EDW Medicaid Data Specialist

Freddie Mac; United States; Remote; USD 100,000 - 120,000; Full time

Job summary

A leading company is seeking a highly experienced EDW Medicaid Data Specialist. This fully remote role, with occasional travel, focuses on leading Medicaid data warehouse operations, engaging with stakeholders to address data needs, and guiding teams to optimize processes. The position demands a robust background in Medicaid systems and proven data analysis skills.

Qualifications

• 10+ years in IT; 5+ years with State Medicaid agencies.
• Strong understanding of claims and eligibility processes.
• Ability to manage large dataset analysis using SQL.

Responsibilities

• Provide guidance on Medicaid data warehouse implementation.
• Lead stakeholders in complex claims processing determinations.
• Train teams on healthcare data utilization and enhancements.

Skills

Data Analysis

Stakeholder Management

SQL

Healthcare Data Understanding

Communication Skills

Education

Master's Degree preferred

Tools

Teradata Database Management System

JIRA

DevOps

Job description

We are seeking a highly experienced EDW Medicaid Data Specialist to join our Enterprise Warehouse Team. This role requires significant expertise of Medicaid Enterprise System modules and data warehousing or decision support systems. This role provides the guidance and direction to support a large data warehouse implementation and maintenance & operations. The selected candidate will provide the required decisions for the business and technical team members to modify, change, enhance or correct within the system, related to claims, provider, and recipient data.

Roles in this function will partner with stakeholders to understand data requirements and support development and models such as interfaces, dashboards, data visualizations, decision aids and business case analysis to support the organization. Additional roles include producing and managing the delivery of activity, value analytics and critical deliverables to external stakeholders and clients.

**This role is fully remote but does require occasional travel to Springfield, IL.**

Key Responsibilities:

• Provide data and information direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations.
• With the specialized knowledge of the Medicaid and Children's Health Insurance Programs, lead and guide internal and external stakeholders to make determinations relating to complex processes involving claims processing/adjudication, recipient/provider eligibility, and 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 and train 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

• More than ten (10) years of experience in information technology with five (5) years of the 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.
• 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.
• Strong culture fit, demonstrating our culture values in action (Integrity, Compassion, Inclusion, Relationships, Innovation, and Performance).

Preferred Qualifications:

• Master's Degree preferred
• More than 2 years of experience working with PERM, T-MSIS, CMS Federal Reporting or similar projects
• More than 2 years of experience in Adult/ChiId Core measures, 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.
• Previous experience in large implementation projects.
• Located within driving distance (3 - 5 Hours) of Springfield, IL.

Physical Requirements & Environmental Conditions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this position, the employee is regularly required to sit and use hands to handle, or feel objects, a keyboard and other office equipment. The employee frequently is required to sit in meetings for long periods of time. The employee will utilize technology tools such as a laptop computer for extended periods of time. The employee must be able to reach with hands and arms and talk or hear. Specific vision abilities required by this position include close vision, color vision, and the ability to adjust focus. The noise level in the work environment is usually moderate.

Briljent is a solutions-based company. Solutions come from creative ideas; ideas come from being creative with differences. Briljent believes diversity and inclusion are critical to the success of the company. Employment at Briljent is based on merit and professional qualifications. We do not discriminate against any employee or applicant because of race, creed, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, veteran status, marital status or any other basis protected by federal, state or local law, regulation or ordinance.