Senior Medicaid Business Data Analyst – EDW & SQL

Senior Medicaid Business Data Analyst – EDW & SQL

Remote – Continental U.S.

Contract Opportunity (not open to third parties)

Occasional travel to Springfield, IL

Core hours:
Monday–Friday, 8:00 AM–5:00 PM Central

Important

This position requires real hands‑on experience working with healthcare data and SQL. Candidates with a traditional Business Analyst background but no Medicaid/public‑sector healthcare or SQL experience are unlikely to be a match.

We’re looking for an experienced Senior Medicaid Business Data Analyst to support a large‑scale State Medicaid Enterprise Data Warehouse (EDW) environment. This is not a traditional Business Analyst role. We need someone who combines strong BA skills with hands‑on SQL and a solid understanding of Medicaid healthcare data. The right person will work with business and technical teams to gather requirements, analyze data, support Medicaid reporting, investigate data issues, and assist with testing and UAT.

• Gather and document business requirements for EDW reports, extracts, enhancements, and Medicaid reporting initiatives
• Develop business requirements, business rules, use cases, user stories, acceptance criteria, data mappings, and process flows
• Work with Medicaid reporting initiatives including CMS‑64/CMS‑21, MARS, T‑MSIS, and PERM
• Translate Medicaid policy and reporting needs into clear business and data requirements
• Write SQL to analyze and validate Medicaid claims, encounters, eligibility/enrollment, provider, and financial data
• Research data questions, anomalies, and reporting variances
• Work closely with ETL, BI, QA, and business teams to resolve data issues
• Facilitate business and technical working sessions
• Document decisions, action items, risks, dependencies, and follow‑ups
• Support testing and UAT, including test scenarios, acceptance criteria, and defect follow‑up
• Maintain requirements traceability through design, testing, and delivery
• Prepare project summaries, presentations, and status updates
• Support change requests, impact analysis, documentation, and training

• 8+ years of Business Analysis experience
• 5+ years working with healthcare data, including claims, encounters, eligibility/enrollment, provider, or financial data
• 3+ years of Medicaid or public‑sector healthcare experience
• 3+ years of hands‑on SQL experience analyzing and validating data
• Experience with State Medicaid, CHIP, MMIS/MES, Medicaid data warehouses, or Medicaid managed care
• Understanding of Fee‑for‑Service and managed care claim adjudication
• Understanding of eligibility/enrollment, claims processing, managed care encounters, and healthcare funding/finance
• Basic understanding of CMS Medicaid reporting requirements
• Experience writing use cases, user stories, acceptance criteria, and supporting UAT
• Strong requirements gathering and stakeholder facilitation experience
• Strong written and verbal communication skills
• Bachelor’s degree in Business, Information Systems, Public Health, or a related field, or equivalent experience
• Ability to travel to Springfield, IL up to three times per year or as needed

• CMS‑64/CMS‑21, MARS, T‑MSIS, and/or PERM
• Medicaid Enterprise Systems (MES) or MMIS
• Medicaid Enterprise Data Warehouse projects
• Tableau, Power BI, or Business Objects
• ETL and enterprise reporting processes
• Azure Dev Ops or JIRA
• Agile/Scrum
• CMS Core Set, HEDIS, or CHIPRA
• CBAP, CCBA, or PMI‑PBA certification
• Located within driving distance of Springfield, IL