Senior Manager, Provider Data & Attribution Governance

CVS Health; Nashville (TN); Presencial; USD 68.000 - 199.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Descripción de la vacante

CVS Health in Nashville seeks a Senior Manager to lead provider data integrity and attribution governance within Medicaid operations, coordinating across provider relations, data management, IT, analytics, and claims to ensure accurate downstream data.

The role emphasizes governance routines, issue resolution, and cross-functional process improvements to support regulatory compliance and an exceptional customer experience.

Formación

• 7-10 years of experience.
• 5+ years of 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.
• Experience coordinating cross-functional issue resolution and operational improvements.

Responsabilidades

• 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.

Conocimientos

SQL

Advanced Excel

Power BI

Tableau

Healthcare analytics

Data reconciliation

Educación

Bachelor's degree or equivalent professional experience

Herramientas

QNXT

MDW (Medicaid Data Warehouse)

Descripción del empleo

CVS Health in Nashville seeks a Senior Manager to lead provider data integrity and attribution governance within Medicaid operations, coordinating across provider relations, data management, IT, analytics, and claims to ensure accurate downstream data.

The role emphasizes governance routines, issue resolution, and cross-functional process improvements to support regulatory compliance and an exceptional customer experience.