Senior Manager, Provider Data & Attribution Integrity

CVS Health; Philadelphia (Philadelphia County); On-site; USD 130,000 - 160,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health is seeking a Senior Manager to lead attribution, membership, and provider data governance for Medicaid operations. You will partner with health plans, network teams, claims, compliance, and IT to ensure data integrity and reliable downstream outputs.

The role emphasizes identifying root causes, driving process improvements, and maintaining governance routines across cross-functional teams to support regulatory and customer-facing outcomes.

Qualifications

• 5+ years of experience in Medicaid, managed care operations, provider data, healthcare analytics.
• Strong SQL, Excel, and data visualization tool experience (Power BI or Tableau).
• Ability to investigate, reconcile complex health data, identify root causes, and recommend actions.
• Experience governing provider attribution, data integrity, and related controls.
• Excellent communication to translate operational data into business risk and actions.
• Experience collaborating with health plans, network teams, and IT.
• Bachelor's degree or equivalent professional experience.

Responsibilities

• Lead attribution, membership, and provider data governance processes.
• Oversee resolution of provider data and attribution issues affecting reporting and downstream operations.
• Partner with health plan leaders, network teams, claims, compliance, and IT to deliver projects.
• Support provider directory accuracy, audit readiness, and regulatory validation.
• Identify root causes and drive improvements to reduce rework and improve reliability.
• Maintain governance routines and cross-functional coordination.

Skills

Medicaid experience

Provider data governance

Healthcare analytics

Cross-functional collaboration

Data quality focus

Process improvement

Education

Bachelor's degree or equivalent

Tools

SQL

Excel

Power BI

Tableau

Job description

CVS Health is seeking a Senior Manager to lead attribution, membership, and provider data governance for Medicaid operations. You will partner with health plans, network teams, claims, compliance, and IT to ensure data integrity and reliable downstream outputs.

The role emphasizes identifying root causes, driving process improvements, and maintaining governance routines across cross-functional teams to support regulatory and customer-facing outcomes.