Medicaid Subject Matter Expert / Data Specialist in EDW Environment

Primary Responsibilities :

• Provide direction, guidance and recommendations supporting decision making for large

Medicaid data warehouse implementation and operations.

and guide internal and external stakeholders to make determinations relating to complex

processes involving claims processing / adjudication, recipient / provider eligibility, and third-party

liability.

recommended solution to meet them with credible reason, justification and validated proof of

concepts.

data appropriately.

processes, driven by Medicaid best practices, standards and policies.

Required Qualifications :

equivalent.

initiatives through data analysis, writing business requirements, and user acceptance testing

of various systems.

Reporting, quality measures, claims processing, Medicaid program eligibility, provider

enrollment, third-party liability.

from enrollment to funding / finance.

mentoring skills.

Inclusion, Relationships, Innovation, and Performance).

Preferred Qualifications :

equivalent database management system.

Functional Description :

This position is a Medicaid Subject Matter Expert for the Illinois Enterprise Data Warehouse supporting

the State of Illinois Medicaid program. This role requires significant expertise of Medicaid Enterprise

System modules and data warehouse or decision support systems. This role provides the guidance and

direction to support a large data warehouse implementation and operations. The selected SME will

provide the required decisions for the business and technical team members to modify, change,

enhance or correct within the system, related to claims, provider, and recipient data.

Roles in this function will partner with stakeholders to understand data requirements and support

development tools and models such as interfaces, dashboards, data visualizations, decision aids and

business case analysis to support the organization. Additional roles include producing and managing the

delivery of activity, value analytics and critical deliverables to external stakeholders and clients. This is a

telecommute position with some (