Medicaid SME/Healthcare Data Analyst

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Judge Group, Inc.
Analyst, Project, Data Warehouse, CMS, SQL, Exchange, Excel, Teradata, Quality, SAP, Business Objects, SAS
Full Time

Job Description

Location: Minneapolis, MN
    Our client is currently seeking a Medicaid SME/ Healthcare Data Analyst

    Title: Medicaid SME/Healthcare Data Analyst

    LOCATION: Remote within U.S.

    Project/Projects: Enterprise Data Warehouse Project

    Primary Responsibilities:

    • Provide Medicaid and CHIP expertise and guidance as it relates to quality of care, eligibility, prescription drugs, managed care, and program information
    • Analyze Medicaid enrollment, provider and claims data, and document requirements, use cases
    • Identify and document data anomalies and collaborate with cross functional teams for effective resolution
    • Share use cases to data analysts for profiling, review results and infer compliance to Medicaid / CMS processes and guidelines
    • Able to juggle multiple priorities and ensure availability to questions and clarifications from data analysts
    • Develop and provide oversight of complex SQL using enrollment, provider, and claims data
    • Be a mentor to our EDW team for Medicaid and CHIP

    Required Qualifications:

    • More than 10 years of healthcare data analysis experience supporting business initiatives through data analysis, writing business requirements, and user acceptance testing of various systems
    • More than 4 years of experience in working with State Medicaid and CHIP agencies
    • 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
    • Excellent verbal/written communication, end client-facing, team collaboration, and mentoring skills
    • In-depth knowledge of CMS reporting requirements for Medicaid
    • In-depth understanding of FFS, Managed Care claim adjudication processes from enrollment to funding/finance.
    • 3+ years of managed care encounters experience
    • Knowledge and understanding of the Health Insurance Exchange (HIE)
    • Knowledge of health insurance, HMO, and managed care principles including Medicaid and Medicare regulation.
    • Knowledge of the Affordable care act and eligibility
    • Able to perform complex data analysis using SQL, Excel against data warehouses utilizing large datasets
    • Versatile in working with relational databases preferably Teradata
    • Be a self-starter and able to thrive in an environment with little guidance
    • Bachelors degree in related field or equivalent experience

    Preferred Qualifications:
    • Knowledge of Quality of Care program is highly preferred
    • Strong time management and organizational skills
    • Effective organizational, analytical, time management, problem-solving, and multi-tasking skills and habits; ability to complete assignments under tight deadlines with little/no direct supervision
    • Knowledge of data integration, software enhancements/planning, and agile methodologies
    • Experience in SAP Business Objects or SAS is nice to have
    • Prior Experience in Tableau or BO version upgrades
    • Experience in Agile/Kanban


This job and many more are available through The Judge Group. Find us on the web at

Company Information

The Judge Group, celebrating its 50th anniversary, is a leading professional services firm specializing in talent, technology, and learning solutions. We consult, staff, train, and solve. Through our work we make people and organizations better. Our services are successfully delivered through a network of more than 30 offices in the United States, Canada, and India. The Judge Group serves more than 50 of the Fortune 100 and is responsible for over 9,000 professionals on assignment annually across a wide range of industries.

Dice Id : cxjudgpa
Position Id : 723511
Originally Posted : 4 months ago

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