This role is a Sr. BTA position focused on translating Medicare Advantage and Medicaid Risk Adjustment business requirements into production-ready technical solutions, including Encounter RA Prioritization and Encounter RA Chart Process support. The ideal candidate brings advanced SAS, SQL, Snowflake, healthcare data integration, data quality, regulatory compliance, and reusable documentation experience. Partners with business analysts, Risk Adjustment stakeholders, IT, and vendor teams to understand provided Medicare Advantage and Medicaid business requirements, translate them into technical specifications, and support process improvements through SAS solutions and future Snowflake capabilities. Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment Prioritization and Encounter Risk Adjustment Chart Process workflows, with future Snowflake migration support. Creates multi-user, real-time, robust database solutions by integrating complex healthcare datasets, including claims, enrollment, provider, pharmacy, clinical records, and vendor chart data. Acts as a technical subject matter expert to convert provided business requirements into system analysis, technical design, advanced SAS/SQL programming, Snowflake modernization, and documentation of business applications/systems. Modernizes legacy SAS ETL workflows into scalable Snowflake architecture using Snowflake SQL, Snowpark Python, and automated pipeline orchestration concepts such as Tasks and Streams Implements validation, reconciliation, and data quality frameworks to support CMS audit standards, state Medicaid requirements, and compliant Risk Adjustment encounter submissions. Builds reusable SAS, SQL, and Snowflake data assets, modular code libraries, and technical documentation to reduce development time and support knowledge transfer across data and actuarial teams. Develops ad-hoc reports to conduct data analysis and validation. Confers with area/department to analyze current operational procedures and trends and identify problems. Conducts business analysis and recommends technical alternative solutions to management as to course of action that best meets the organization's goals. Research, evaluate and assess the financial impact of issues identified in data/processes. Analyzes requirements, procedures, and problems to automate processing or to improve existing business systems. Creates multiuser, real-time, robust database solutions. Acts as subject matter expert to provide business and technical expertise in requirements solicitation, system analysis, technical design, programming and documentation of business applications/systems. May be responsible for monitoring and reporting to management on the status of departmental projects: Anticipates and identifies issues that could inhibit achieving the project goals and objectives, and implementing corrective actions and mitigation strategies. Provides oversight and resolves complex issues, optimizing performance, resolving problems, and providing timely follow-up on identified issues. Provides guidance and training to staff on process, procedures and issue resolution. Complies with all policies and standards
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Job Type
Full-time
Career Level
Senior