Data Modeler-Lead

Genzeon; United States; Remote; USD 110,000 - 140,000; Full time

Job summary

A leading company in IT Services and Consulting is seeking a Data Modeler/Lead specializing in Healthcare Data Systems. This remote full-time position involves designing comprehensive data models and leading data warehousing initiatives, requiring a deep understanding of health plan data structures and industry standards. The ideal candidate will possess extensive experience in data modeling, SQL, and healthcare data governance, contributing to dynamic healthcare analytics and reporting efforts.

Qualifications

• 10+ years of experience in data modeling with a focus on healthcare data.
• Expert-level proficiency in dimensional modeling and data vault methodology.
• Hands-on experience with SQL and cloud data processing platforms.

Responsibilities

• Design and implement data models for health plan operations.
• Develop logical and physical models for regulatory reporting.
• Lead data warehousing initiatives and optimize data pipelines.

Skills

Data modeling

SQL

Data governance

Data quality

Health plan knowledge

Education

Bachelor's degree in IT or related field

Healthcare data standards knowledge

Tools

Informatica PowerCenter

Databricks

Job description

Direct message the job poster from Genzeon

Data Modeler / Lead - Healthcare Data Systems

FTE

Remote

Data Modeler / Lead - Healthcare Data Systems

Position Overview

We are seeking an experienced Data Modeler/Lead with deep expertise in health plan data models and enterprise data warehousing to drive our healthcare analytics and reporting initiatives. The candidate should have hands-on experience with modern data platforms and a strong understanding of healthcare industry data standards.

Key Responsibilities

• Design and implement comprehensive data models for health plan operations, including member enrollment, claims processing, provider networks, and medical management
• Develop logical and physical data models that support analytical and regulatory reporting requirements (HEDIS, Stars, MLR, risk adjustment)
• Create and maintain data lineage documentation and data dictionaries for healthcare datasets
• Establish data modeling standards and best practices across the organization

Technical Leadership

• Lead data warehousing initiatives using modern platforms like Databricks or traditional ETL tools like Informatica
• Architect scalable data solutions that handle large volumes of healthcare transactional data
• Collaborate with data engineers to optimize data pipelines and ensure data quality
• Apply deep knowledge of health plan operations, medical coding (ICD-10, CPT, HCPCS), and healthcare data standards (HL7, FHIR, X12 EDI)
• Design data models that support analytical, reporting and AI/ML needs
• Ensure compliance with healthcare regulations including HIPAA/PHI, and state insurance regulations
• Partner with business stakeholders to translate healthcare business requirements into technical data solutions

Data Governance & Quality

• Implement data governance frameworks specific to healthcare data privacy and security requirements
• Establish data quality monitoring and validation processes for critical health plan metrics
• Lead efforts to standardize healthcare data definitions across multiple systems and data sources

Required Qualifications

Technical Skills

• 10+ years of experience in data modeling with at least 4 years focused on healthcare/health plan data
• Expert-level proficiency in dimensional modeling, data vault methodology, or other enterprise data modeling approaches
• Hands-on experience with Informatica PowerCenter/IICS or Databricks platform for large-scale data processing
• Strong SQL skills and experience with Oracle Exadata and cloud data warehouses (Databricks)
• Proficiency with data modeling tools (Hackolade, ERwin, or similar)

Healthcare Industry Knowledge

• Deep understanding of health plan data structures including claims, eligibility, provider data, and pharmacy data
• Experience with healthcare data standards and medical coding systems
• Knowledge of regulatory reporting requirements (HEDIS, Medicare Stars, MLR reporting, risk adjustment)
• Familiarity with healthcare interoperability standards (HL7 FHIR, X12 EDI)

Preferred Qualifications

• Experience with Medicare Advantage, Medicaid, or Commercial health plan operations
• Cloud platform certifications (AWS, Azure, or GCP)
• Experience with real-time data streaming and modern data lake architectures
• Knowledge of machine learning applications in healthcare analytics
• Previous experience in a lead or architect role within healthcare organizations

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Information Technology

• Industries

  IT Services and IT Consulting

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