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Revenue Integrity Provider Insights & Reporting…
- CVS Health (Raleigh, NC)
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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
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Role Overview
This role is critical to building and maintaining robust data pipelines that power reporting and analytics for risk adjustment and provider performance projects. You’ll work closely with analysts, reporting leads, and business stakeholders to transform raw data into trusted, scalable datasets that support market provider performance office and executive-level dashboards.
Key Responsibilities
Design, build, and maintain ETL pipelines using** **_PySpark_** **and** **_AWS Glue_** **to process large volumes of structured and semi-structured data. Collaborate with reporting and insights teams to gather data requirements and ensure accurate, timely, and complete data delivery. Develop** **_advanced SQL queries_** **, including complex joins and Common Table Expressions (CTEs) for transformation, aggregation, and analysis. Use Git for version control, code management, and team collaboration. Design and manage scalable Datalake and warehouses on AWS using services such as S3, Redshift, Glue Catalog, and Athena. Build and optimize data solutions on** **_DynamoDB_** **and other NoSQL/relational databases as needed. Create interactive dashboards and visualizations in** **_Amazon QuickSight_** **to support data-driven decision-making. Automate workflows using** **_AWS Step Functions, EventBridge, and Lambda_** **to support efficient data operations. Monitor and optimize data processing performance, ensuring reliability and scalability Troubleshoot and resolve data quality or processing issues across source systems and downstream reporting . Keep up with industry best practices in cloud data engineering, security, and DevOps automation.
Required Qualifications
+ **Hands-on experience with PySpark and/or Python**
+ **Advanced SQL skills**
+ **Experience with version control using Git or similar tools.**
+ **Familiarity with key AWS services: S3, Redshift, Glue, Lambda, Step Functions, DynamoDB, Athena, QuickSight, CloudWatch, and/or CodeCommit.**
+ **Management consulting, business process consulting and/or strategic business planning.**
+ **Enterprise-wide and/or cross-functional large-scale initiatives with high degree of complexity.**
+ **Demonstrated experience successfully implementing change in regulated and highly complex organizations**
Preferred Technical Qualifications
+ **2+ years Government Programs experience including Medicare,** **Commercial ACA, and/or Medicaid**
+ **Risk adjustment working knowledge and understanding**
+ **Understanding of Databricks and its data engineering concepts.**
Additional Preferred Skills
+ **Strong understanding of on-premises data warehousing concepts, and AWS data lake architecture**
+ **Exposure to big data technologies**
+ **Experience building and supporting reporting solutions in healthcare, especially related to risk adjustment or provider attribution.**
+ **Knowledge of** **_DevOps or CI/CD_** **practices for data pipeline development.**
+ **Demonstrated ability to work effectively in cross-functional teams and manage multiple priorities in a fast-paced environment.**
Education Requirements
+ **Bachelor's degree in Business Administration/Management, Finance, Economics, Statistics, Mathematics, Data Science, HIM, Information Systems, Computer Science, or other relevant degree or 5 years of equivalent work experience**
NOTE: This position is Work from Home Remote. Candidates from anywhere in the United States are encouraged to apply
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$54,300.00 - $119,340.00
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.
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.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 11/29/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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