Medicaid Provider Data & Attribution Lead

CVS Health; Elm (PA); In loco; USD 120.000 - 180.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources

Descrizione del lavoro

CVS Health is seeking a Senior Manager to lead Medicaid data governance, attribution, and related operations. You will collaborate with provider relations, IT, analytics, claims, and compliance to ensure accurate provider data and reliable downstream reporting.

The role emphasizes end-to-end governance, issue resolution, root-cause analysis, and process improvements. A Bachelor's degree and 5+ years in Medicaid or managed care data, with SQL, Excel, Power BI, Tableau, and QNXT/MDW experience are

Competenze

• 5+ years of experience in Medicaid, managed care operations, provider data, healthcare analytics.
• Experience with SQL, advanced Excel, Power BI, Tableau, or comparable analytical tools.
• Ability to investigate, analyze, and reconcile complex health care data, identify root causes, and recommend corrective actions.
• Experience managing provider attribution methodologies, governance, reporting, and operational execution.

Mansioni

• 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.

Conoscenze

SQL

Advanced Excel

Power BI

Tableau

Data analysis

Communication

Formazione

Bachelor's degree or equivalent professional experience

Strumenti

QNXT

MDW (Medicaid Data Warehouse)

Descrizione del lavoro

CVS Health is seeking a Senior Manager to lead Medicaid data governance, attribution, and related operations. You will collaborate with provider relations, IT, analytics, claims, and compliance to ensure accurate provider data and reliable downstream reporting.

The role emphasizes end-to-end governance, issue resolution, root-cause analysis, and process improvements. A Bachelor's degree and 5+ years in Medicaid or managed care data, with SQL, Excel, Power BI, Tableau, and QNXT/MDW experience are