Principal Analyst, Medicaid Policy Analysis

Arcadia

3d • $190,000 - $215,000 • Remote

About The Position

Arcadia is a leading healthcare platform that transforms complex healthcare data into trusted intelligence. We help providers, payers, and life sciences organizations achieve measurable clinical, operational, and financial outcomes through advanced analytics and responsible AI. Our platform, built on a comprehensive data foundation, is used by hundreds of organizations to improve cost, quality, and outcomes. We are backed by Nordic Capital and are committed to investing in our platform, AI capabilities, and people to fulfill our purpose of helping healthcare deliver better outcomes for everyone.

This role is a unique opportunity within the Customer Insights team, focusing on Medicaid policy analysis for a significant state Medicaid agency account. This position is crucial for interpreting program rules and policy documents into actionable analytic logic, and for building the necessary data models, registries, and dashboards. The ideal candidate will possess a rare blend of policy fluency, customer presence, and technical skill, with the ability to quickly learn and leverage AI-assisted development tools. Success in this role involves rapid onboarding, contributing to customer engagements, independently delivering analytical work, owning the day-to-day analytic workstream, and becoming a recognized expert in Medicaid policy analysis.

Requirements

• Working knowledge of health programs and managed care plans, with the ability to translate policy documents and program rules into analytic logic.
• Direct Medicaid or managed care plan experience is a plus.
• Clinical code and claims fluency, including ICD-10, CPT/HCPCS, and revenue codes for building clinical cohorts.
• Experience with claims, eligibility, and provider/NPI data (NPPES, enrollment files), and understanding of claims timing and completeness.
• Hands-on, demonstrable fluency with AI coding and analysis tools (Claude Code, Cursor, or similar) as the core of how you work.
• Ability to pick up AI tools quickly and use them heavily for onboarding and delivery.
• Advanced SQL skills (CTEs, window functions, performance on large claims and eligibility tables) to a real engineering standard.
• Data modeling experience to a real engineering standard.
• Hands-on experience building dashboards and reports in a BI tool (QuickSight, Power BI, Tableau) and Excel.
• Experience creating executive-ready decks.
• Direct customer-facing experience with senior stakeholders, comfortable scoping ambiguous requests, navigating competing priorities, and exercising sound analytical judgment on short timelines without close oversight.
• A track record of leading an analytic program end-to-end for senior customer or executive audiences, setting own priorities, and operating without a project manager or close direction.
• Sound judgment with sensitive data and PHI.

Nice To Haves

• Direct experience with a state Medicaid agency, a Medicaid-serving prime contractor or consultancy, or a Medicaid managed care plan.
• California Medi-Cal experience.
• Familiarity with population health concepts: risk stratification, registries, care management, network adequacy, and access and equity analysis.
• Experience with Python and dbt.
• Familiarity with the AWS ecosystem and its analytics tools (e.g., Athena, Redshift, QuickSight).
• Comfort with orchestration tooling, Jira, Confluence, and GitHub-based workflows.
• Experience mentoring less experienced analysts.

Responsibilities

• Interpret state and federal Medicaid program rules, eligibility and aid-code structures, benefit and coverage design, and program guidance into precise, testable analytic logic (cohort definitions, code sets, exclusions, stratification criteria) and document the interpretation for auditability.
• Advise senior customer leadership on data capabilities and limitations, including the measurability of proposed definitions, volume impacts, threshold effects on caseload, cost, or provider capacity, and anticipate how policy changes affect data and future questions.
• Translate ambiguous policy and operational questions into member and provider data marts, cohort and stratification logic, and registry extracts using SQL and Python on Foundry and Redshift/Athena.
• Deliver analytical outputs in various formats required by the customer, including dashboards, recurring reports, Excel files, and leadership decks.
• Identify and root-cause data-quality issues, reconcile counts across sources, trace data errors to their origin, and agree on definitions for undocumented fields and codes with customer data staff.
• Serve as the senior analytic voice for state program leadership, policy and data staff, prime contractors, and vendor partners in recurring working sessions, translating between policy, operational, and technical audiences.
• Collaborate with Customer Management to set priorities, scope projects, and define timelines, with the authority to push back on feasibility or value.
• Create client-facing materials such as leadership summaries, detailed methodology decks, decision memos, and technical explainers tailored to diverse audiences.
• Set personal priorities and make decisions with incomplete information.
• Act as the senior analytic voice with agency and partner leadership.
• Raise the bar for other analysts through setting standards, review, and example.
• Operate independently without a project manager or close direction.
• Follow all security policies and procedures to protect PHI and Arcadia intellectual property.

Benefits

• Competitive Compensation
• Amazing Benefits
• Unlimited FTO (Flexible Time Off)
• Employee driven programs and initiatives for personal and professional development
• A flexible, remote-friendly company

What This Job Offers

• Job Type: Full-time
• Career Level: Principal
• Education Level: No Education Listed