Provider Data & Attribution Governance Lead

CVS Health; Dover (DE); On-site; USD 68,000 - 199,000; Full time

Job summary

CVS Health is seeking a Senior Manager to lead provider data integrity, attribution governance, and related operational controls within Medicaid operations. You will coordinate with provider relations, IT, analytics, claims, and other teams to ensure accurate data and proper downstream reflection.

The role requires strong analytical, communication, and cross-functional collaboration skills. The position emphasizes governance, issue resolution, and process improvements to drive reliability and

Qualifications

• 7-10 years of experience in Medicaid, managed care operations, provider data, or healthcare analytics.
• Experience with cross-functional issue resolution and driving operational improvements.
• Ability to translate complex data issues into clear business risk and action plans.

Responsibilities

• Lead attribution, membership, and provider data governance processes to ensure accurate outputs.
• Oversee resolution of provider data and attribution issues affecting member assignment and downstream operations.
• Partner with health plan leaders, network teams, provider data teams, claims, compliance, marketing, operations, and technology partners to deliver projects.
• Support provider directory accuracy, audit readiness, and regulatory validation activities through monitoring and remediation.
• Identify recurring defects, root causes, and control gaps, then drive process improvements for reliability.
• Maintain governance routines and cross-functional coordination for attribution and provider data operations.

Skills

SQL

Advanced Excel

Power BI

Tableau

Communication

Education

Bachelor's degree

Job description

CVS Health is seeking a Senior Manager to lead provider data integrity, attribution governance, and related operational controls within Medicaid operations. You will coordinate with provider relations, IT, analytics, claims, and other teams to ensure accurate data and proper downstream reflection.

The role requires strong analytical, communication, and cross-functional collaboration skills. The position emphasizes governance, issue resolution, and process improvements to drive reliability and