Provider Data & Attribution Integrity Lead (Medicaid)

CVS Health; Central City (CO); On-site; USD 110,000 - 150,000; Full time

Job summary

CVS Health is seeking a Senior Manager to lead attribution governance and provider data integrity across Medicaid operations. The role coordinates between provider relations, IT, analytics, claims, and other teams to maintain accurate data downstream.

You will oversee governance routines, monitor issues, and drive improvements to reduce rework while supporting regulatory requirements and customer experience. A Bachelor’s degree and 5+ years in related fields are expected.

Qualifications

• 5+ years of experience in Medicaid, managed care operations, provider data, healthcare analytics.
• Strong experience with SQL, advanced Excel, Power BI, Tableau or similar tools.
• Ability to investigate, analyze, reconcile complex health care data, identify root causes, and recommend corrective actions.
• Experience resolving provider data issues, including provider identifiers, affiliations, and contractual relationships.
• Excellent written and verbal communication to translate operational issues into business risk and action plans.

Responsibilities

• Lead attribution, membership, and provider data governance processes.
• Oversee resolution of provider data and attribution issues affecting member assignment and reporting accuracy.
• Partner with plan leaders and cross‑functional teams to deliver projects meeting regulatory and customer needs.
• Support provider directory accuracy, audit readiness, and regulatory validations.
• Identify defects, root causes, and gaps; drive process improvements for reliability.

Skills

Data governance

Healthcare analytics

Communication

Root cause analysis

Project coordination

Education

Bachelor's degree or equivalent

Tools

SQL

Excel

Power BI

Tableau

QNXT

MDW

Job description

CVS Health is seeking a Senior Manager to lead attribution governance and provider data integrity across Medicaid operations. The role coordinates between provider relations, IT, analytics, claims, and other teams to maintain accurate data downstream.

You will oversee governance routines, monitor issues, and drive improvements to reduce rework while supporting regulatory requirements and customer experience. A Bachelor’s degree and 5+ years in related fields are expected.