Manager, Medicaid Data (T-MSIS) and Payment Model Implementation - Remote

UnitedHealth Group•Washington, DC

2d•$112,700 - $193,200•Remote

About The Position

The role supports Medicaid data and policy work for the CMS Innovation Center’s LEAD model. It is a hands-on individual-contributor position focused on working directly with Medicaid data, including T-MSIS Analytic Files (TAF), and translating model policy into data specifications, code, and results for model operations such as attribution, payment calculations, and quality measurement. The successful candidate will independently structure ambiguous analytical work, collaborate with policy and task leads, and deliver accurate, well-documented work. The role is with OptumServe Consulting/The Lewin Group (OSC/Lewin), a health care and human services consulting and policy analysis firm. Remote work is available from anywhere in the United States, except hires in the Minneapolis or Washington, D.C. area must work in the office at least four days per week. Remote employees must follow UnitedHealth Group’s Telecommuter Policy.

Requirements

Master’s degree or higher in public health, public policy, health services research, economics, statistics, epidemiology, data science, or another relevant field, with at least 6 years of relevant professional experience; or a bachelor’s degree in a relevant field with at least 8 years of relevant professional experience.
At least 2 years of direct experience working with T-MSIS data.
Experience working in the CMS Integrated Data Repository (IDR) in Snowflake or Databricks environments.
Experience translating payment model or program policy into data specifications and code, such as attribution, payment, benchmark, or quality-measure calculations.
Proficiency programming in SQL, including building analytic files from large claims and enrollment datasets.
Solid working knowledge of Medicaid eligibility, enrollment, and claims data, including known data-quality issues and differences in state reporting.
Understanding of Medicaid policy and delivery systems, including fee-for-service and managed care, sufficient to interpret how policy choices affect data and results.
Ability to independently structure ambiguous analytic assignments, manage competing priorities, and drive work to completion.
Strong written and verbal communication skills, including the ability to explain data and methodology clearly to technical and non-technical audiences.
Attention to detail and ability to produce accurate, well-documented, high-quality work in a fast-moving client-service environment.
Ability to work effectively both independently and collaboratively in a multidisciplinary project environment.

Nice To Haves

Experience working with Medicaid data across multiple states.
Programming experience in Python.
Experience supporting a CMS Innovation Center model or another federal healthcare demonstration.
Experience with alternative payment models, accountable care, or total cost of care methodologies.
Experience working in or directly supporting a state Medicaid agency, CMS, CMCS, CMMI, a Medicaid managed care organization, or a Medicaid data or policy contractor.
Consulting experience managing multiple concurrent assignments and responding to evolving federal client priorities.

Responsibilities

Conduct hands-on analysis of Medicaid data, including T-MSIS data, to support implementation and operations for the LEAD model.
Translate model policy and methodology into data specifications, business rules, and code for beneficiary attribution, payment calculations, and quality measurement.
Write, test, and maintain SQL code to build analytic files, define populations, and produce model outputs; use Python where appropriate.
Assess Medicaid data quality and completeness across states; account for differences in state data, delivery systems, managed care, and fee-for-service environments, and document effects on model calculations.
Link and analyze Medicaid data alongside Medicare data sources, including data in the CMS Integrated Data Repository (IDR), as needed to support model methodology.
Develop and maintain documentation of specifications, code, data sources, assumptions, and quality assurance checks.
Perform and support quality assurance of analytic outputs and deliverables, including independent code review and reconciliation of results.
Summarize analytic findings and methodology for technical and non-technical audiences through memos, tables, and presentation materials for CMS.
Share Medicaid data knowledge with colleagues and review their work as needed.