Senior Manager, Data Engineering – Medicare Revenue

Job not on LinkedIn

🔥 5 minutes ago

🏈 Alabama, Arizona, +40 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $82.9k - $182.5k / year

⏰ Full Time

🟠 Senior

🚰 Data Engineer

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

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

• Own the data foundation supporting the Medicare revenue engine • Design, build, and operate data pipelines and analytic tables for Medicare revenue projection models • Ingest, normalize, and reconcile claims, encounters, eligibility/enrollment, EMR/chart extracts, vendor/program files, and CMS artifacts • Implement HCC / ICD-10 mapping, model-year versioning, and diagnosis-year versus payment-year constructs • Own data quality, reconciliation, lineage, and snapshot/freeze processes for accruals, AtoE, and audit • Partner with enterprise data/IT on Databricks or equivalent lakehouse standards, Spark/PySpark, orchestration, CI/CD, access control, and cost/performance • Provide documented datasets to Modeling, Finance, Actuarial, and Revenue Integrity • Define freshness and completeness SLAs and monitor data drift and source-system changes • Lead and mentor data engineers and establish engineering practices for a regulated, financially sensitive environment • Support modular revenue, membership/mix, and related outputs

🎯 Requirements

• 8+ years in data engineering • 4+ years of expert-level experience in healthcare data, including claims, encounters, eligibility, provider, and clinical/chart sources • 4+ years of hands-on production experience with Databricks / Spark (PySpark), Python, SQL, lakehouse / ELT patterns, orchestration such as Airflow or equivalent, and data-quality frameworks • 4+ years of experience supporting risk-adjustment, actuarial, or finance workloads, including reconciliation, point-in-time history, and auditability • Strong understanding of PHI, HIPAA, and controls appropriate to revenue and CMS-submission data • Familiarity with 834/837, ICD-10, and HCC assignment • SAS nice to have, especially for legacy actuarial extracts • Direct RA file experience with MMR, MOR, MAO-004, and EDS/encounter status • Prior work on member-level RA engines, suspect/recapture warehouses, or revenue-forecast data products • Bachelor’s in CS, engineering, or related field, or equivalent experience

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being