EDW Medicaid Subject Matter Expert or Data Specialist - Remote

UnitedHealth Group Inc.•Chicago, IL

40d•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. This position is a Medicaid Subject Matter (SME) Expert for the Enterprise Data Warehouse supporting the State Medicaid program. This role requires significant expertise of Medicaid Enterprise System modules and data warehousing or decision support systems. This role provides the guidance and direction to support a large data warehouse implementation and maintenance & operations. The selected SME will provide the required decisions for the business and technical team members to modify, change, enhance or correct within the system, related to claims, provider, and recipient data. Roles in this function will partner with stakeholders to understand data requirements and support development tools and models such as interfaces, dashboards, data visualizations, decision aids and business case analysis to support the organization. Additional roles include producing and managing the delivery of activity, value analytics and critical deliverables to external stakeholders and clients. This is a telecommute position with some (<25%) required travel to Springfield, IL for onsite customer meetings.</span> You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Requirements

10+ years of experience in information technology with 5+ years of experience working directly with/for State Medicaid agencies or equivalent supporting business initiatives through data analysis, writing business requirements and testing/validation of various systems
2+ years of experience working CMS Federal Reporting MARS, PERM, T-MSIS, Quality of Care CMS Core Measure or similar projects
Knowledge of the Centers for Medicare and Medicaid Services reporting requirements and the programs covered
Understanding of claims, recipient/eligibility, and provider/enrollment data processes
Proven ability to create and perform data analysis using SQL, Excel against data warehouses utilizing large datasets
Proven excellent verbal/written communication and presentation skills, manager/executive/director-level client facing, team collaboration, and mentoring skills
Proven solid culture fit, demonstrating our culture values in action (Integrity, Compassion, Inclusion, Relationships, Innovation, and Performance)
Ability to travel to Springfield, IL two (3) to three (4) times per year or as needed

Nice To Haves

2+ years of experience in HEDIS, CHIPRA or similar quality metrics
Experience with data analysis using Teradata Database Management System or other equivalent database management system
Experience using JIRA, Rally, DevOps or equivalent
Experience in large implementation or DDI project
Located within driving distance (3 - 5 Hours) of Springfield, IL
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Responsibilities

Provide direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations
With the specialized knowledge of the Medicaid and Children's Health Insurance Programs (CHIP), lead and guide internal and external stakeholders to make determinations relating to complex processes involving claims processing/adjudication, recipient eligibility, provider enrollment, and third-party liability
Proactively identify and understand state Medicaid agency data needs and determines the recommended solution to meet them with credible reason, justification and validated proof of concepts
Direct technical and business teams on healthcare topics understanding and utilizing healthcare data appropriately
Proactively suggest and recommend enhancements and improvements throughout the project processes, driven by Medicaid best practices, standards and policies