Senior Manager, Provider Data & Attribution Governance

CVS Health; Hartford (CT); Vor Ort; USD 140.000 - 190.000; Vollzeit

Benefits dieser Stelle

Medical coverage

Dental coverage

Vision coverage

PTO

Retirement plan

Zusammenfassung

CVS Health in Hartford, CT seeks a Senior Manager to lead attribution, membership, and provider data governance within Medicaid operations. You will partner with provider relations, data teams, IT, analytics, claims, and other departments to ensure accurate, well-governed provider and attribution data across downstream systems.

You will identify root causes, drive process improvements, support regulatory validation, and maintain governance routines and documentation while collaborating with

Qualifikationen

• 5+ years in Medicaid, managed care operations, provider data, or healthcare analytics.
• Experience with SQL and BI tools such as Power BI or Tableau.
• Ability to investigate, reconcile, and root-cause health care data issues.
• Experience with provider data issues, identifiers, affiliations, contracts.
• Strong communication to translate operational issues into risks and actions.
• Experience managing provider attribution methodologies and governance.

Aufgaben

• Lead attribution, membership, and provider data governance processes.
• Oversee resolution of provider data and attribution issues affecting metrics.
• Partner with health plan, network, data, claims, compliance, marketing, and IT teams.
• Support directory accuracy, audits, and regulatory validation activities.
• Identify root causes and drive process improvements to reduce rework.

Kenntnisse

Medicaid operations

SQL & Excel & BI tools

Data reconciliation

Communication skills

Provider attribution governance

QNXT/MDW experience

Provider data management

Ausbildung

Bachelor's degree or equivalent experience

Tools

Power BI

Tableau

SQL

Advanced Excel

Jobbeschreibung

CVS Health in Hartford, CT seeks a Senior Manager to lead attribution, membership, and provider data governance within Medicaid operations. You will partner with provider relations, data teams, IT, analytics, claims, and other departments to ensure accurate, well-governed provider and attribution data across downstream systems.

You will identify root causes, drive process improvements, support regulatory validation, and maintain governance routines and documentation while collaborating with