Medicare Data Platform Lead

CVS Health Corporation; Providence (RI); On-site; USD 83,000 - 183,000; Full time

Job summary

CVS Health Corporation in Providence, RI seeks an experienced data engineer to own the Medicare revenue data foundation, ensuring timely, complete, auditable member-month, diagnosis, and CMS data for Finance.

The role requires deep expertise in healthcare data and production-grade Databricks/Spark environments, with a focus on data quality, SLA governance, and cross-functional collaboration within a regulated setting.

Qualifications

• 8+ years in data engineering.
• 4+ years of expert level experience in healthcare data: claims, encounters, eligibility, provider, and clinical/chart sources.
• 4+ years of hands-on production experience with Databricks / Spark (PySpark), Python, and SQL / Lakehouse / ELT patterns, orchestration (e.g., Airflow or equivalent), and data-quality frameworks.
• 4+ years of experience supporting risk-adjustment, actuarial, or finance workloads (reconciliation, point-in-time history, auditability).
• Strong understanding of PHI, HIPAA, and controls appropriate to revenue and CMS-submission data.

Responsibilities

• Design, build, and operate the data pipelines and analytic tables feeding the Medicare revenue projection model.
• Ingest, normalize, and reconcile claims/encounters, eligibility/enrollment, EMR/chart extracts, and CMS artifacts.
• Implement HCC/ICD-10 mapping, versioning, and year constructs to support accurate modeling.
• Own data quality, reconciliation, lineage, and snapshot/freeze processes for accruals and audit.
• Partner with enterprise data/IT on lakehouse standards: Spark/PySpark, orchestration, CI/CD, access control, cost/performance.
• Provide trusted datasets to Modeling, Finance, Actuarial, and Revenue Integrity; define SLAs for freshness and completeness.

Skills

Data engineering

Healthcare data

Leadership

Mentoring

Cross-functional collaboration

Education

Bachelor’s in CS/Engineering or related field

Tools

Databricks

Spark

PySpark

Python

SQL

Airflow

CI/CD

Data-quality frameworks

Job description

CVS Health Corporation in Providence, RI seeks an experienced data engineer to own the Medicare revenue data foundation, ensuring timely, complete, auditable member-month, diagnosis, and CMS data for Finance.

The role requires deep expertise in healthcare data and production-grade Databricks/Spark environments, with a focus on data quality, SLA governance, and cross-functional collaboration within a regulated setting.