Strategic Lead, Provider Data & Attribution Integrity

CVS Health; Montpelier (VT); On-site; USD 68,000 - 199,000; Full time

Job summary

CVS Health is seeking a senior manager to lead provider data governance, attribution, and related operational controls within Medicaid operations. You will coordinate with provider relations, IT, analytics, and claims teams to ensure data integrity and accurate downstream processing.

The role requires extensive experience in Medicaid data and governance, strong analytical skills, and collaboration across multiple departments to achieve regulatory compliance and improved customer outcomes.

Qualifications

• 7-10 years of experience in healthcare data/operations.
• 5+ years in Medicaid, managed care operations, provider data, or healthcare analytics.
• Strong SQL, Excel, BI tools proficiency.
• Ability to investigate and reconcile complex healthcare data and identify root causes.

Responsibilities

• Lead provider data governance and attribution processes to ensure accurate operational outputs.
• Oversee resolution of provider data and attribution issues affecting member assignment and reporting.
• Partner with health plan leaders, network teams, provider data teams, claims, compliance, marketing, operations and technology to deliver projects.
• Support provider directory accuracy, audit readiness, and regulatory validation through monitoring and remediation.
• Identify defects and root causes and drive process improvements for reliability.
• Maintain governance routines and cross-functional coordination for attribution and provider data operations.

Skills

SQL

Advanced Excel

Power BI

Tableau

Analytical mindset

Cross-functional collaboration

Communication

Education

Bachelor's degree

Tools

SQL

Power BI

Tableau

Excel

Job description

CVS Health is seeking a senior manager to lead provider data governance, attribution, and related operational controls within Medicaid operations. You will coordinate with provider relations, IT, analytics, and claims teams to ensure data integrity and accurate downstream processing.

The role requires extensive experience in Medicaid data and governance, strong analytical skills, and collaboration across multiple departments to achieve regulatory compliance and improved customer outcomes.