Senior Provider Data & Attribution Governance Lead

CVS Health; Virginia Beach (VA); In loco; USD 90.000 - 130.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Equity award program

Descrizione del lavoro

CVS Health is seeking a Senior Manager to lead attribution and provider data governance across Medicaid operations. You will align provider data accuracy with downstream systems, working with analytics, IT, claims and operations to ensure reliable outputs.

The role emphasizes governance, issue remediation, and collaboration with plans, network teams and compliance. A strong background in data analytics and healthcare operations is required.

Competenze

• Experience in Medicaid managed care operations and provider data governance.
• Ability to investigate and reconcile complex health care data and identify actionable root causes.
• Strong communication to translate operational issues into business risk and actions.

Mansioni

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

Conoscenze

Medicaid experience

Provider data governance

Healthcare analytics

Root-cause analysis

Cross-functional collaboration

Communication skills

Attribution governance

QNXT experience

MDW data

Provider rosters management

Formazione

Bachelor's degree

Strumenti

SQL

Excel

Power BI

Tableau

Descrizione del lavoro

CVS Health is seeking a Senior Manager to lead attribution and provider data governance across Medicaid operations. You will align provider data accuracy with downstream systems, working with analytics, IT, claims and operations to ensure reliable outputs.

The role emphasizes governance, issue remediation, and collaboration with plans, network teams and compliance. A strong background in data analytics and healthcare operations is required.