Strategic Lead, Provider Data & Attribution Integrity

CVS Health; Concord (NH); Presencial; USD 68 000 - 199 000; Tempo integral

Resumo da oferta

CVS Health is seeking a Senior Manager to lead provider data integrity and attribution governance across Medicaid operations. You will partner with provider relations, data management, analytics, claims, and IT to ensure accurate provider and attribution information throughout downstream systems.

You will oversee governance routines, identify defects, drive improvements, and support audit readiness. Strong communication and cross-functional collaboration are essential in this role based in

Qualificações

• 7-10 years of experience.
• 5+ years 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.
• 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.

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.

Conhecimentos

Data analysis

Root cause analysis

Cross-functional collaboration

Communication

Formação académica

Bachelor's degree

Ferramentas

SQL

Power BI

Tableau

Excel

Descrição da oferta de emprego

CVS Health is seeking a Senior Manager to lead provider data integrity and attribution governance across Medicaid operations. You will partner with provider relations, data management, analytics, claims, and IT to ensure accurate provider and attribution information throughout downstream systems.

You will oversee governance routines, identify defects, drive improvements, and support audit readiness. Strong communication and cross-functional collaboration are essential in this role based in