Medicare Revenue Data Engineering Lead

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

Benefits offered by this job

Bonus program

Equity awards

Comprehensive benefits

Job summary

CVS Health Corporation is seeking a data engineer to own the data foundation for the Medicare revenue engine, requiring expert health data, claims, CMS files, and production-grade Databricks/PySpark. The role focuses on making member-month, diagnosis, and payment data timely, complete, lineage-traced, and auditable for finance forecasting.

You will design pipelines, ingest and reconcile sources, implement HCC/ICD-10 mappings, ensure data quality, and partner with enterprise data/IT on lakehouse

Qualifications

• 8+ years in data engineering
• 4+ years healthcare data (claims, encounters, eligibility, provider, charts)
• 4+ years production experience with Databricks / Spark (PySpark), Python, SQL and Lakehouse patterns; orchestration (Airflow) and data-quality frameworks
• 4+ years supporting risk-adjustment, actuarial, or finance workloads; strong PHI/HIPAA controls

Responsibilities

• Design, build, and operate data pipelines and analytic tables for Medicare revenue projection.
• Ingest, normalize, and reconcile claims/encounters, eligibility, EMR/chart extracts, vendor files, and CMS artifacts.
• Implement HCC/ICD-10 mapping, model-year versioning, and year constructs to support modelers.
• Own data quality, reconciliation, lineage, and snapshot/freeze processes for accruals and audits.
• Partner with enterprise data/IT on Databricks 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; monitor source-system changes affecting forecasts.
• Lead and mentor data engineers; set engineering practices in a regulated environment.
• Support modular outputs (revenue, membership/mix) to evolve the engine without rewriting the warehouse.

Skills

Databricks / Spark

Python

SQL

Airflow

Data quality

Education

Bachelor’s in CS/Engineering

Tools

SAS

Job description

CVS Health Corporation is seeking a data engineer to own the data foundation for the Medicare revenue engine, requiring expert health data, claims, CMS files, and production-grade Databricks/PySpark. The role focuses on making member-month, diagnosis, and payment data timely, complete, lineage-traced, and auditable for finance forecasting.

You will design pipelines, ingest and reconcile sources, implement HCC/ICD-10 mappings, ensure data quality, and partner with enterprise data/IT on lakehouse