Senior Manager, Medicaid Provider Data & Attribution

CVS Health; Raleigh (NC); Sur place; USD 68 000 - 199 000; Plein temps

Avantages offerts par ce poste

Medical coverage

Dental coverage

Vision coverage

Paid time off

Résumé du poste

CVS Health is seeking a Senior Manager to lead provider data integrity, attribution governance, and related controls that support Medicaid operations. You will partner with provider relations, IT, analytics, claims, and other departments to ensure accurate provider and attribution data across downstream systems.

You will establish governance routines, drive process improvements, monitor compliance, and support directory accuracy, audits, and regulatory validation.

Qualifications

• 7-10 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 investigate, analyze, and reconcile complex health care data, identify root causes, and recommend corrective actions.
• Experience coordinating cross-functional issue resolution and operational improvements.

Responsabilités

• Lead attribution, membership, and provider data governance processes to ensure accurate and reliable outputs.
• Oversee resolution of provider data and attribution issues affecting member assignment and downstream operations.
• Partner with plan leaders, provider data teams, analytics, and technology to deliver projects supporting performance and regulatory requirements.
• Support provider directory accuracy, audit readiness, and regulatory validation activities through monitoring and remediation.

Connaissances

SQL

Advanced Excel

Power BI

Tableau

Formation

Bachelor's degree or equivalent professional experience

Outils

None

Description du poste

CVS Health is seeking a Senior Manager to lead provider data integrity, attribution governance, and related controls that support Medicaid operations. You will partner with provider relations, IT, analytics, claims, and other departments to ensure accurate provider and attribution data across downstream systems.

You will establish governance routines, drive process improvements, monitor compliance, and support directory accuracy, audits, and regulatory validation.