Medicaid data specialist (Local to Springfield, IL)

Medicaid data specialist (Local to Springfield, IL)

Posted 2 weeks ago by 1751378112

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Negotiable
Outside
Remote
USA
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Agile Methodology Content Management Systems Cross-Functional Coordination Database Management Data Warehousing Information Technology JIRA Management Microsoft Azure Microsoft Excel Rally Software SQL (Programming Language) Stakeholder Management

Summary: The Medicaid Data Specialist role requires extensive experience in information technology, particularly in supporting state Medicaid agencies. The position emphasizes expertise in claims adjudication, recipient eligibility, and provider enrollment data processes, along with strong analytical skills in SQL and Excel. Exceptional communication and leadership abilities are essential for collaboration with stakeholders at all levels. The role also involves occasional travel to Springfield, IL for client meetings.

Key Responsibilities:

  • Support state Medicaid agencies or equivalent entities with data processes.
  • Analyze large, complex datasets using SQL and Excel in enterprise data warehouse environments.
  • Ensure compliance with CMS programs and reporting requirements.
  • Communicate effectively with stakeholders, including C-level executives.
  • Mentor and coordinate cross-functional teams.
  • Travel to Springfield, IL for client meetings as required.

Key Skills:

  • 10+ years of experience in information technology.
  • 5+ years of experience supporting state Medicaid agencies.
  • Deep understanding of claims adjudication, recipient eligibility, and provider enrollment data processes.
  • Proficient in SQL and Excel.
  • In-depth knowledge of CMS programs and reporting requirements.
  • Exceptional communication and presentation skills.
  • Strong collaboration and leadership capabilities.
  • Ability to travel to Springfield, IL 2-4 times annually.
  • Master's degree in a related field (preferred).
  • Experience with CMS Federal Reporting, quality metrics, Teradata, Agile tools, and large-scale Medicaid system implementations (preferred).

Salary (Rate): undetermined

City: undetermined

Country: USA

Working Arrangements: remote

IR35 Status: outside IR35

Seniority Level: undetermined

Industry: Other

Detailed Description From Employer:

Requirements

  • 10+ years of experience in information technology, including 5+ years directly supporting state Medicaid agencies or equivalent entities.
  • Deep understanding of claims adjudication, recipient eligibility, and provider enrollment data processes.
  • Proficient in SQL and Excel for analyzing large, complex datasets in enterprise data warehouse environments.
  • In-depth knowledge of CMS programs and reporting requirements (e.g., T-MSIS, CMS-64/21).
  • Exceptional communication and presentation skills across all levels of an organization, including C-level stakeholders.
  • Strong collaboration and leadership capabilities; demonstrated mentoring and cross-functional coordination.
  • Ability to travel to Springfield, IL 2 4 times annually for client meetings.

Preferred Qualifications

  • Master s degree in a related field
  • 2+ years of experience with:
    • CMS Federal Reporting (PERM, T-MSIS, CMS-64/21)
    • Quality metrics such as HEDIS, Adult/Child Core Measures, or CHIPRA
    • Teradata or equivalent database management systems
    • Agile tools like JIRA, Rally, or Azure DevOps
    • Large-scale Medicaid system implementations
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