Medicaid Payment Model Analytics Consultant
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Experience, qualification, and soft skills, have you got everything required to succeed in this opportunity Find out below.
In this role, you will analyze Medicaid data to support payment model implementation and operations, translating policy into analytical outputs. You’ll collaborate with policy and analytic teams to deliver well-documented, QA’d analytics that inform care payment and quality measures. You’ll work remotely nationwide with office expectations in certain locations. This is a hands-on, impact-focused position shaping Medicaid data usage across states and delivery systems.
Compensation / Benefits
- comprehensive benefits package
- equity stock purchase
- 401k contribution
- incentive and recognition programs
Responsibilities
- Conduct hands-on analysis of Medicaid data (TAF) to support payment model implementation and operations
- Translate policy and methodology into data specifications, business rules, and analytic code
- Develop, test, and maintain SQL code to build analytic files, define populations, and produce model outputs
- Use Python and other analytic tools to support data processing, analysis, and quality assurance
- Support attribution, payment calculation, quality measurement, and other operational methodologies
- Assess Medicaid data quality and completeness across states, delivery systems, and delivery models
- Analyze Medicaid claims, enrollment, provider, and other program data for client needs
- Maintain documentation of specifications, methodologies, code, assumptions, and QC procedures
- Perform QA reviews and validation on analytic outputs and deliverables
- Prepare tables, reports, and materials summarizing analytic findings for technical and non-technical audiences
- Collaborate with policy, operations, and analytic staff as a project team member
Key requirements
- 3+ years of experience with healthcare data in a consulting, research, government, or business environment
- 1+ years direct experience with Medicaid data, including T-MSIS
- Experience conducting quantitative analysis using healthcare claims and xhuatnn enrollment data
- Experience translating business, policy, or program requirements into analytic specifications
- Understanding of Medicaid eligibility, enrollment, claims, and encounter data
- Familiarity with Medicaid payment and delivery systems (managed care and fee-for-service)
- Proficiency programming in SQL
- Excellent oral and written communication skills and deadline orientation
- Attention to detail and commitment to producing accurate work
- communication skills
- attention to detail
- team collaboration
- SQL
- Python
- data processing
Remote working/work at home options are available for this role.
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