Medicaid Provider Data & Attribution Lead

CVS Health; Connecticut; Sur place; USD 120 000 - 170 000; Plein temps

Avantages offerts par ce poste

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources

Résumé du poste

CVS Health is seeking a Senior Manager to lead provider data integrity, attribution governance, and related controls across Medicaid operations. You will coordinate with provider data teams, IT, analytics, and claims to ensure accurate downstream data and successful project delivery.

The role demands 5+ years in Medicaid/managed care data, strong SQL/Excel/BI tooling proficiency, and proven ability to translate complex data issues into actionable business steps.

Qualifications

• 5+ years of experience in Medicaid, managed care operations, provider data, healthcare analytics.

Responsabilités

• Lead attribution, membership, and provider data governance processes to ensure accurate and reliable operational outputs.
• Oversee resolution of provider data and attribution issues that affect member assignment, reporting accuracy, and downstream operations.
• Partner with health plan leaders, network teams, provider data teams, claims, compliance, marketing, operations, and technology partners to deliver projects that support business performance, regulatory requirements, and customer experience.
• Support provider directory accuracy, audit readiness, and regulatory validation activities through monitoring, documentation, and issue remediation.
• Identify recurring defects, root causes, and control gaps, then drive process improvements that reduce rework and improve operational reliability.
• Maintain governance routines, process documentation, and cross-functional coordination for attribution and provider data operations.

Connaissances

SQL

Advanced Excel

Power BI

Tableau

Healthcare analytics

Formation

Bachelor's degree or equivalent professional experience

Outils

QNXT

MDW (Medicaid Data Warehouse)

Description du poste

CVS Health is seeking a Senior Manager to lead provider data integrity, attribution governance, and related controls across Medicaid operations. You will coordinate with provider data teams, IT, analytics, and claims to ensure accurate downstream data and successful project delivery.

The role demands 5+ years in Medicaid/managed care data, strong SQL/Excel/BI tooling proficiency, and proven ability to translate complex data issues into actionable business steps.