[Hiring] Senior Manager, Data Engineering @CVS Health

Role Description

This role owns the data foundation that the Medicare revenue engine runs on. It requires an expert in healthcare and risk-adjustment data, including claims, encounters, eligibility, clinical/chart sources, and CMS payment and diagnosis files. Expertise in production-grade platforms (Databricks / Spark lakehouse, Python, SQL) is also required. The job is to make member-month, diagnosis, and payment data timely, complete, lineage-traced, and auditable so Finance can forecast and book revenue with confidence.

Responsibilities

• Design, build, and operate the data pipelines and analytic tables that feed the Medicare revenue projection model (member-month grain, HCC/diagnosis history, engagement/visit flags, CMS files, program attributes).
• Ingest, normalize, and reconcile: claims/encounters (837 and internal), eligibility/enrollment, EMR/chart extracts, vendor/program files, and CMS artifacts (MMR, MOR, MAO-004, and related).
• Implement HCC / ICD-10 mapping, model-year (e.g., V24/V28) versioning, and diagnosis-year vs. payment-year constructs so modelers do not have to reverse-engineer source systems.
• Own data quality, reconciliation, lineage, and snapshot/freeze processes required 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 trusted, documented datasets to Modeling, Finance, Actuarial, and (as needed) Revenue Integrity.
• Define SLAs for freshness and completeness; monitor drift and source-system changes that would invalidate forecasts.
• Lead and mentor data engineers; set engineering practices for a regulated, financially sensitive environment.
• Support modular outputs (revenue, membership/mix, other items) so the engine can evolve without rewriting the warehouse.

Qualifications

• 8+ years in data engineering
• 4+ years of expert level experience in healthcare data: claims, encounters, eligibility, provider, and clinical/chart sources
• 4+ years of hands-on production experience with Databricks / Spark (PySpark), Python, and SQL/ Lakehouse / ELT patterns, orchestration (e.g., Airflow or equivalent), and data-quality frameworks.
• 4+ years of experience supporting risk-adjustment, actuarial, or finance workloads (reconciliation, point-in-time history, auditability).
• Strong understanding of PHI, HIPAA, and controls appropriate to revenue and CMS-submission data.

Preferred Qualifications

• Familiarity with 834/837, ICD-10, and HCC assignment.
• SAS (nice to have, especially for legacy actuarial extracts).
• Direct RA file experience (MMR, MOR, MAO-004, EDS/encounter status).
• Prior work on member-level RA engines, suspect/recapture warehouses, or revenue-forecast data products.

Education

• Bachelor’s in CS, engineering, or related field (or equivalent experience).

Pay Range

The typical pay range for this role is: $82,940.00 - $182,549.00. 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. This position also includes an award target in the company’s equity award program.

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.

We anticipate the application window for this opening will close on: 10/30/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.