EDW Medicaid Subject Matter Expert - Data Specialist - Remote

About the Role

Key Responsibilities

• Provide direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations
• Lead and guide internal and external stakeholders to make determinations relating to complex processes involving claims processing/adjudication, recipient eligibility, provider enrollment, and third-party liability, with specialized knowledge of Medicaid and CHIP
• Proactively identify and understand state Medicaid agency data needs and determine the recommended solutions with credible reason, justification and validated proof of concepts
• Direct technical and business teams on healthcare topics understanding and utilizing healthcare data appropriately
• Proactively suggest and recommend enhancements and improvements throughout the project processes, driven by Medicaid best practices, standards and policies

Requirements

• 10+ years of experience in information technology with five (5) years of experience working directly with/for State Medicaid agencies or supporting business initiatives through data analysis, requirements writing, and system testing/validation
• Knowledge of Centers for Medicare and Medicaid Services reporting requirements and programs
• Understanding of claims, recipient/eligibility, and provider/enrollment data processes
• Proven ability to create and perform data analysis using SQL, Excel against data warehouses with large datasets
• Excellent verbal/written communication and presentation skills, including client-facing, team collaboration, and mentoring abilities
• Ability to travel to Springfield, IL two (3) to three (4) times per year

Nice to Have

• 2+ years of experience working with PERM, T-MSIS, CMS Federal Reporting (MARS) or similar projects
• 2+ years of experience in HEDIS, CHIPRA or similar quality metrics
• Experience with data analysis using Teradata Database Management System or other equivalent database management system
• Experience using JIRA, Rally, DevOps or equivalent
• Experience on large implementation or DDI project
• Located within driving distance (3 - 5 Hours) of Springfield, IL

Qualifications

• Formal educational background is implied but not explicitly specified in the description

Benefits & Perks

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution
• Salary range from $110,200 to $188,800 annually
• Additional benefits subject to eligibility