Medicaid Model Analytics Consultant - Remote

Position: Medicaid Payment Model Analytics Consultant - Remote
Job d:

Location:

Eden Prairie, Minnesota, United States Salary: $91,700 - $163,700/year

Job Area:
Optum Insight Consulting Company:
United Health Group For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.

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  the wide-ranging field of health human services consulting, OSC/Lewin provides both depth and breadth of expertise.  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.

Primary 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

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

3+ years of experience working with healthcare data in a consulting, research, government, or business environment1+ years of direct experience working with Medicaid data, including T-MSISExperience 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 SQLProven excellent oral and written communication skills and a focus on meeting deadlines

Demonstrated attention to detail and commitment to producing accurate,…