Senior Manager, Provider Data & Attribution Governance

CVS Health; Clayton (NC); Presencial; USD 120.000 - 180.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources

Descripción de la vacante

CVS Health seeks a Senior Manager to lead attribution governance and provider data operations across Medicaid. You will coordinate between provider relations, IT, analytics, claims, and compliance to ensure accurate data and reliable downstream results.

The role emphasizes governance routines, issue remediation, and data quality enhancements using SQL, Power BI, and Tableau. A Bachelor's degree and 5+ years in Medicaid or managed care data are required, with strong communication to translate

Formación

• 5+ years of Medicaid, managed care operations, provider data, healthcare analytics.
• Experience with SQL, advanced Excel, Power BI, Tableau.
• Ability to independently investigate, analyze, and reconcile complex health care data.
• Experience investigating and resolving provider data issues, including discrepancies involving provider identifiers, affiliations, contractual relationships, etc.
• Strong communication skills to translate complex operational issues into business risk and actions.

Responsabilidades

• Lead attribution, membership, and provider data governance processes to ensure accurate outputs.
• Oversee resolution of provider data and attribution issues affecting member assignment and reporting.
• Partner with health plan leaders, network teams, provider data teams, claims, compliance, marketing, operations, and IT to deliver projects.
• Support provider directory accuracy, audit readiness, and regulatory validation activities.
• Identify recurring defects and drive process improvements to reduce rework and improve reliability.
• Maintain governance routines and cross-functional coordination for attribution and provider data operations.

Conocimientos

Provider data governance

Attribution governance

Data reconciliation

Analytical thinking

Stakeholder communication

Root cause analysis

Regulatory knowledge

Educación

Bachelor's degree

Herramientas

SQL

Power BI

Tableau

QNXT

MDW

Descripción del empleo

CVS Health seeks a Senior Manager to lead attribution governance and provider data operations across Medicaid. You will coordinate between provider relations, IT, analytics, claims, and compliance to ensure accurate data and reliable downstream results.

The role emphasizes governance routines, issue remediation, and data quality enhancements using SQL, Power BI, and Tableau. A Bachelor's degree and 5+ years in Medicaid or managed care data are required, with strong communication to translate