Medicare Revenue Data Engineering Lead

CVS Health Corporation; Iowa City (IA); 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 senior data engineer to own the Medicare revenue data foundation. You will design and operate data pipelines, ingest and reconcile claims, eligibility, and CMS artifacts, and implement HCC/ICD-10 mapping with a focus on auditable, timely datasets for finance forecasts.

Requires 8+ years in data engineering with 4+ years in healthcare data and hands-on Databricks/Spark, Python, and SQL.

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 that feed the Medicare revenue projection model.
• Ingest, normalize, and reconcile claims/encounters, eligibility/enrollment, EMR/chart extracts, vendor/program files, and CMS artifacts.
• Implement HCC / ICD-10 mapping, model-year versioning, and diagnosis-year vs. payment-year constructs.
• Own data quality, reconciliation, lineage, and snapshot/freeze processes required for accruals, AtoE, and audit.
• Partner with enterprise data/IT on Databricks lakehouse standards: Spark/PySpark, orchestration, CI/CD, access control, and cost/performance.
• Provide trusted datasets to Modeling, Finance, Actuarial, and Revenue Integrity as needed.
• Define SLAs for freshness; monitor drift and source-system changes that affect forecasts.
• Lead and mentor data engineers; set engineering practices for a regulated environment.
• Support modular outputs (revenue, membership/mix, etc.) for future evolution.

Skills

Data engineering

Healthcare data

Databricks / Spark

Python

SQL / Lakehouse

Airflow

Data quality

Education

Bachelor's in CS or related field

Tools

Databricks

Spark

Airflow

SAS

Job description

CVS Health Corporation is seeking a senior data engineer to own the Medicare revenue data foundation. You will design and operate data pipelines, ingest and reconcile claims, eligibility, and CMS artifacts, and implement HCC/ICD-10 mapping with a focus on auditable, timely datasets for finance forecasts.

Requires 8+ years in data engineering with 4+ years in healthcare data and hands-on Databricks/Spark, Python, and SQL.