Medicaid Analytics Lead: Program Integrity & Policy

Remote Jobs; United States; Hybrid; USD 80,000 - 120,000; Full time

Job summary

BerryDunn's Health Analytics Practice Group seeks a Senior Medicaid Analyst to apply policy, analytics, and operational knowledge to strengthen Medicaid program performance for public-sector clients. The role focuses on Hawai'i Med-QUEST and related program integrity initiatives, including fraud, waste, and abuse and payment integrity.

You will collaborate with multidisciplinary teams to identify vulnerabilities, assess impacts, and implement improvements, while mentoring junior staff and

Qualifications

• Master's degree in public health, health policy, health administration, public policy, data analytics, economics, information systems, or a related field.
• Five+ years of Medicaid/healthcare analytics or related consulting experience.
• Knowledge of Medicaid program structure, claims, encounters, enrollment, and related functions.
• Experience analyzing healthcare data to identify trends, risks, and opportunities.
• Experience with Excel, SQL, SAS, Power BI, Tableau or similar tools.

Responsibilities

• Analyze Medicaid claims, encounters, provider, member, and eligibility data to identify trends and opportunities for program improvement.
• Support program integrity, fraud, waste, abuse, and third-party liability initiatives through analysis and monitoring.
• Evaluate policies, processes, and controls to identify gaps and improvement opportunities.
• Develop performance measures, reports, dashboards, and decision-support materials for leadership.
• Translate complex information into clear findings and actionable recommendations.
• Lead analyses and collaboration across multidisciplinary teams; mentor junior staff.

Skills

Medicaid program knowledge

Data analysis & visualization

Communication

Mentoring junior staff

Education

Master's degree in public health/health policy or related field

Tools

SQL

SAS

Power BI

Job description

BerryDunn's Health Analytics Practice Group seeks a Senior Medicaid Analyst to apply policy, analytics, and operational knowledge to strengthen Medicaid program performance for public-sector clients. The role focuses on Hawai'i Med-QUEST and related program integrity initiatives, including fraud, waste, and abuse and payment integrity.

You will collaborate with multidisciplinary teams to identify vulnerabilities, assess impacts, and implement improvements, while mentoring junior staff and