change, Medical Economics, and Policy teams.
• Evaluate effectiveness of initiatives and iterate improvements.

Skills

Healthcare analytics

Leadership

Data analysis

SQL

Python

SAS

R

Education

Bachelor's degree in Business Analytics, Data Science, Healthcare Administration, Statistics, Economics, Computer Science

Tools

ACAS

QNXT

HRP

SAS

SQL

Python

R

Job description

CVS Health in Hartford, CT is seeking a Lead Decision Scientist to guide analytics for Payment Integrity and FWE/SIU programs. You will lead a team of decision scientists, shape ideation processes, and drive data-driven opportunities that improve affordability and program outcomes.

You will partner with SIU, Analytics & Behavior Change, Medical Economics, and Clinical Policy to define metrics, build datasets, dashboards, and predictive analyses, and present findings to senior leaders.