Senior Manager, Medicaid Provider Data & Attribution

CVS Health; Portland (ME); Hybrid; USD 120,000 - 180,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Senior Manager to lead attribution governance and provider data integrity for Medicaid operations. You will coordinate with provider relations, IT, analytics, and claims teams to ensure accurate attribution and data quality across downstream systems.

Responsibilities include overseeing governance processes, resolving data issues, and driving improvements to reduce rework and improve reliability.

Qualifications

• 5+ years in Medicaid, managed care operations, provider data, or healthcare analytics.
• Proficient with SQL, advanced Excel, Power BI, Tableau, or similar tools.
• Ability to investigate, analyze, and reconcile complex health data and identify root causes.
• Experience resolving provider data issues across identifiers, affiliations, and contracts.
• Strong communication to translate operational issues into business risk and actions.
• Experience in provider attribution governance, reporting, and execution.
• Experience leveraging QNXT and MDW data for decisions and issue resolution.
• Experience managing provider rosters and directory accuracy across systems.
• Experience coordinating across multiple teams on provider data issues.
• Bachelor's degree or equivalent professional experience.

Responsibilities

• Lead attribution, membership, and provider data governance processes.
• Oversee resolution of provider data and attribution issues affecting member assignment and downstream operations.
• Collaborate with health plan, network, claims, compliance, and IT teams to deliver projects.
• Support provider directory accuracy, audit readiness, and regulatory validation via monitoring and remediation.
• Identify recurring defects and root causes; drive process improvements to reduce rework.
• Maintain governance routines, documentation, and cross-functional coordination for attribution and provider data operations.

Skills

Medicaid experience, managed care

Provider data governance

Healthcare analytics

SQL

Excel

Power BI

Tableau

Data reconciliation

Strong communication

Education

Bachelor's degree or equivalent

Tools

QNXT

MDW data

Job description

CVS Health is seeking a Senior Manager to lead attribution governance and provider data integrity for Medicaid operations. You will coordinate with provider relations, IT, analytics, and claims teams to ensure accurate attribution and data quality across downstream systems.

Responsibilities include overseeing governance processes, resolving data issues, and driving improvements to reduce rework and improve reliability.