Springfield, Illinois, USA
4 days ago
HC Quality & Population Health Data Scientist

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Applies rigorous data science principles and methods to continuous quality improvement and methodical evaluation of HEDIS and Population Health interventions. Synthesizes salient data analytics to craft actionable data stories that highlight successes, opportunities, and recommendations for performance improvement by HEDIS measure and subpopulation level. Leads data science infrastructure development and automation via SQL, Python, Excel, R, Power BI, and additional tools. Leads development of custom analytics to meet regulatory requirements (e.g., Quarterly Business Reports, Annual Reports, RFP).

Primary Job Duties & Responsibilities

Leads rigorous evaluation research into prioritized Medicaid population health interventions from end-to-end (e.g., research design, methodology, analysis, presentation, continuous improvement cycle)Leads the development of fact/dimensional data models within Power BI that serve evaluation research effortLeads all data science efforts to continuously monitor our HEDIS and population health performance metrics by applying data-appropriate methodologies and techniques that are rigorous and actionableLeads KPI design, Power BI data modeling, custom algorithms, machine learning, and continuous quality improvement techniques that are guided by sound data science principles and reasoningLeads project management and communication of multi-month, cross-functional data science infrastructure projectsLeads in-depth program evaluation analytics to understand the successes and opportunities within the Population Health Management Programs offered by Aetna Better Health of IllinoisLeads custom data insights generation for senior leadership and regulatory/accreditation reporting (e.g., Illinois Department of Healthcare and Family Services, NCQA)Leads the iterative development of actionable, custom-built Power BI solutions that can be used by frontline staff as well as senior leadershipTransforms data intake and reporting efforts that are highly manual into standardized, automated processes that monitor and flag any data validity, accuracy, and completeness issuesEffectively communicates data insights to key stakeholders with varying data skillsTrains fellow analysts in advanced data science principles, Power BI, SQL, python, R, Hadoop, data visualizations, and other essential data science skillsTrains colleagues on how to use and interpret custom-built Power BI solutionsOther duties as needed



Required Qualifications

At least 5 years of experience within the analytics industryAt least 3 years of demonstrated healthcare analytics experience within Medicaid/Medicare spaceAdvanced knowledge of data science principles and techniques (e.g., inferential statistics, machine learning, algorithms, data modeling, statistical significance testing, forecasting)Advanced knowledge of identifying appropriate data science methods based upon the existing data and research questionsAdvanced knowledge of evaluation research, longitudinal trending (e.g., YoY, MoM, QoQ), and population monitoring to demonstrate effectiveness, opportunities, and successes of care management, HEDIS, and population health interventionsAdvanced knowledge of effectively communicating data verbally and visually to data experts as well as non-data expertsAdvanced knowledge of data-appropriate visualization techniques (e.g., bar, line, scatter, boxplot, choropleth map, heatmap, matrix table, decomposition tree, pareto, histograms)In-depth experience in RFP work and generating evidence-based data stories for quarterly/monthly reportingAdvanced knowledge of healthcare data types (e.g., qualitative, quantitative, geospatial)Advanced knowledge of SQL and writing SQL code within SQL Server Management StudioAdvanced knowledge of relational database design including fact-dimensional data modelingAdvanced knowledge of Power BI (e.g., DAX)Advanced knowledge of Microsoft Excel (e.g., formulas, pivot tables/graphs, data slicers, statistical toolkit)Advanced knowledge of designing and evaluating KPIs, outcome measures, and other custom-built metricsAdvanced knowledge of population analytics (e.g., Dx, med econ profiling, SDOH, utilization pattern, CPC, ICD-10, HCPCS) and profiling techniques to gain subpopulation level data insightsAdvanced knowledge of HEDIS and other healthcare data industry standards, issues, and trendsAdvanced knowledge of triangulating salient internal and external data sources to enhance various, fact/dimensional 360° data infrastructure projectsAbility to curate data to ensure that it is valid, accurate, and completeAbility to work efficiently within Microsoft 365 environment that leverages Teams and SharePointAbility to independently plan and execute data analytics requests within cross-functional teamsAbility to prioritize multiple data requests within a fast-paced environmentExceptional attention to detail, critical thinking, and data communication skillsExceptional ability to convey complex information in simple, effective ways and craft evidence-based data stories that are clear, concise, and actionableDemonstrates a positive attitude and works efficiently to ensure that deadlines are met



Preferred Qualifications

Python, R, Hadoop



Education

Bachelor’s degree in Data Science, Analytics, Computer Science, Math, Psychology, Statistics, Sociology or equivalent experience. Master's degree preferred.
 

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,330.00 - $145,860.00

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: 09/14/2025

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

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