Senior Manager, Informatics

CVS Health

2d•$67,900 - $199,144•Remote

About The Position

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. Position Summary This position will support East Coast hours, starting by 9:00 am ET. Aetna Clinical Enablement (ACE) has an exciting opportunity for a Senior Informatics Manager to join our HEDIS Data Enablement Team. The Healthcare Effectiveness Data and Information Set (HEDIS) is one of the most widely used healthcare quality data sets in the country. HEDIS reporting is a requirement for NCQA Health Plan Accreditation, CMS Medicare Advantage, Medicare Stars, Exchange, Medicaid, and many states. HEDIS measure results are used within the enterprise and externally to drive quality initiatives that improve the health of Aetna’s members. The HEDIS Data Enablement Team is responsible for data management, supporting internal stakeholders, measure and run issue research and resolution, identifying measure and technology opportunities, providing HEDIS measure data and research to support initiatives, and the business owner for HEDIS data management for regulatory reporting. In this role, the Senior Informatics Manager will function as the central business liaison for the HEDIS Medicaid Business Unit, partnering with cross-functional teams to execute high-impact quality and regulatory initiatives. The role requires translating Medicaid business requirements into structured project plans, facilitating stakeholder alignment, and ensuring adherence to NCQA HEDIS technical specifications and state-level compliance standards. The Senior Informatics Manager will drive delivery across the full project lifecycle—requirements intake, build coordination, testing oversight, reporting validation, and post-implementation review—while proactively identifying risks and optimizing workflows to improve efficiency and performance outcomes.

Requirements

5+ years of data analytics experience
3+ years experience with health care data (enrollment, claims, lab) in a data warehouse environment
3+ years experience using advanced SQL querying abilities in a large relational database environment including the ability to handle large datasets from multiple data sources
3+ years experience creating reports and pivot tables in Excel
Ability to interpret technical specifications
Ability to communicate technical concepts to non-technical audiences (written and verbal)
Adept at probing into granular details of big data and complex technical processes
Strong problem solving skills and critical thinking ability
Strong collaboration and communication skills within and across teams
Bachelor's Degree or equivalent work experience required

Nice To Haves

Expertise writing SQL queries to work with large complex data sets
Ability to understand and probe into technical processes and data
Experience working with health care data sources (enrollment, claims, lab)
Be organized and exhibit attention to detail
Ability to manage conflicting priorities and multiple projects concurrently
Ability to work independently under general direction
Accountable for meeting commitments
Driven to provide an excellent customer experience for stakeholders.
Experience with Agile methodology in the Product Owner role
Successful track record of managing technical projects from discovery to delivery
Experience with HEDIS or other quality measurement program
Experience with Google Cloud Platform (GCP) administration
Experience with BigQuery data platform
Agile Product Owner experience

Responsibilities

Act as the primary liaison between the HEDIS Medicaid Business Unit and IT platform migration teams.
Lead and actively participate in IT business requirements sessions, translating Medicaid operational workflows and regulatory specifications into detailed, actionable system requirements.
Validate that technical design aligns with NCQA HEDIS specifications, CMS guidance, and state-specific Medicaid reporting requirements.
Provide formal business sign-off on requirements, build logic, and configuration decisions to ensure regulatory compliance and operational integrity.
Maintain deep understanding of Medicaid state reporting requirements, including state-specific measure variations, hybrid vs. administrative specifications, and submission formats.
Ensure migration decisions preserve measure integrity, numerator/denominator logic, stratifications, and audit documentation standards.
Evaluate proposed technical solutions and make informed decisions balancing regulatory risk, operational feasibility, and long-term scalability.
Oversee User Acceptance Testing (UAT), defect prioritization, and validation processes to ensure accurate measure output and reporting continuity.