Medicaid Payment Model Analytics Consultant - Remote

UnitedHealth Group•Eden Prairie, MN

1d•$91,700 - $163,700•Remote

About The Position

Optum Serve Consulting/The Lewin Group (OSC/Lewin), a national health care and human services consulting and policy analysis firm, supports public, nonprofit, and private-sector organizations. The Medicaid Payment Model Analytics Consultant will support Medicaid data and policy work for CMS Innovation Center payment models, including the LEAD model. This hands-on analytics role works directly with Medicaid data, including T-MSIS Analytic Files (TAF), to support model implementation and operations. The consultant translates policy and methodology into data specifications, code, analyses, and operational outputs, including attribution, payment calculations, and quality measurement. The role works closely with senior analysts, policy experts, and project leadership to deliver accurate, well-documented analytic products. The position is remote from anywhere in the U.S.; 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

3+ years of experience working with healthcare data in a consulting, research, government, or business environment.
1+ years of direct experience working with Medicaid data, including T-MSIS.
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.
Proficiency programming in SQL.
Excellent oral and written communication skills and a focus on meeting deadlines.
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.