Data Scientist – Utilization Management
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Job Description
Data Scientist at CVS Health building analytic solutions and machine learning models. Collaborating with data engineering teams to innovate healthcare analytics.
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
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
- Experience with Google Cloud Platform, big query, and other cloud-based tools (preferred)
- Experience with delivering machine learning models end-to-end (preferred)
- Experience with building AI solutions on multi-modal data and experiences with RAG, embeddings, or prompt engineering (preferred)
- Exposure to model deployment (APIs, cloud platforms) and LLM packages such as LangChain, LangGraph, Langfuse (preferred)
- Strong written and verbal communication skills
Benefits:
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs
- Confidential counseling and financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
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