Director Data Science

Profile

Job Description
Do things that matter. Diabetes, congestive heart failure, COPD, back pain, asthma, pulmonary fibrosis, chronic kidney disease, Alzheimer's, multiple sclerosis, cancer... everyone knows someone affected by these conditions. Our goal is to decrease cost and improve health for members with chronic disease. We do this by using data science and advanced analytics (e.g., condition-specific predictive models and clinical data mining) to improve their care journeys and outcomes, focusing on the right members getting the right interventions at the right time.

Mission aligned to improve health. With 1,000 health hubs, 1,100 minute clinics, 23M lives insured by Aetna, and 100M lives with pharmacy benefits coverage through Caremark. With this unique collection of assets, CVS Health has an unparalleled platform to make a significant impact on healthcare in the US and beyond.

We have actual big data. The combined data assets of CVS are massive: medical and pharmacy claims, health care records, commercial store, and transactional data for 100M members. The scale of our data will allow you to design and test powerful experiments and challenge yourself to innovate in ways that others simply cannot.

An elite team. You'll be joining a team of MDs, PhDs, MBAs, and top analytics professionals that bring their clinical, technical, and economic experience to bear on some of the toughest targets in healthcare.

Focus of the Position (PBM Analytics)

Our PBM Analytics team is tasked with optimizing our ability to engage with our 100M Caremark members to help them make better healthcare decisions, particularly relating to the medications they take. Our goals are to improve clinical outcomes and to help members gain more transparency into the healthcare system so that they can save money and have better experiences. To do this we've developed a leading capability that combines data science, agile marketing, behavioral economics, large scale experimentation, and optimization of our digital capabilities. Through this we message millions of members each year about real challenges they face and help them become healthier or save money – we drive tangible and meaningful impact for our members.

• This role is to establish a team that manages the aggregate financial impact of PBM products, initiatives, and contracts on pharmacy cost trend aligning to our Enterprise goal of effective cost management.
• The team's goal is to provide timely, accurate, actionable data and analysis for utilization and unit cost management to reduce pharmacy trend for our clients: quantifying how our various products and programs are impacting pharmacy cost trends, and helping prioritize actions that would lead to further cost improvements across Commercial and other lines of business.
• The leader will interface with senior leadership, describing detailed and intricate data in a way that can be digested by VPs and above. The role combines a dense subject matter expertise with advanced communication skills. In addition, the leader in this new position must be able to describe potential pharmacy cost actions that should occur and work across diverse stakeholder groups to ensure those actions and new opportunities are implemented and monitored with high precision and success.
• Oversee regular trend analyses and material development for department reporting and meetings.
• Provide oversight and leadership of all activities related to Medical Economics team and align with senior MEU and Product leaders to set organizational strategy.
• Work alongside other MEU MER Directors to understand market themes and best practices for implementation.
• Deliver performance evaluation and business-impacting recommendations for all cost savings analytics
• Proactively and independently identify critical pharmacy cost issues and design and recommend solutions to business problems to staff, senior Executive leadership, and key business partners
• Work cross-functionally across a diverse stakeholder group including: Product, Clinical, Finance, Actuarial, Trade, Medical Economics and Data Science

Required Qualifications
• 7 years with Medical Cost Analytics, Actuarial Science, Healthcare Analytics
• 5 years of people management experience

COVID Requirements
CVS Health requires its Colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.

If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. In some states and roles, you may be required to provide proof of full vaccination before you can begin to actively work. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with **MEMBERS ONLY**SIGN UP NOW***.

If you are unable to be fully vaccinated due to disability, medical condition, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with **MEMBERS ONLY**SIGN UP NOW***. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. In some states and roles, you may be required to have an approved reasonable accommodation before you can begin to actively work. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications
• Foundational knowledge of PBM business functions, including underwriting, sales, product development, network management, and trade/formulary

• Demonstrates a strong ability to communicate technical concepts and implications to business partners.

• Strong analytical ability and familiarity with advanced financial and healthcare concepts. Demonstrates critical thinking and expresses ideas clearly, concisely, and logically from a cross functional perspective.

• Well versed in advanced analytics tools and languages to analyze large data sets from multiple data sources.

• Anticipates and prevents problems and roadblocks before they occur

Education
• Bachelor's degree in quantitative field, or an equivalent combination of formal education and experience. Preferred background in Mathematics, Finance, Data Science or Actuarial Science

Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Apply

Company info

Sign Up Now - FinancialServicesCrossing.com