Senior Medicaid Data & Policy Lead — Remote

Myticas Consulting Inc.; Illinois; Remote; USD 83,000 - 99,000; Full time

Job summary

Clover Consulting seeks a senior EDW Medicaid SME for a 12+ month contract to support CMS-64 reporting and federal requirements. Remote work with occasional travel to Illinois is available, and the role anchors Medicaid policy alongside data warehouse teams.

The candidate will translate complex policy into concrete business rules, brief senior leaders, and coordinate with state agencies and external vendors to ensure accurate reporting and alignment with federal guidance.

Qualifications

• 15+ years of healthcare experience with State Medicaid agencies or equivalent.
• 10+ years working directly with Medicaid data warehouses or MMIS.
• 3+ years with CMS reporting components like MARS, T-MSIS, PERM.
• Strong knowledge of Medicaid policy, eligibility, waivers, and data flows.
• Ability to translate policy into business rules for techncial teams.

Responsibilities

• Serve as senior Medicaid business and policy SME for IL EDW.
• Lead CMS-64 reporting support, FMAP, and reconciliation of EDW to financial submissions.
• Support CMS reporting such as MARS, T-MSIS, PERM, Core Set measures.
• Brief executives and state leadership with clear, concise updates.
• Mentor analysts and coordinate with vendors on reporting timelines.

Skills

Medicaid policy

CMS reporting

Executive briefings

SQL

Stakeholder management

Travel readiness

Tools

Azure DevOps

JIRA

Tableau

Power BI

Teradata

Data warehousing

Job description

Clover Consulting seeks a senior EDW Medicaid SME for a 12+ month contract to support CMS-64 reporting and federal requirements. Remote work with occasional travel to Illinois is available, and the role anchors Medicaid policy alongside data warehouse teams.

The candidate will translate complex policy into concrete business rules, brief senior leaders, and coordinate with state agencies and external vendors to ensure accurate reporting and alignment with federal guidance.