Senior Medicaid Data & Policy Leader - Remote

UnitedHealth Group; Chicago (IL); Remote; USD 113,000 - 193,000; Full time

Benefits offered by this job

Telecommuter policy

Comprehensive benefits

401k and incentives

Job summary

UnitedHealth Group is seeking a Senior Medicaid SME to support the State Medicaid Agency EDW, focusing on CMS-64 and federal reporting. The role requires deep policy knowledge and the ability to translate guidance into actionable rules for data teams, with regular executive briefs.

The position offers remote work within the U.S. and collaboration with senior state leadership, including Bureau Chiefs and Agency Directors, across Medicaid policy and data management.

Qualifications

• 15+ years in healthcare, incl. 10+ years with State Medicaid agencies, MMIS/MES vendors, or Medicaid data warehouse/decision support programs
• 3+ years CMS reporting (MARS, T-MSIS, PERM, Core Set)
• Hands-on CMS-64 reporting experience (expenditure reporting, FMAP, reconciliation)
• Deep Medicaid data knowledge (claims, encounters, eligibility, provider, financial)
• Ability to brief senior executives with clear, concise briefings
• Translate policy/federal guidance into actionable business rules for technical teams
• Ability to travel to Springfield, IL 3–4 times per year

Responsibilities

• Serve as a senior Medicaid business and policy SME for the IL EDW, guiding State and Optum teams on claims, eligibility, provider, managed care/encounter, TPL, and financial data
• Lead CMS-64 reporting support, including expenditure categories, FMAP and match rules, reporting periods, and reconciliations
• Support other federal reporting work such as MARS, T-MSIS, PERM, and CMS Core Set/Quality of Care measures
• Translate CMS guidance into clear business rules, requirements, and acceptance criteria
• Brief State senior leadership up to the Agency Director with concise analyses
• Prepare and deliver executive briefings and issue summaries to Optum leadership and State staff

Skills

Medicaid policy

CMS reporting

SQL

Executive briefings

Tools

SQL

Job description

UnitedHealth Group is seeking a Senior Medicaid SME to support the State Medicaid Agency EDW, focusing on CMS-64 and federal reporting. The role requires deep policy knowledge and the ability to translate guidance into actionable rules for data teams, with regular executive briefs.

The position offers remote work within the U.S. and collaboration with senior state leadership, including Bureau Chiefs and Agency Directors, across Medicaid policy and data management.