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Position Summary
The UM Analytics team provides data-driven insights that directly influence clinical and operational decision-making across Aetna's Utilization Management organization. We partner with Medical Affairs leadership, Medical Directors, and operational teams to evaluate care models, identify cost and quality improvement opportunities, and translate complex healthcare data into actionable recommendations.
This Lead Decision Scientist will be embedded within the Medical Affairs analytics pod, serving as the primary analytics partner for care model leadership and clinical stakeholders. You will own the end-to-end analytics lifecycle — from intake and problem framing through data extraction, analysis, insight generation, and stakeholder presentation — for a portfolio of Medical Affairs projects. This is not a "run-the-report" role: you will be expected to proactively identify opportunities, shape the analytical agenda, and drive projects to completion, ensuring that insights translate into measurable business and clinical outcomes.
You will work closely with Medical Directors, care model leads, and cross-functional operational teams to prioritize, scope, and deliver high-impact analyses spanning areas such as care model performance evaluation, clinical program effectiveness, utilization trend analysis, and exploratory research to support new initiatives.
Required Qualifications
- 7+ years of professional experience in data analytics, decision science, or a quantitative analytics role
- 3+ years of experience working with healthcare data (claims, clinical, enrollment, or similar)
- Advanced proficiency in SQL, including complex query design across large-scale datasets (e.g., BigQuery, Teradata, or similar enterprise data platforms)
- Demonstrated experience leading analytics projects end-to-end — from stakeholder problem definition through final deliverable and recommendation
- Experience building dashboards, reports, or data visualizations using tools such as Tableau, Power BI, Looker, or similar
- Track record of presenting analytical findings and recommendations to senior leadership or cross-functional business partners
- Proficiency in at least one programming language for data analysis (Python or R)
- Experience working in a matrixed environment with multiple concurrent stakeholder groups
Preferred Qualifications
- Strong understanding of managed care, utilization management, or health plan operations (e.g., familiarity with concepts such as DRG, clinical claim review, care model design, or medical policy)
- Ability to translate ambiguous business questions into structured analytical frameworks without heavy direction
- Proven ability to push projects forward independently — proactively managing timelines, escalating blockers, and driving stakeholders toward decisions
- Excellent communication and storytelling skills — can distill complex analytical findings into clear, concise narratives for both technical and non-technical audiences, including Medical Directors and operational leaders
- Strong consultative mindset — comfortable pushing back on requests to reframe problems, prioritize effectively, and ensure the right questions are being asked
- Experience mentoring or guiding junior analysts on analytical methodology and professional development
- Familiarity with statistical modeling, A/B testing, or causal inference methods applied to healthcare program evaluation
- Comfort working with ambiguity and evolving priorities in a fast-paced environment
Education
Bachelor's degree or equivalent work experience in Mathematics, Statistics, Computer Science, Analytics, Engineering, Public Health, Health Informatics, or related quantitative discipline. Master's degree preferred.
Pay Range
The typical pay range for this role is:
$130,295.00 - $260,590.00
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. This position also includes an award target in the company’s equity award program.
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: 07/31/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
