Medicaid Payment Model Analytics Consultant - Remote

UnitedHealth Group; Eden Prairie (MN); Remote; USD 92,000 - 164,000; Full time

Job summary

UnitedHealth Group is seeking a Health Data Analytics Consultant to support Medicaid data and policy work for CMS Innovation Center payment models, including LEAD. You will work hands-on with Medicaid data, including T-MSIS, to translate policy into analytic outputs while collaborating with senior analysts and project leaders.

You’ll have the flexibility to work remotely from anywhere in the United States, with in-office requirements only for Minneapolis area four days a week where applicable.

Qualifications

• 3+ years of healthcare data experience in a consulting, research, government, or business setting.
• 1+ years of Medicaid data experience with T-MSIS.
• Experience with healthcare claims and enrollment data analysis.
• Ability to translate policy or program requirements into analytic specifications.
• Proficiency in SQL.
• Strong written and oral communication; ability to meet deadlines.
• Understanding of Medicaid eligibility, enrollment, claims, and encounter data.

Responsibilities

• Conduct hands-on analysis of Medicaid data including T-MSIS to support model implementation and operations.
• Translate policy and methodology into data specifications, business rules, and analytic code.
• Develop, test, and maintain SQL code to build analytic files, define populations, and produce model outputs.
• Use Python and other analytic tools to support data processing, analysis, and quality assurance.
• Support attribution, payment calculation, quality measurement, and other operational methodologies.
• Assess Medicaid data quality and differences across states, delivery systems, and care environments.
• Analyze Medicaid claims, enrollment, provider and other program data to support client needs.
• Document specifications, methodologies, code, assumptions, and QC procedures.
• Perform quality assurance reviews and validation checks on analytic outputs and deliverables.
• Prepare tables, reports, presentations for technical and non-technical audiences.
• Work with policy, operations, and analytic staff as a project team member.

Skills

Healthcare data

Medicaid data

Quantitative analysis

Policy translation

SQL

Python

Communication skills

Attention to detail

Tools

SQL (code)

Snowflake

Databricks

Python

Job description

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Medicaid Payment Model Analytics Consultant - Remote (2393622)

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

Optum Serve Consulting/The Lewin Group (OSC/Lewin), a premier national health care and human services consulting and policy analysis firm, brings 50 years of experience finding answers and solving problems for leading organizations in the public, non-profit, and private sectors.

In the wide-ranging field of health human services consulting, OSC/Lewin provides both depth and breadth of expertise. Currently, OSC/Lewin has more than 250 consultants drawn from industry, government and academia. They all share a solid commitment to OSC/Lewin’s core values of objectivity, integrity, analytical innovation, vision, and dedication to client satisfaction.

At OSC/Lewin, we help federal, state, and other decision-makers strengthen health and human services programs, make informed policy choices, and implement critical initiatives. The Health Data Analytics Consultant will support Medicaid data and policy work for CMS Innovation Center payment models, including the LEAD model. This is a hands-on analytic role focused on working directly with Medicaid data, including T-MSIS Analytic Files (TAF), to support model implementation and operations. The consultant will help translate policy and methodology into data specifications, code, analyses, and operational outputs, including attribution, payment calculations, and quality measurement. This person will work closely with senior analysts, policy experts, and project leadership to deliver accurate, well-documented analytic products.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Conduct hands-on analysis of Medicaid data, including T-MSIS data, to support payment model implementation and operations
• Translate policy and methodology into data specifications, business rules, and analytic code
• Develop, test, and maintain SQL code to build analytic files, define populations, and produce model outputs
• Use Python and other analytic tools, as appropriate, to support data processing, analysis, and quality assurance
• Support attribution, payment calculation, quality measurement, and other operational methodologies used in healthcare payment models
• Assess Medicaid data quality and completeness and account for differences across states, delivery systems, and managed care and fee-for-service environments
• Analyze Medicaid claims, encounter, enrollment, provider, and other program data to support client needs
• Develop and maintain documentation of specifications, methodologies, code, assumptions, and quality control procedures
• Perform quality assurance reviews and validation checks on analytic outputs and deliverables
• Prepare tables, reports, presentations, and other materials that summarize analytic findings for technical and non-technical audiences
• Work effectively and cooperatively with policy, operations, and analytic staff as a member of project teams

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 3+ years of experience working with healthcare data in a consulting, research, government, or business environment
• 1+ years of direct experience working with Medicaid data, including T-MSIS
• Experience conducting quantitative analysis using healthcare claims and enrollment data
• Experience translating business, policy, or program requirements into analytic specifications
• Understanding of Medicaid eligibility, enrollment, claims, and encounter data
• Familiarity with Medicaid payment and delivery systems, including managed care and fee-for-service environments
• Proficiency programming in SQL
• Proven excellent oral and written communication skills and a focus on meeting deadlines
• Demonstrated attention to detail and commitment to producing accurate, high-quality work

Preferred Qualifications:

• Experience working with Medicaid data across multiple states
• Experience working in the CMS Integrated Data Repository (IDR) in Snowflake or Databricks environments
• Experience working in Snowflake
• Programming experience in Python
• Experience supporting healthcare payment models, value-based care programs, or alternative payment models
• Experience working in large healthcare data warehouse environments, such as the Chronic Conditions Warehouse (CCW)
• Experience preparing technical documentation, specifications, and analytic reports

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.