EDW Senior Healthcare Business/Data Analyst (Medicaid Reporting)
hace 1 día
Springfield
Job DescriptionSenior Medicaid Business Data Analyst – EDW & SQL Remote – Continental U.S. (prefer candidates within a commutable distance to Springfield, IL) Travel to Springfield 3 times a year Contract role - not open to third parties Position Overview We are seeking an experienced Senior Healthcare Business/Data Analyst to support a large-scale State Medicaid Enterprise Data Warehouse (EDW) environment. This role combines traditional Business Analyst responsibilities with hands-on healthcare data analysis. The ideal candidate will have strong experience gathering and documenting requirements, working with Medicaid healthcare data, supporting federal and State reporting, and using SQL to research and validate data. The analyst will work closely with business stakeholders, technical teams, and a Medicaid Subject Matter Expert to support reporting, data analysis, requirements, testing, and ongoing EDW initiatives. Key Responsibilities • Gather, document, and manage business requirements for EDW reports, extracts, enhancements, and Medicaid reporting initiatives., • Support federal reporting activities including CMS-64/CMS-21, MARS, T-MSIS, and PERM., • Analyze business processes and document requirements for new or modified processes., • Help translate Medicaid policy and reporting guidance into clear business rules and requirements., • Develop business requirements, business rules, use cases, user stories, acceptance criteria, data mappings, and process flows., • Maintain requirements traceability throughout design, testing, and delivery., • Facilitate working sessions with business users, technical teams, and project stakeholders., • Document meeting outcomes, decisions, action items, and follow-up activities., • Track questions, dependencies, risks, and issues., • Write SQL to profile and analyze healthcare data, including:, • Claims, • Encounters, • Eligibility and enrollment, • Provider data, • Financial data, • Use SQL and data analysis to validate requirements and investigate business and reporting questions., • Identify and document data anomalies and reporting variances., • Work with ETL, BI, and QA teams to investigate and resolve data issues., • Support testing and UAT, including test scenarios, acceptance criteria, defect reporting, and follow-up., • Prepare presentations, summaries, and project status updates., • Maintain business documentation, data definitions, process documentation, and operational materials., • Support end-user training and development of training materials., • Mentor junior analysts and serve as a backup resource for day-to-day Medicaid reporting and business questions., • Support intake and change requests, including impact analysis and BA effort estimates.Required Qualifications, • Bachelor’s degree in Business, Information Systems, Public Health, or a related field, or equivalent experience., • 8+ years of Business Analysis experience, including:, • Requirements gathering, • Business documentation, • Stakeholder facilitation, • User Acceptance Testing (UAT), • 5+ years of experience working with healthcare data such as:, • Claims, • Encounters, • Eligibility/enrollment, • Provider, • Financial data, • 3+ years of Medicaid or public-sector healthcare experience, including experience with environments such as:, • State Medicaid/CHIP agencies, • MMIS/MES, • Medicaid data warehouses, • Medicaid managed care, • 3+ years of hands-on SQL experience analyzing and validating data within relational databases or data warehouses., • Understanding of Fee-for-Service and managed care claim adjudication, including eligibility/enrollment, claims processing, managed care encounters, and funding/finance., • Basic understanding of CMS Medicaid reporting requirements., • Experience developing use cases, user stories, acceptance criteria, and supporting testing/UAT., • Experience facilitating meetings and documenting outcomes., • Strong written and verbal communication skills., • Ability to communicate data findings to both technical and non-technical audiences., • Strong organizational skills with the ability to manage competing priorities and deadlines with limited supervision., • Ability to travel to Springfield, IL up to three times per year or as needed.Preferred Qualifications, • Experience with federal Medicaid reporting, including:, • CMS-64/CMS-21, • MARS, • T-MSIS, • PERM, • Knowledge of CMS Core Set, HEDIS, CHIPRA, or similar healthcare quality measures., • Knowledge of Medicaid, Medicare, managed care, HMO, ACA, and eligibility processes., • Experience supporting Medicaid Enterprise System (MES), MMIS, or Enterprise Data Warehouse projects., • Teradata experience., • Experience with Tableau, Power BI, Business Objects, or similar BI/reporting tools., • Familiarity with ETL and enterprise reporting processes., • Experience with SharePoint, Teams, and Microsoft 365., • Experience with Azure DevOps or JIRA., • Agile/Scrum experience., • CBAP, CCBA, or PMI-PBA certification., • Candidates located within driving distance of Springfield, IL are preferred.