Data Analyst (Medicaid / Claims)

Job Description

Job Description

Senior Data Analyst (Medicaid, Claims & Healthcare Analytics)

Total Required Experience in Years: 10+ Years

Mode of Work: Tallahasseee, FL Onsite

Mode of Interview: Face-to-Face (F2F)

Job Description:

Seeking an experienced Senior Data Analyst with strong expertise in Medicaid and healthcare claims data analysis to support enterprise reporting, program evaluation, operational analytics, and policy decision-making initiatives. The ideal candidate will possess advanced analytical skills in SQL, SAS, Python, and data visualization platforms while working with large healthcare datasets, Medicaid claims, provider, eligibility, and encounter data.

The role requires close collaboration with business stakeholders, leadership, and technical teams to deliver actionable insights, ensure regulatory compliance, and support federal and state reporting initiatives.

Key Responsibilities:

• Analyze Medicaid claims, eligibility, provider, and encounter datasets.

• Identify trends, anomalies, risks, and opportunities through advanced analytics.

• Support program evaluation and policy analysis initiatives.

• Develop executive dashboards and operational reports using Power BI or Tableau.

• Collaborate with stakeholders to define reporting and analytical requirements.

• Present analytical findings to technical and non-technical audiences.

• Develop and validate data extracts for CMS and state reporting.

• Support healthcare performance metrics and compliance reporting.

• Ensure compliance with HIPAA and data governance standards.

• Document data sources, methodologies, assumptions, and reporting logic.

• Support audits, special projects, and federal reporting initiatives.

• Develop technical documentation for recurring reports and data pipelines.

• Apply machine learning techniques for forecasting and risk stratification where appropriate.

• Perform data validation, quality assurance, and reconciliation activities.

• Provide knowledge transfer and documentation for reporting solutions.

Required Skills:

• Medicaid Claims Analysis

• Healthcare Data Analytics

• Medicaid Eligibility Data

• Provider Data Analysis

• Encounter Data Analysis

• SQL

• SAS

• Python

• Power BI

• Tableau

• Data Visualization

• Dashboard Development

• Data Extraction

• Data Validation

• Data Quality

• Healthcare Reporting

• CMS Reporting

• Statistical Analysis

• Reporting Automation

• Data Documentation

• HIPAA Compliance

• Data Governance

• Business Intelligence

• Stakeholder Communication

Preferred Skills:

• State Healthcare Programs

• Federal Healthcare Programs

• Medicaid Managed Care

• Long-Term Services and Supports (LTSS)

• Waiver Programs

• Azure

• AWS

• Machine Learning

• Predictive Analytics

• Advanced Statistical Modeling

• Cloud Data Platforms

Required Qualifications:

• Bachelor\'s or Master\'s Degree in Data Science, Statistics, Computer Science, or a related field.

• Minimum 5+ years of experience in data analysis.

• Strong experience analyzing healthcare or Medicaid claims data.

• Strong proficiency with SQL and SAS.

• Working knowledge of Python for data analysis and automation.

• Minimum 3+ years of experience with Power BI, Tableau, or similar BI platforms.

• Strong understanding of Medicaid, healthcare claims, eligibility, provider, and encounter data.

• Excellent communication and presentation skills.

• Experience presenting analytical findings to business stakeholders.

Preferred Qualifications:

• Experience working with State or Federal healthcare programs.

• Experience with Medicaid Managed Care.

• Experience supporting LTSS or Waiver programs.

• Experience with Azure or AWS cloud platforms.

• Experience implementing machine learning models.

• Experience with advanced statistical analysis and forecasting.

Deliverables:

• Medicaid Claims Analysis Reports

• Executive Dashboards

• Power BI Reports

• Tableau Dashboards

• CMS Reporting Extracts

• State Reporting Deliverables

• Data Validation Reports

• Performance Metrics

• Forecasting Models

• Risk Stratification Reports

• Technical Documentation

• Data Pipeline Documentation

• Knowledge Transfer Documentation

Education:

• Bachelor\'s or Master\'s Degree in Data Science, Statistics, Computer Science, or a related field (or equivalent experience).