Provider Data & Attribution Integrity Lead (Medicaid)

CVS Health; Illinois; On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources

Job summary

CVS Health is seeking a Senior Manager to lead provider data governance and attribution-related operations for Medicaid. You will coordinate with provider relations, IT, analytics, and claims to ensure data accuracy and reliable downstream reporting.

The role requires 5+ years in Medicaid or managed care data, strong SQL, Excel, Power BI, and Tableau skills, and the ability to translate complex data issues into actionable risk and improvements.

Qualifications

• 5+ years of experience in Medicaid or managed care data and analytics.
• Proficient with SQL, advanced Excel, Power BI and Tableau.
• Ability to investigate, reconcile, and resolve complex healthcare data issues.
• Experience addressing provider data discrepancies across systems.
• Strong communication to translate data issues into business risks and actions.

Responsibilities

• Lead attribution, membership, and provider data governance processes.
• Oversee resolution of provider data and attribution issues affecting reporting.
• Partner with health plan, network, provider data, claims, compliance, marketing, and IT teams on projects.
• Support provider directory accuracy, audits, and regulatory validation activities.
• Identify defects and drive process improvements to reduce rework and improve reliability.
• Maintain governance routines and cross-functional coordination for attribution and provider data operations.

Skills

SQL

Excel (advanced)

Power BI

Tableau

Data governance

Healthcare analytics

Regulatory awareness

Education

Bachelor's degree or equivalent experience

Tools

QNXT

MDW

Job description

CVS Health is seeking a Senior Manager to lead provider data governance and attribution-related operations for Medicaid. You will coordinate with provider relations, IT, analytics, and claims to ensure data accuracy and reliable downstream reporting.

The role requires 5+ years in Medicaid or managed care data, strong SQL, Excel, Power BI, and Tableau skills, and the ability to translate complex data issues into actionable risk and improvements.