Business Data Analyst – Medicaid

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🕒 2 dias atrás

🌽 Illinois – Remoto

🌽 Illinois – Remote

⏰ Tempo Integral

🟠 Sênior

🔴 Especialista

📉 Analista de Dados

🦅 Patrocina Visto H1B

Esta empresa já patrocinou vistos H1B no passado.

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CSpring

SiteLinkedInTodas as Vagas

51 - 200 funcionários

🤝 B2B

💼 Consultoria

☁️ SaaS

B2B • Consulting • SaaS

A CSpring oferece as soluções e a expertise necessárias para alcançar metas de negócios habilitadas por tecnologia. Nossa equipe de consultores em tempo integral foca em soluções orientadas por dados que alinham metas de negócios com tecnologia e tornam a informação acessível, confiável e envolvente.

Descrição

• Gather, document, and manage business requirements for EDW reports, extracts, and enhancements, including CMS-64/CMS-21, MARS, T-MSIS, and PERM support • Analyze current business processes and systems and document requirements for new or changed processes • Translate federal and State Medicaid policy and reporting guidance into business rules and requirements • Write business requirements, business rules, use cases, user stories, acceptance criteria, data mappings, and process flows • Maintain requirements traceability through design, testing, and delivery • Facilitate working sessions with State business users, Optum technical teams, and other partners • Capture meeting minutes, decisions, action items, and follow-ups • Track questions, dependencies, and risks and escalate issues when needed • Write SQL to profile and analyze Medicaid enrollment, eligibility, provider, claims, encounter, and financial data • Identify and document data anomalies and variances and collaborate with ETL, BI, and QA teams on resolution • Share use cases with data and quality analysts, review profiling results, and confirm alignment with requirements and Medicaid/CMS guidelines • Support testing and UAT, including test scenarios, acceptance criteria, defect reporting, and follow-up • Prepare presentations, summaries, and status updates for leadership and customers • Maintain business documentation, data definitions, the Operations Guide, and process documentation in SharePoint and Azure DevOps • Support end-user training and training materials • Mentor junior analysts and serve as backup to the Medicaid SME • Peer review project artifacts and help manage intake and change requests, including impact analysis and BA effort estimates

🎯 Requisitos

• 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, documentation, stakeholder facilitation, and user acceptance testing • 5+ years of experience working with healthcare data such as claims, encounters, eligibility/enrollment, provider, or financial data • 3+ years of experience with Medicaid or public-sector healthcare programs • 3+ years of experience writing SQL to analyze and validate data in a relational database or data warehouse • Understanding of Fee for Service and managed care claim adjudication • Basic understanding of CMS reporting requirements for Medicaid • Experience writing use cases, user stories, and acceptance criteria and supporting testing/UAT • Experience facilitating meetings and documenting outcomes • Proficient in MS Word, Excel, PowerPoint, Visio, MS Project, SharePoint, and Teams • Strong written and verbal communication skills • Organized and detail-oriented, with ability to manage competing priorities and tight deadlines with limited supervision • Ability to travel to Springfield, IL up to three times per year or as needed • Bonus experience with CMS-64/CMS-21, MARS, T-MSIS, PERM, CMS Core Set, HEDIS, CHIPRA, Medicaid/Medicare regulation, ACA, MES/MMIS, Enterprise Data Warehouse DDI, Teradata, SQL Assistant/Query Studio, Business Objects, Tableau, Power BI, ETL, Microsoft 365, Azure DevOps, JIRA, Agile/Scrum, and CBAP, CCBA, or PMI-PBA certification

🏖️ Benefícios

• Purposeful projects improving systems that serve real people • People-first culture with support, autonomy, and community • Strategic, hands-on work • Collaborative work with clients and teams • Meaningful work and opportunities for career growth • Fully remote work arrangement • Travel to Springfield, IL up to three times per year or as needed