Manager – Medicaid Provider Data Services

CVS Health

Lead a team of Medicaid Provider Data Services Analysts within CVS Health, ensuring accurate loading and maintenance of Medicaid Provider data. Coordinate with various internal departments and stakeholders.

Posted 4/16/2026full-timeRemote • Massachusetts, Missouri, Oklahoma, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $54,300 - $145,860 per yearWebsite

About the role

Key responsibilities & impact

Lead a team of Medicaid Provider Data Services Analysts responsible for loading and maintaining Medicaid Provider data within Aetna QNXT
Team will also include provider operations analyst and potential pre-cred support for implementation activities
Provides assistance and support to other departments, as needed, to obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc
Coordinates provider status information with member services and other internal departments
Recruits, develops, and motivates staff
Initiates and communicates a variety of personnel actions including, employment, termination, performance reviews, salary reviews, and disciplinary actions
Monitors staff performance, including weekly staff metrics; coaches and mentors’ staff on performance issues or concerns

Requirements

What you’ll need

3+ years of recent and related experience in Provider Operations, Provider Relations, or Network operations
1+ years of experience in Medicaid provider operations
At least 1 year of experience with ensuring the provider data entered into the provider database is accurate and the provider documentation is complete and accurate
1+ years of experience in managing, coaching, and leading a team of Provider Data Services Analysts
At least 1 years of experience leading or managing a production-oriented team
Strong collaboration skills
Strong reporting and data analysis skills and experience
Ability to load balance and prioritize work to meet key performance metrics around TAT and quality
Drive and oversee productivity of staff
Experience with new Medicaid state implementation related to provider requirements
Leadership skills including staff development
Critical thinking and problem-solving skills
Familiarity with Provider Data/Enterprise systems
Strong skills in Microsoft products
QuickBase knowledge

Benefits

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

provider operationsprovider relationsnetwork operationsMedicaid provider operationsdata analysisperformance metricsstaff performance monitoringstaff developmentprovider data accuracyproduction-oriented team management

Soft Skills

collaborationleadershipcoachingcritical thinkingproblem-solvingcommunicationmotivationload balancingprioritizationmentoring