Data Scientist - Pharmacy Benefits

CVS Health is hiring a Data Scientist to improve member experience and service quality in Caremark’s pharmacy benefits business. The role develops and delivers analytics, predictive models, and generative AI solutions, partnering with clinical, operational, and business stakeholders across the solution lifecycle.

Responsibilities

• Partner closely with clinical and operational experts to unpack complex operational processes, identify bottlenecks, and translate requirements into technical solutions
• Design, build, and validate data science solutions—ranging from Generative AI pipelines and predictive models to rules-based logic
• Manage end-to-end delivery from initial data extraction and modeling to production deployment and lifecycle monitoring (e.g., testing, performance dashboards, alert thresholds)
• Extract, curate, and analyze large-scale operational data using SQL and Python
• Translate complex modeling outputs into clear, business-driven narratives and presentations for clinical and business leadership

Preferred

• Initiative: Proven ability to independently investigate ambiguous problems, interview process owners, and structure solutions rather than waiting for defined specifications
• Stakeholder Communication: Ability to translate complex data science concepts into clear business risks and opportunities for non-technical partners
• ML Model & Generative AI: Practical experience building ML solutions or LLM-based solutions (e.g., prompt design, RAG architectures, model evaluation frameworks)
• Production Monitoring: Experience establishing model performance guardrails, such as drift detection, production monitoring, and alerting systems
• Domain Experience: Familiarity with healthcare data (e.g., pharmacy claims, clinical workflows, or unstructured clinical notes)
• Cloud & Tools: Familiarity with Google Cloud Platform (GCP) or similar enterprise cloud environments, as well as AI-assisted software development tools
• Master's degree in a quantitative field or MBA strongly preferred
• Machine Learning Solutions
• Prompt Design
• RAG Architectures
• Model Evaluation
• Model Performance Guardrails
• Drift Detection
• Production Monitoring
• Alerting Systems
• Healthcare Data
• Pharmacy Claims
• Clinical Workflows
• Unstructured Clinical Notes
• Google Cloud Platform
• Enterprise Cloud Environments
• AI-Assisted Software Development
• Master’s Degree
• Quantitative Field
• MBA
• Initiative
• Independent Problem-Solving
• Complex-to-Business Translation

Benefits

• Eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range.
• Full-time position eligible for a comprehensive benefits package, based on eligibility.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources.
• Hybrid work arrangement

Company

• Health care services, pharmacy services, and health plans
• Woonsocket, Rhode Island, USA
• https://www.cvshealth.com/
• Founded in 1963
• 10001+ employees

Qualifications

• 1+ years of professional experience writing production-grade code in Python and querying complex datasets using SQL
• 1+ years of professional experience building, validating, and deploying machine learning models, statistical models, algorithmic solutions, or LLM-based solutions
• Experience using Git/GitHub for version control and collaborative code development
• Experience delivering presentations, reports, or business reviews to cross-functional stakeholders
• Bachelor's degree or equivalent work experience in Computer Science, Statistics, Mathematics, Analytics, Engineering, or a related quantitative field
• Initiative: Proven ability to independently investigate ambiguous problems, interview process owners, and structure solutions rather than waiting for defined specifications
• Stakeholder Communication: Ability to translate complex data science concepts into clear business risks and opportunities for non-technical partners
• ML Model & Generative AI: Practical experience building ML solutions or LLM-based solutions (e.g., prompt design, RAG architectures, model evaluation frameworks)
• Production Monitoring: Experience establishing model performance guardrails, such as drift detection, production monitoring, and alerting systems
• Domain Experience: Familiarity with healthcare data (e.g., pharmacy claims, clinical workflows, or unstructured clinical notes)
• Cloud & Tools: Familiarity with Google Cloud Platform (GCP) or similar enterprise cloud environments, as well as AI-assisted software development tools
• Master's degree in a quantitative field or MBA strongly preferred
• 1+ years of professional experience writing production-grade code in Python and querying complex datasets using SQL.
• 1+ years of professional experience building, validating, and deploying machine learning models, statistical models, algorithmic solutions, or LLM-based solutions.

Required skills

• Git/GitHub, Google Cloud Platform (GCP), Healthcare Data, Large Language Models (LLMs), Machine Learning, Model Evaluation, Production Model Monitoring, Prompt Design, Python, Retrieval-Augmented Generation (RAG), SQL, Statistical Modeling

Experience

• 1+ years