Senior Manager, Medicaid Provider Data & Attribution

CVS Health; Austin (TX); On-site; USD 120,000 - 150,000; Full time

Benefits offered by this job

Bonus eligibility

Equity award program

Comprehensive benefits

Job summary

CVS Health is seeking a Senior Manager to lead attribution, membership, and provider data governance within Medicaid operations. The role partners with multiple teams to ensure accurate provider data, reliable outputs, and compliant processes across downstream systems.

The ideal candidate brings 5+ years in Medicaid or managed care data environments, strong SQL/Excel/Power BI/Tableau skills, and proven ability to reconcile complex health data while communicating risks and actions clearly.

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.
• Demonstrated ability to independently investigate, analyze, and reconcile complex health care data, identify root causes, and recommend corrective actions.
• Demonstrated experience investigating and resolving provider data issues, including discrepancies involving provider identifiers, affiliations, contractual relationships, etc.
• Strong communication skills, including the ability to translate complex operational issues into clear business risk, action plans, and ownership.

Responsibilities

• Lead attribution, membership, and provider data governance processes to ensure accurate operational outputs.
• Oversee resolution of provider data and attribution issues that affect member assignment, reporting accuracy, 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, documentation, and remediation.
• Identify recurring defects, root causes, and control gaps, then drive process improvements that reduce rework.
• Maintain governance routines, process documentation, and cross-functional coordination for attribution and provider data operations.

Skills

Medicaid operations

Provider data governance

Healthcare analytics

Data reconciliation

Communication

Education

Bachelor's degree or equivalent professional experience

Tools

SQL

Excel

Power BI

Tableau

Job description

CVS Health is seeking a Senior Manager to lead attribution, membership, and provider data governance within Medicaid operations. The role partners with multiple teams to ensure accurate provider data, reliable outputs, and compliant processes across downstream systems.

The ideal candidate brings 5+ years in Medicaid or managed care data environments, strong SQL/Excel/Power BI/Tableau skills, and proven ability to reconcile complex health data while communicating risks and actions clearly.