Data Analytics Manager

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

The Medicare Risk Adjustment team is focused on Encounter Data Systems (EDS), MAO-004 submissions, ACA analytics, and regulatory reporting.

Responsibilities:

Proven success leading cross-functional projects in large-scale healthcare data operations, compliance, data quality, and analytics initiatives.

Expert in end-to-end Risk Adjustment processes, encounter data validation, HCC analytics, provider coding accuracy, CMS reporting, and healthcare data governance. Strong blend of technical expertise and leadership skills with experience driving operational excellence, regulatory compliance, and data-driven decision making.

• Experienced healthcare analytics professional with 7+ years of healthcare industry experience.
• 5+ years of Medicare Risk Adjustment, EDS, MAO-004, or ACA analytics experience.
• Experience leading projects and healthcare data initiatives.
• Strong knowledge of CMS regulations, HCC models, and regulatory reporting.

• Experience with SQL, SAS, Databricks, Cloud platforms (GCP/Azure/AWS), and Power BI.
• Background in healthcare claims, encounter data, and provider analytics.
• Experience with data governance, automation, and process improvement.
• Master's degree a plus.

Education: Bachelor's degree or rel. work experience.

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.