Provider Data & Attribution Integrity Lead (Medicaid Ops)

CVS Health; Ohio; On-site; USD 95,000 - 135,000; 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 seeks a Senior Manager to lead provider data governance and attribution processes, ensuring accurate, auditable outputs across downstream systems. You will partner with Medicaid operations, IT, and analytics to drive continuous process improvements and regulatory compliance.

The role requires 5+ years in Medicaid or managed care data, strong SQL/Excel/BI skills, and excellent communication. Eligible for CVS Health’s comprehensive benefits package.

Qualifications

• 5+ years of experience in Medicaid, managed care operations, provider data, healthcare analytics.
• Experience with SQL, advanced Excel, Power BI, Tableau, or comparable analytical tools.
• Strong ability to investigate, analyze, and reconcile complex health care data and drive corrective actions.

Responsibilities

• Lead attribution, membership, and provider data governance processes for accurate outputs.
• Oversee resolution of provider data and attribution issues affecting member assignment and reporting.
• Collaborate with health plan, network, provider data, claims, compliance 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 ops.

Skills

Data governance

Analytical thinking

Communication skills

Education

Bachelor's degree or equivalent professional experience

Tools

SQL

Power BI

Tableau

Excel

QNXT

MDW

Job description

CVS Health seeks a Senior Manager to lead provider data governance and attribution processes, ensuring accurate, auditable outputs across downstream systems. You will partner with Medicaid operations, IT, and analytics to drive continuous process improvements and regulatory compliance.

The role requires 5+ years in Medicaid or managed care data, strong SQL/Excel/BI skills, and excellent communication. Eligible for CVS Health’s comprehensive benefits package.