Senior Manager, Provider Data & Attribution Governance

CVS Health; City of Albany (NY); On-site; USD 68,000 - 199,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Retirement savings

Job summary

CVS Health leads Medicaid provider data integrity and attribution governance, coordinating with/provider data management, IT, analytics, claims and operations to ensure accurate information reflected in downstream systems.

The senior manager role drives governance routines, root-cause analysis, and cross-functional improvements to enhance performance, regulatory compliance, and customer experience across the organization.

Qualifications

• 7-10 years of experience in healthcare operations or data governance.
• 5+ years of Medicaid or managed care data and analytics.
• Strong SQL, Excel, Power BI, Tableau skills and ability to translate data issues into business risk.

Responsibilities

• Lead attribution, membership, and provider data governance processes to ensure accurate and reliable operational outputs.
• Oversee resolution of provider data and attribution issues affecting member assignment, reporting accuracy, and downstream operations.
• Partner with health plan leaders, network teams, provider data teams, claims, compliance, marketing, operations, and technology to deliver projects that support performance and regulatory requirements.
• Support provider directory accuracy, audit readiness, and regulatory validation activities through monitoring, documentation, and remediation.
• Identify recurring defects, root causes, and control gaps, driving process improvements to reduce rework and improve reliability.
• Maintain governance routines, process documentation, and cross-functional coordination for attribution and provider data operations.

Skills

Provider data governance

Data quality analysis

Cross-functional collaboration

SQL & BI tools

Regulatory awareness

Education

Bachelor's degree or equivalent professional experience

Tools

QNXT

MDW

Job description

CVS Health leads Medicaid provider data integrity and attribution governance, coordinating with/provider data management, IT, analytics, claims and operations to ensure accurate information reflected in downstream systems.

The senior manager role drives governance routines, root-cause analysis, and cross-functional improvements to enhance performance, regulatory compliance, and customer experience across the organization.