Business Data Analyst – Medicaid

Job not on LinkedIn

🕒 October 20

🌽 Illinois – Remote

🌽 Illinois – Remote

⏰ Full Time

🟠 Senior

🔴 Lead

📉 Data Analyst

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This company has sponsored H1B visas in the past.

👻 Ghost score 18%

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CSpring

WebsiteLinkedInAll Job Openings

51 - 200 employees

🤝 B2B

💼 Consulting

☁️ SaaS

B2B • Consulting • SaaS

CSpring is a consulting firm that specializes in unlocking the power and potential of data to achieve technology-enabled business goals. Founded in 1996, the company focuses on data-driven solutions that align with clients' business objectives, offering services such as data architecture, management, analytics, and reporting. With a team of full-time consultants, CSpring collaborates with both public and private sector clients to develop technology strategies, architect data solutions, build software, and create visualizations tailored to meet unique client needs. CSpring is also recognized as a certified Woman-owned Business Enterprise (WBE) and has been named a Best Place to Work in Indiana.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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

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