Medicaid Data Governance & Attribution Lead

CVS Health; Beryl (WV); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health benefits

Paid time off

Retirement savings

Job summary

CVS Health is seeking a Senior Manager to lead attribution, membership, and provider data governance within Medicaid operations, ensuring accurate, reliable downstream data and operations.

The role partners with health plan leaders, data teams, claims, and technology to deliver projects that meet regulatory requirements and improve customer experience. Candidates bring 5+ years in Medicaid or managed care data, strong SQL, Excel, Power BI, Tableau skills, and proven problem-solving abilities.

Qualifications

• 5+ years in Medicaid, managed care operations, provider data or healthcare analytics.
• Experience with SQL, advanced Excel, Power BI, Tableau or comparable tools.
• Ability to investigate, analyze and reconcile complex healthcare data and identify root causes.

Responsibilities

• Lead attribution, membership, and provider data governance processes to ensure accurate outputs.
• Oversee resolution of provider data and attribution issues affecting member assignment and reporting.
• Partner with health plan leaders, network teams, provider data teams, claims, compliance, marketing, and IT to deliver data projects.

Skills

Provider data governance

Medicaid operations

Healthcare analytics

SQL

Excel advanced

Power BI

Tableau

Data reconciliation

Communication

Cross-functional collaboration

Education

Bachelor's degree or equivalent professional experience

Tools

QNXT

MDW (Medicaid Data Warehouse)

Job description

CVS Health is seeking a Senior Manager to lead attribution, membership, and provider data governance within Medicaid operations, ensuring accurate, reliable downstream data and operations.

The role partners with health plan leaders, data teams, claims, and technology to deliver projects that meet regulatory requirements and improve customer experience. Candidates bring 5+ years in Medicaid or managed care data, strong SQL, Excel, Power BI, Tableau skills, and proven problem-solving abilities.