Senior Medicaid Analyst

Overview

Berry Dunn's Health Analytics Practice Group (HAPG) is dedicated to supporting decision-makers in state government healthcare agencies, mission-driven organizations, and other public and private sector organizations. Our team brings together deep expertise in health economics, actuarial science, data science, policy analysis, and advanced analytics to help clients address complex questions involving healthcare financing and payment, cost and risk, program performance, and the use of data to inform policy, operational, and strategic decisions.

As a Senior Medicaid Analyst
, you will apply Medicaid program expertise, healthcare analytics, and policy and operational knowledge to help public-sector clients strengthen program performance, oversight, and accountability. You will analyze Medicaid claims, encounter, provider, member, eligibility, and program data; evaluate program policies and operations; identify risks and opportunities; and translate complex findings into practical recommendations for decision-makers.

The position will focus on supporting Hawaiʻi Med-QUEST’s program integrity initiatives, including fraud, waste, and abuse, payment integrity, third-party liability, compliance, and related operational improvement efforts. You will work closely with program integrity leaders, forensic and payment integrity specialists, Medicaid compliance and policy experts, claims analysts, business analysts, vendors, and client stakeholders to identify potential program vulnerabilities, assess operational and financial impacts, and support implementation of effective program improvements.

This position offers the opportunity to contribute to high-impact work such as:

• Analyzing claims, provider, member, and eligibility data to identify unusual patterns, program risks, improper payment indicators, and opportunities for improved oversight.
• Assessing Medicaid program policies, business processes, and controls to identify operational gaps, root causes, and potential improvements.
• Supporting fraud, waste, and abuse, payment integrity, and third-party liability initiatives through research, analysis, monitoring, and decision support.
• Developing reports, performance measures, and recommendations that help Medicaid leaders strengthen program integrity, recover or avoid inappropriate expenditures, and improve program operations.

You will collaborate with multidisciplinary teams of Medicaid experts, healthcare analysts, health economists, actuaries, policy and compliance professionals, forensic specialists, data scientists, and other professionals. You will also have opportunities to lead complex analyses and work streams, work directly with client and project leadership, mentor junior staff, and contribute to the continued growth of Berry Dunn’s Medicaid and public-sector healthcare capabilities. Our work environment values critical thinking, intellectual curiosity, mutual respect, and rigorous, evidence-based problem-solving, with an unwavering focus on delivering results that matter to our clients and the communities they serve.

This position offers flexibility in work location, including fully onsite, hybrid, or remote arrangements. The preferred location is Hawaiʻi or the U.S. West Coast. Berry Dunn's Hawaiʻi office is located in Kapolei, Oʻahu. The role requires availability during Hawaii Standard Time (HST) working hours and may require periodic travel within Hawaiʻi and the continental United States based on project needs.

• Analyze Medicaid claims, encounter, provider, member, eligibility, financial, and program data to identify trends, anomalies, risks, improper payment indicators, and opportunities for program improvement.
• Support Medicaid program integrity, fraud, waste, and abuse, payment integrity, and third-party liability initiatives through policy and operational analysis, provider and member research, trend monitoring, and assessment of financial and program impacts.
• Evaluate Medicaid policies, business rules, program operations, workflows, and controls to identify gaps, root causes, compliance concerns, and opportunities to strengthen program effectiveness and accountability.
• Develop and interpret performance measures, reports, dashboards, analytical summaries, and other decision-support products for Medicaid leadership, program integrity teams, and project stakeholders.
• Translate complex data, policy, compliance, and operational information into clear findings, risks, recommendations, and implementation…