Role Description
Enterprise Data Warehouse (EDW) Medicaid Subject Matter Expert/Data Specialist
• 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
• Third-party liability
• Proactively identify and understand state Medicaid agency data needs and determine the recommended solution to meet them with credible reason, justification and validated proof of concepts.
• Direct technical and business teams on understanding healthcare topics and utilizing healthcare data appropriately.
• Proactively suggest and recommend enhancements and improvements throughout the project processes, driven by Medicaid best practices, standards and policies.
This position is a Medicaid Subject Matter (SME) Expert for the Enterprise Data Warehouse supporting the State Medicaid program. This role requires significant expertise of Medicaid Enterprise System modules and data warehousing or decision support systems. It provides guidance and direction to support a large data warehouse implementation for both DDI and maintenance & operations.
• Partner with stakeholders to understand data requirements and support development tools and models such as:
• Interfaces
• Dashboards
• Data visualizations
• Decision aids
• Business case analysis
• Produce and manage the delivery of activity, value analytics and critical deliverables to external stakeholders and clients.
Qualifications
• More than ten (10) years of experience in information technology with five (5) years of experience working directly with/for State Medicaid agencies or equivalent, supporting business initiatives through data analysis, writing business requirements and testing/validation of various systems.
• More than 2 years of experience working on CMS Federal Reporting MARS, PERM, T-MSIS, Quality of Care CMS Core Measure or similar projects.
• Understanding of claims, recipient/eligibility, and provider/enrollment data processes.
• Able to create and perform data analysis using SQL, Excel against data warehouses utilizing large datasets.
• Knowledge of the Centers for Medicare and Medicaid Services reporting requirements and the programs covered.
• Excellent verbal/written communication and presentation skills, manager/executive/director-level client facing, team collaboration, and mentoring skills.
Requirements
• Core customer business hours to conduct work are M-F 8 AM - 5 PM CST.
Preferred Qualifications
• Strong culture fit, demonstrating our culture values in action (Integrity, Compassion, Inclusion, Relationships, Innovation, and Performance).
• Experience using JIRA, Rally, DevOps or equivalent.
• Previous experience on large implementation or DDI project.
Benefits
• This is a remote position.