Senior Manager, Informatics

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🔥 13 hours ago

🦌 Connecticut, Idaho, +1 more states – Remote

🦌 Connecticut – Remote 🥔 Idaho – Remote 🤠 Texas – Remote

💵 $67.9k - $199.1k / year

⏰ Full Time

🟠 Senior

👔 Manager

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Act as the primary liaison between the HEDIS Medicaid Business Unit and IT platform migration teams. • Lead and actively participate in IT business requirements sessions, translating Medicaid operational workflows and regulatory specifications into detailed, actionable system requirements. • Validate that technical design aligns with NCQA HEDIS specifications, CMS guidance, and state-specific Medicaid reporting requirements. • Provide formal business sign-off on requirements, build logic, and configuration decisions to ensure regulatory compliance and operational integrity. • Maintain deep understanding of Medicaid state reporting requirements, including state-specific measure variations, hybrid vs. administrative specifications, and submission formats. • Ensure migration decisions preserve measure integrity, numerator/denominator logic, stratifications, and audit documentation standards. • Evaluate proposed technical solutions and make informed decisions balancing regulatory risk, operational feasibility, and long-term scalability. • Oversee User Acceptance Testing (UAT), defect prioritization, and validation processes to ensure accurate measure output and reporting continuity.

🎯 Requirements

• 5+ years of data analytics experience • 3+ years experience with health care data (enrollment, claims, lab) in a data warehouse environment • 3+ years experience using advanced SQL querying abilities in a large relational database environment including the ability to handle large datasets from multiple data sources • 3+ years experience creating reports and pivot tables in Excel • Ability to interpret technical specifications • Ability to communicate technical concepts to non-technical audiences (written and verbal)

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs and other resources