Senior Manager, Medicaid Provider Data & Attribution

CVS Health; Denver (CO); On-site; USD 68,000 - 199,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits

Job summary

CVS Health is seeking a Senior Manager to lead provider data integrity, attribution governance, and related operational controls across Medicaid operations. The role acts as a liaison among provider relations, data management, IT, analytics, claims, and other teams to ensure accurate and consistent provider and attribution information downstream.

You will oversee governance, data quality, and regulatory validation, drive cross-functional improvements, and maintain documentation to support audit

Qualifications

• 7-10 years of experience in healthcare analytics or Medicaid operations.
• 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.
• Experience coordinating cross-functional issue resolution and operational improvements.
• 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 and reliable operational outputs.
• Oversee resolution of provider data and attribution issues that affect member assignment, reporting accuracy, and downstream operations.
• Partners with health plan leaders, network teams, provider data teams, claims, compliance, marketing, operations, and technology partners to deliver projects that support business performance, regulatory requirements, and customer experience.
• Support provider directory accuracy, audit readiness, and regulatory validation activities through monitoring, documentation, and issue remediation
• Identify recurring defects, root causes, and control gaps, then drive process improvements that reduce rework and improve operational reliability.
• Maintain governance routines, process documentation, and cross-functional coordination for attribution and provider data operations.

Skills

Data analysis

Cross-functional collaboration

Communication

Problem solving

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 provider data integrity, attribution governance, and related operational controls across Medicaid operations. The role acts as a liaison among provider relations, data management, IT, analytics, claims, and other teams to ensure accurate and consistent provider and attribution information downstream.

You will oversee governance, data quality, and regulatory validation, drive cross-functional improvements, and maintain documentation to support audit