Data Scientist - Utilization Management

CVS Health • West Virginia, West Virginia • 2h ago

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 :

If you're eager to make a real impact in the health care industry through your own meaningful contributions, explore a role in technology with CVS Health. Our journey calls for technical innovators and data visionaries: come help us pave the way.

As a Data Scientist, you will collaborate with the data engineering teams to leverage advanced analytics, machine learning models, AI-driven solutions, and strategic problem solving to grow products at CVS Health.

A successful candidate will be one which is able to think independently and critically, enjoys ambiguous problems with data, is highly adaptable, and loves to collaborate with both technical and non-technical leaders.

As a Data Scientist, you will:

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

Required Qualifications

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

Preferred Qualifications

Experience with Google Cloud Platform, big query, and other cloud-based tools

Experience with delivering machine learning models end-to-end

Experience with building AI solutions on multi-modal data and experiences with RAG, embeddings, or prompt engineering

Exposure to model deployment (APIs, cloud platforms) and LLM packages such as LangChain, LangGraph, Langfuse

Strong written and verbal communication skills, experience presenting information to various audiences

Education

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

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$64,890.00 - $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 our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 04/30/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.

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