Enterprise Data Modeler – Healthcare Payer

As an Enterprise Data Modeler - Healthcare Payer, you will make an impact by designing and establishing enterprise-wide data models that serve as the foundation for a large-scale healthcare data transformation program. You will be a valued member of the Data & Analytics team and work collaboratively with business leaders, data architects, governance teams, and healthcare domain stakeholders to create scalable, business-aligned data structures that enable analytics, reporting, AI, and operational excellence.

• Develop and maintain enterprise business data models that align with organizational data strategy and business objectives.
• Create conceptual, canonical, logical, physical, and domain data models across key Medicare Advantage business domains.
• Facilitate workshops and collaborate with business and technology stakeholders to establish common business definitions, data standards, and entity relationships.
• Align data models with data governance, metadata management, master data management (MDM), analytics, reporting, and AI initiatives.
• Partner with implementation teams to translate business-driven data models into scalable technical solutions on modern cloud-based data platforms.

We strive to provide flexibility wherever possible. Based on this role's business requirements, this is a remote position open to qualified applicants in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.

The working arrangements for this role are accurate as of the date of posting. This may change based on the project you're engaged in, as well as business and client requirements. Rest assured; we will always be clear about role expectations.

• Extensive experience in enterprise data modeling, including conceptual, canonical, logical, physical, and domain-driven modeling methodologies.
• Strong data architecture experience within health plan/payer environments** - Medicare Advantage-specific experience is a plus, but not required for candidates with solid payer data experience (e.g., claims, enrollment, provider networks) and the willingness and aptitude to ramp up quickly on Medicare Advantage-specific domains (Members & Enrollment, Providers & Networks, Claims & Encounters, Authorizations & Referrals, Care Management, HEDIS/STARS, Risk Adjustment (RAF/HCC), CMS Reporting, Delegated/IPA Models, and Value-Based Care).
• Proven ability to translate complex business concepts into enterprise data models and establish consistent business definitions across multiple stakeholder groups.
• Experience facilitating requirements discovery sessions, business workshops, and cross-functional stakeholder engagements.
• Strong understanding of data governance, metadata management, master data management (MDM), data quality, and data lineage concepts.
• Experience working with modern cloud-based data platforms and data lakehouse architectures, with willingness and aptitude to ramp up on Databricks specifically (direct Databricks experience is a plus, not a requirement).
• Experience supporting enterprise-scale data transformation, modernization, or data architecture initiatives.
• Bachelor's degree or equivalent combination of education and relevant professional experience.

• Hands-on experience with Databricks or similar unified analytics platforms.
• Demonstrated expertise within the Medicare Advantage healthcare domain specifically.
• Experience designing healthcare enterprise information models for payer organizations.
• Knowledge of healthcare regulatory reporting requirements and CMS data standards.
• Familiarity with data product frameworks and domain-oriented…