Springfield, IL, 62762, USA
34 days ago
Medicaid Subject Matter Expert/Data Specialist in EDW Environment
Primary Responsibilities: + Provide 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 determines the recommended solution to meet them with credible reason, justification and validated proof of concepts. + Direct 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. Required Qualifications: + 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). + Ability to travel to Springfield, IL two (3) to three (4) times per year. Preferred Qualifications: + More than 2 years of experience working with PERM, T-MSIS, CMS Federal Reporting or similar projects + More than 2 years of experience in 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 on large implementation project. + Located within driving distance (3 - 5 Hours) of Springfield, IL.
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