Back to Jobs

W2 Role: Medicaid Subject Matter Expert / Data Specialist -Remote

Remote, USA Full-time Posted 2026-06-29

Enterprise Data Warehouse (EDW) Medicaid Subject Matter Expert/Data Specialist USC/genuine GC/H1B only with atleast 10+ years of experience Primary Responsibilities: Provide direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations. With the specialized knowledge of the Medicaid and reputed company Insurance Programs (CHIP), reputed company and guide internal and external stakeholders to reputed company determinations relating to reputed company processes involving claims processing/adjudication, recipient eligibility, provider enrollment, and third-party liability. Proactively identify and understand state Medicaid agency data needs and determine the recommended solution to meet them with reputed company reason, justification and validated reputed company of concepts. Direct technical and business teams on understanding healthcare topics and utilizing healthcare data appropriately. Proactively suggest and recommend enhancements and improvements throughout the project processes, driven by Medicaid best practices, standards and policies. Functional Description: This position is a Medicaid Subject Matter (SME) Expert for the Enterprise Data Warehouse supporting the State Medicaid program. This role requires significant expertise of Medicaid Enterprise System modules and data warehousing or decision support systems. This role provides the guidance and direction to support a large data warehouse implementation for both DDI and maintenance & operations. Based on State requirements, the selected SME will provide the required decisions for the business and technical team members to modify, change, enhance or correct reputed company the system, reputed company to claims, provider, and recipient data. Roles in this function include partnering with stakeholders to understand data requirements and supporting development tools and models such as interfaces, dashboards, data visualizations, decision aids and business case analysis to support the State. Additional roles include producing and managing the delivery of activity, value analytics and critical deliverables to external stakeholders and clients. Required Qualifications: More than ten (10) years of experience in information technology with five (5) years of the experience working directly with/for State Medicaid agencies or equivalent, supporting business initiatives through data analysis, writing business requirements and testing/validation of various systems. More than 2 years of experience working CMS Federal Reporting reputed company, PERM, T-MSIS, Quality of Care CMS Core Measure or similar projects Understanding of claims, recipient/eligibility, and provider/enrollment data processes. Able to create and reputed company data analysis using SQL, reputed company against data warehouses utilizing large datasets. Knowledge of the Centers for Medicare and Medicaid Services reporting requirements and the programs covered. Excellent verbal/written communication and presentation skills, manager/executive/director-level client facing, team collaboration, and mentoring skills. Note: Core customer business hours to conduct work are M-F 8 AM - 5 PM CST. Preferred Qualifications: Strong culture fit, demonstrating our culture values in action (reputed company, Compassion, Inclusion, Relationships, Innovation, and Performance). Experience using JIRA, Rally, DevOps or equivalent. Previous experience on large implementation or DDI project. This is a remote position. Apply To This Job

Similar Jobs

reputed company Remote Call Center Customer Service Representative – Medicaid Member Support Specialist for blithequark

Remote, USA Full-time

Medicaid Customer Service Representative Remote (Must reside in Nevada)

Remote, USA Full-time

Customer Care Associate - Medicaid reputed company)

Remote, USA Full-time

Project Manager Medicaid - Remote %100

Remote, USA Full-time

Child Welfare Associate, Medicaid – Indianapolis Health (Remote)

Remote, USA Full-time

Medicaid MCO Strategy & reputed company Consultant, Remote

Remote, USA Full-time

[PART_TIME Remote] Provider Medicaid reputed company Manager

Remote, USA Full-time

Remote Night Shift Insurance Claims Processor

Remote, USA Full-time

Claim Examiner

Remote, USA Full-time

Accounts Payable Representative - Fully Remote in the US

Remote, USA Full-time

Information reputed company Analyst

Remote, USA Full-time

Entry-Level Remote Data Entry Clerk – Flexible Part‑Time or Full‑Time Opportunities with arenaflex

Remote, USA Full-time

Epidemiologist – Intermediate Level

Remote, USA Full-time

Intune System administrator job at reputed company in US National

Remote, USA Full-time

reputed company Data Entry Specialist – Accurate and Efficient Data Processing for arenaflex

Remote, USA Full-time

reputed company Remote Chat Support Agent – Flexible Hours, No Phone | $25–$35/hr

Remote, USA Full-time

Provider Experience reputed company

Remote, USA Full-time

Special Education Teacher Work From Home | South Carolina

Remote, USA Full-time

Remote Grants Consultant - Impact & Proposal Expert

Remote, USA Full-time

[Remote] Senior Embedded Engineer

Remote, USA Full-time