Internship Cvs Prior Authorization Jobs (NOW HIRING)

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

The Vice President, Data Strategy & Clinical Intelligence, will report to the EVP, Chief Medical Officer of CVS Health, will create a high-performing analytics team, forge productive partnerships with the enterprise Data & Technology team, establish the frameworks and infrastructure to measure Medical Affairs' contribution to enterprise goals, and serve as the medical affairs representative to enterprise AI governance, with specific responsibility for clinical safety and quality of AI applications.This role is both strategic and operational. The successful candidate will need to translate clinical questions into data strategies, navigate a complex matrixed organization, build credibility with business unit leaders who control data access, and produce insights that change how CVS Health makes clinical and business decisions.ResponsibilitiesAnalytics Strategy & Team Build Stand up a new clinical analytics function within Medical Affairs, recruit data engineers, data scientists, and clinical informaticists who can operate at the intersection of healthcare data and business strategy. Build a productive working relationship with Data and Technology team, establishing service-level expectations, and creating a sustainable operating model for how Medical Affairs accesses enterprise data assets. Develop the data architecture, pipelines, and reporting infrastructure needed to deliver recurring performance insights to Medical Affairs leadership and the business units it serves. Create a self-service analytics layer where feasible, reducing dependence on ad-hoc data requests and enabling Medical Affairs leaders (Aetna CMO, Caremark CMO, Retail Health CMO, Chief Quality Officer, Chief Psychiatric Officer, Women's Health and Genomics CMO ) to track their own KPIs.Clinical Metrics Definition & Performance Management Partner with business units, Digital, Data & Technology, and Finance to establish rigorous, enterprise-accepted definitions for critical clinical metrics-including prior authorization burden, decision quality, days spent at home, clinical outcomes by care journey, total cost of care attributable to clinical initiatives, and safety outcomes. Own the Medical Affairs strategic execution scorecard: set baselines, define targets, build tracking mechanisms, and deliver regular performance reporting against operating plan KPIs and longer-term strategic goals.Advanced Analytics & Data Science Identify and prioritize high-value analytical use cases that leverage CVS Health's unique data assets across pharmacy, insurance claims, clinical encounters, and consumer behavior-including but not limited to provider and long-term care facility profiling, fraud detection, clinical pathway optimization and predictive models for earlier diagnosis of rare diseases. Develop models and insights that directly support Medical Affairs strategic priorities such as care journey optimization, behavioral health and women's health program expansion, biosimilar adoption, formulary strategy, and cardiovascular disease mortality reduction. Create data-driven provider performance profiles that support network quality improvement, clinically integrated network (CIN) development, and value-based care contracting.Clinical AI Governance & Patient Safety Serve as the Medical Affairs representative to the enterprise AI governance group, ensuring that clinical safety, quality, and patient-outcome perspectives are embedded in all AI governance decisions. Develop clinical AI readiness criteria and validation protocols for new AI applications before they are deployed in clinical or member-facing contexts. Design and implement a systematic framework for ongoing monitoring of clinical AI applications-including model output accuracy, bias detection, performance drift, and adverse outcome tracking. Partner with the Chief Quality Officer and Enterprise Patient Safety team to integrate AI safety monitoring into broader patient safety and quality governance structures.Evidence Generation & Academic Partnerships Provide strategic direction to the Clinical Evidence Production team, setting research priorities that align with Medical Affairs and enterprise strategic goals. Build and manage relationships with top-tier academic institutions and health services research organizations, establishing CVS Health as a credible partner for high-impact studies on integrated care delivery, pharmacy-based interventions, and population health management. Ensure the data infrastructure and governance frameworks support rigorous, IRB-compliant research using CVS Health's longitudinal, multi-domain datasets. Increase the volume and impact of peer-reviewed publications, white papers, and external presentations that demonstrate the clinical value of CVS Health's integrated model, directly supporting the enterprise imperative to create distinct and durable enterprise value.Strategic Partnership & Value Communication Translate data and evidence into compelling narratives for diverse audiences: ELT leadership, business unit presidents, regulators, plan sponsors, and external clinical partners. Serve as a trusted analytical advisor to the CMO and the Medical Affairs leadership team, bringing data-informed perspectives to clinical strategy, resource allocation, and investment prioritization.Qualifications 15+ years of progressive experience in healthcare data strategy, clinical analytics, health services research, or clinical informatics, with at least 5 years in a leadership role. Clinical degree (e.g. MD, DO) with informatics or data science training or experience. Candidates without a clinical degree will be considered if they bring deep clinical domain fluency and a track record of earning credibility with physician and pharmacist leaders. Deep expertise in healthcare data ecosystems-claims data, clinical data, pharmacy data, quality measurement (HEDIS, Stars, CAHPS), and value-based care analytics. Demonstrated success building analytics teams and capabilities within large, matrixed healthcare organizations, including experience working across business units where data resources are decentralized. Track record of translating complex data into strategic business narratives that influence executive decision-making. Exceptional relationship-building and influencing skills. Proven experience to operates effectively in complex organizations Engages credibly with clinical and business stakeholders, translating clinical evidence into financial, operational, and strategic impact. Strong understanding of clinical AI/ML applications in healthcare, including model validation, bias detection, drift monitoring, and regulatory considerations will be valued Experience establishing or managing research partnerships with academic medical centers or health services research institutions will be valued Experience in managed care, pharmacy benefit management, or integrated health system settings would be valued Familiarity with FDA and CMS regulatory frameworks relevant to clinical decision support and AI in healthcare would be valuedEducation:Bachelor's degreeClinical degree will be valuedAdvanced degree in quantitative discipline (biostatistics, epidemiology, health informatics, data science) will be valuedPay RangeThe typical pay range for this role is:$325,000-$400,000
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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options,a401(k) plan(including matching company contributions), and anemployee stock purchase plan. No-cost programs for all colleaguesincluding wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleaguesincluding paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.For more information, visithttps://jobs.cvshealth.com/us/en/benefits

Pay Range

The typical pay range for this role is:

$0.00 - $0.00

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 fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing 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: 06/08/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.