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Senior Manager, Data Engineering – Medicare Revenue
CVS Health. Own the data foundation supporting the Medicare revenue engine .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Expertise in data engineering with a focus on healthcare data management, including claims and eligibility processing, alongside strong capabilities in data pipeline design and implementation using Databricks, Spark, and Python. Proven ability to ensure data quality and compliance with HIPAA and CMS standards in a regulated environment.
Highest-signal resume keywords
Data EngineeringHealthcare Data ManagementDatabricks / Spark (PySpark)Data Quality FrameworksHIPAA Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data Pipeline DesignSQLPythonELT PatternsData ReconciliationHCC / ICD-10 MappingData Quality AssuranceData LineageOrchestration (Airflow)Risk-Adjustment Workloads
Soft Skills
MentoringCollaborationLeadership
Tools & Technologies
DatabricksSparkPySparkAirflowSAS
Industry Keywords
PHIHIPAACMS834/837MMRMORMAO-004EDSRevenue ForecastingActuarial Data
Tech Stack
Tools & technologiesAirflowPySparkPythonSparkSQL
About the role
Key responsibilities & impact- 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
What you’ll need- 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
Comp & perks- 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