Senior Manager, Provider Data & Attribution Governance

CVS Health; Columbus (OH); On-site; USD 68,000 - 199,000; Full time

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Senior Manager to lead provider data integrity, attribution governance, and related operational controls supporting Medicaid operations. You will act as a key liaison across provider relations, data management, IT, analytics, claims, and other teams to ensure data accuracy and reliable downstream processes.

You will oversee data governance routines, address issues impacting member assignment and reporting, and drive improvements reducing rework while ensuring regulatory

Qualifications

• 7-10 years of experience.
• 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

SQL

Advanced Excel

Power BI

Tableau

Medicaid

Data reconciliation

Cross-functional

Communication

Education

Bachelor's degree or equivalent

Tools

QNXT

MDW

Job description

CVS Health is seeking a Senior Manager to lead provider data integrity, attribution governance, and related operational controls supporting Medicaid operations. You will act as a key liaison across provider relations, data management, IT, analytics, claims, and other teams to ensure data accuracy and reliable downstream processes.

You will oversee data governance routines, address issues impacting member assignment and reporting, and drive improvements reducing rework while ensuring regulatory