Note: The job is a remote job and is open to candidates in USA. Optum Serve Consulting/The Lewin Group is hiring a Medicaid Payment Model Analytics Consultant to support CMS Innovation Center payment models, including the LEAD model. The role analyzes Medicaid data and translates policy and methodologies into specifications, code, analyses, and operational outputs such as attribution, payment calculations, and quality measurement.

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

Skills

• 3+ years of experience working with healthcare data in a consulting, research, government, or business environment
• 1+ years of direct experience working with Medicaid data, including T-MSIS
• Experience 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 SQL
• Proven excellent oral and written communication skills and a focus on meeting deadlines
• Demonstrated attention to detail and commitment to producing accurate, high-quality work
• Experience working with Medicaid data across multiple states
• Experience working in the CMS Integrated Data Repository (IDR) in Snowflake or Databricks environments
• Experience working in Snowflake
• Programming experience in Python
• Experience supporting healthcare payment models, value-based care programs, or alternative payment models
• Experience working in large healthcare data warehouse environments, such as the Chronic Conditions Warehouse (CCW)
• Experience preparing technical documentation, specifications, and analytic reports

Benefits

• Flexible remote work from anywhere within the U.S.; hires in the Minneapolis or Washington, D.C. area are required to work in the office a minimum of four days per week.
• A comprehensive benefits package, subject to eligibility requirements
• Incentive and recognition programs, subject to eligibility requirements
• Equity stock purchase, subject to eligibility requirements
• 401k contribution, subject to eligibility requirements

Company Overview

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