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Data Scientist – Quality and Population Health

Remote, USA Full-time Posted 2025-11-03
Description: • 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) • Leads rigorous evaluation research into prioritized Medicaid population health interventions end-to-end (research design, methodology, analysis, presentation, continuous improvement cycle) • Leads the development of fact/dimensional data models within Power BI that serve evaluation research effort • Leads all data science efforts to continuously monitor HEDIS and population health performance metrics using appropriate methodologies • Leads KPI design, Power BI data modeling, custom algorithms, machine learning, and continuous quality improvement techniques • Leads project management and communication of multi-month, cross-functional data science infrastructure projects • Leads in-depth program evaluation analytics to understand successes and opportunities within Population Health Management Programs • Leads custom data insights generation for senior leadership and regulatory/accreditation reporting (e.g., Illinois Department of Healthcare and Family Services, NCQA) • Leads iterative development of actionable, custom-built Power BI solutions for frontline staff and senior leadership • Transforms manual data intake and reporting efforts into standardized, automated processes that monitor and flag data validity, accuracy, and completeness issues • Effectively communicates data insights to key stakeholders with varying data skills • Trains fellow analysts and colleagues in advanced data science principles, Power BI, SQL, Python, R, Hadoop, and data visualizations • Trains colleagues on how to use and interpret custom-built Power BI solutions • Other duties as needed Requirements: • At least 5 years of experience within the analytics industry • At least 3 years of demonstrated healthcare analytics experience within Medicaid/Medicare space • Advanced 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 questions • Advanced knowledge of evaluation research, longitudinal trending, and population monitoring to demonstrate effectiveness of interventions • Advanced knowledge of effectively communicating data verbally and visually to data experts as well as non-data experts • Advanced knowledge of data-appropriate visualization techniques (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 reporting • Advanced knowledge of healthcare data types (qualitative, quantitative, geospatial) • Advanced knowledge of SQL and writing SQL code within SQL Server Management Studio • Advanced knowledge of relational database design including fact-dimensional data modeling • Advanced knowledge of Power BI (e.g., DAX) • Advanced knowledge of Microsoft Excel (formulas, pivot tables/graphs, data slicers, statistical toolkit) • Advanced knowledge of designing and evaluating KPIs, outcome measures, and other custom-built metrics • Advanced knowledge of population analytics (Dx, med econ profiling, SDOH, utilization pattern, CPC, ICD-10, HCPCS) and profiling techniques • Advanced knowledge of HEDIS and other healthcare data industry standards, issues, and trends • Ability to curate data to ensure that it is valid, accurate, and complete • Ability to work efficiently within Microsoft 365 environment (Teams and SharePoint) • Ability to independently plan and execute data analytics requests within cross-functional teams • Ability to prioritize multiple data requests within a fast-paced environment • Exceptional attention to detail, critical thinking, and data communication skills • Exceptional ability to convey complex information in simple, effective ways and craft evidence-based data stories • Demonstrates a positive attitude and works efficiently to ensure that deadlines are met • Bachelor’s degree in Data Science, Analytics, Computer Science, Math, Psychology, Statistics, Sociology or equivalent experience (Master's degree preferred) • Preferred qualifications: Python, R, Hadoop Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • Eligible for a CVS Health bonus, commission or short-term incentive program • No-cost programs 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 • Other benefits depending on eligibility Apply tot his job Apply To this Job

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