Senior Data Scientist

CVS Health's Analytics & Behavior Change (A&BC) is an organization working to solve some of the most challenging problems at the intersection of technology and healthcare. A&BC leverages advanced analytics, machine learning, modeling, and a hypothesis-driven approach to quickly transform data into actionable, customer-centric insights to drive growth, improve health outcomes and access to health care across all of our businesses in CVS Health. We are responsible for understanding the data flow from a business perspective to create a solution architecture to model the business. Our data teams build next-generation data and machine learning platforms and AI products in the cloud that help power CVS Health to make healthier happen for 100+ million customers.

Aetna's Clinical Enablement and Augmentation is seeking a talented and motivated Senior Data Scientist to join our team, focusing on the support and evaluation of innovative technology products designed for care management clinicians and members. This role will be pivotal in supporting the preparation of data to support member outreach, and the synthesis and analysis of the results of these outreaches—helping to inform success and opportunities for improvement.

Responsibilities include:

• Analyze outbound voice-AI call outcomes (reach, engagement, conversion) across multiple outreach use cases to measure performance and identify opportunities for improvement and inform scaling decisions.
• Create data structures and pipelines to standardize and streamline data collection, ensuring integrity and reliability for reporting and analysis.
• Partner with engineering to validate data flowing into and out of the voice AI platform, including call results, transcripts, and dashboard metrics, as well as data integration of call output back into CVS systems.
• Develop and maintain reporting on reach rates, validation rates, and conversion metrics for operational and clinical leadership.
• Support evaluations across each stage of the product lifecycle (POC, pilot, scale), defining success metrics and go/no-go criteria.
• Design and maintain audit frameworks for AI call quality.
• Collaborate with business stakeholders across lines of business to translate operational questions into analysis.
• Contribute to broader platform integration workstreams (e.g., targeting, filtering, real-time analytics) as needed.
• Utilize advanced statistical techniques to analyze both structured and unstructured data, addressing complex business challenges.
• Employ data visualization techniques to effectively communicate analytical results and support strategic decision-making among stakeholders.
• Work closely with cross-functional teams, including IT and business partners, throughout all phases of initiatives—from exploration of clinical opportunities to implementation of solutions.

Required Qualifications

• 3+ years Analytic experience
• 3+ years SQL Programming experience
• 3+ year experience at a Data Scientist
• 3+ year experience with Python
• 2+ year experience with Cloud (GCP, AWS or Azure)
• 2+ year experience communicating technical concepts to business
• 2+ year experience with ML Modeling, machine learning algorithms, statistical analysis, data engineering and data visualization

Preferred Qualifications

• Experience with BigQuery (BQ) and Claude-First coding and workflows
• Understanding of health care industry and clinical research concepts
• Experience with large, unstructured data sets
• Experience implementing natural language processing techniques

Education

• Bachelor's degree in Data Science, Statistics, Computer Science, Business Analytics, Economics, Physics, Engineering, or related discipline
• Master's degree preferred

Portfolio Overview

The CEA (Clinical Enablement & Augmentation) portfolio in A&BC builds and enables AI-powered tools that help nurses and care managers spend more time with members delivering personalized support. Aetna Care Managers provide outreach and clinical support to our most medically complex members when they need it most. The portfolio has 4 squads with six products, including a mix of internally built solutions and start-up partnerships. Conversational AI is one of the squads, partnering with start-ups to leverage new technologies to expand and augment outreach to members to support their health journey. The portfolio is anchored by our flagship solutions, Case Assistant, Case Documentation and Smart Care, while also expanding into new frontiers like AI-driven voice outreach (this squad) and clinical conversation intelligence solutions.