Manager, Medicaid Payment Model Analytics Consultant - Remote

UnitedHealth Group•Washington, DC

3d•$112,700 - $193,200•Remote

About The Position

Optum Serve Consulting/The Lewin Group (OSC/Lewin), a premier national health care and human services consulting and policy analysis firm, brings 50 years of experience finding answers and solving problems for leading organizations in the public, non-profit, and private sectors. OSC/Lewin provides both depth and breadth of expertise in the wide-ranging field of health human services consulting. Currently, OSC/Lewin has more than 250 consultants drawn from industry, government and academia. They all share a solid commitment to OSC/Lewin’s core values of objectivity, integrity, analytical innovation, vision, and dedication to client satisfaction. At OSC/Lewin, we help federal, state, and other decision-makers strengthen health and human services programs, make informed policy choices, and implement critical initiatives. The Health Data Analytics Consultant will support Medicaid data and policy work for CMS Innovation Center payment models, including the LEAD model. This is a hands-on analytic role focused on working directly with Medicaid data, including T-MSIS Analytic Files (TAF), to support model implementation and operations. The consultant will help translate policy and methodology into data specifications, code, analyses, and operational outputs, including attribution, payment calculations, and quality measurement. This person will work closely with senior analysts, policy experts, and project leadership to deliver accurate, well-documented analytic products. 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

3+ years of experience working with healthcare data in a consulting, research, government, or business environment
1+ year of direct experience working with Medicaid data, including T-MSIS
Proficiency programming in SQ
Experience conducting quantitative analysis using healthcare claims and enrollment data
Experience translating business, policy, or program requirements into analytic specifications
Understanding of Medicaid eligibility, enrollment, claims, and encounter data
Familiarity with Medicaid payment and delivery systems, including managed care and fee-for-service environments
Proven excellent oral and written communication skills and a focus on meeting deadlines
Demonstrated attention to detail and commitment to producing accurate, high-quality work

Nice To Haves

Experience working with Medicaid data across multiple states
Experience working in the CMS Integrated Data Repository (IDR) in Snowflake or Databricks environments
Experience working in Snowflake
Programming experience in Python
Experience supporting healthcare payment models, value-based care programs, or alternative payment models
Experience working in large healthcare data warehouse environments, such as the Chronic Conditions Warehouse (CCW)
Experience preparing technical documentation, specifications, and analytic reports

Responsibilities

Conduct hands-on analysis of Medicaid data, including T-MSIS data, to support payment model implementation and operations
Translate policy and methodology into data specifications, business rules, and analytic code
Develop, test, and maintain SQL code to build analytic files, define populations, and produce model outputs
Use Python and other analytic tools, as appropriate, to support data processing, analysis, and quality assurance
Support attribution, payment calculation, quality measurement, and other operational methodologies used in healthcare payment models
Assess Medicaid data quality and completeness and account for differences across states, delivery systems, and managed care and fee-for-service environments
Analyze Medicaid claims, encounter, enrollment, provider, and other program data to support client needs
Develop and maintain documentation of specifications, methodologies, code, assumptions, and quality control procedures
Perform quality assurance reviews and validation checks on analytic outputs and deliverables
Prepare tables, reports, presentations, and other materials that summarize analytic findings for technical and non-technical audiences
Work effectively and cooperatively with policy, operations, and analytic staff as a member of project teams