Note: The job is a remote job and is open to candidates in USA. Optum’s OptumServe Consulting/The Lewin Group is hiring a Manager to support Medicaid data and policy work for the CMS Innovation Center’s LEAD model. The role translates model policy into data specifications, code, and analysis for attribution, payment calculations, and quality measurement, while documenting and validating analytic work.
Responsibilities
- Conduct hands-on analysis of Medicaid data, including T-MSIS data, to support implementation and operations for the LEAD model
- Translate model policy and methodology into clear data specifications, business rules, and code for core payment model functions, including beneficiary attribution, payment calculations, and quality measurement
- Write, test, and maintain SQL code to build analytic files, define populations, and produce model outputs; use Python where appropriate
- Assess Medicaid data quality and completeness across states, account for differences in state data, delivery systems, and managed care and fee-for-service environments, and document how those differences affect model calculations
- Link and analyze Medicaid data alongside Medicare data sources, such as data located in the CMS Integrated Data Repository (IDR), as needed to support model methodology
- Develop and maintain clear documentation of specifications, code, data sources, assumptions, and quality assurance checks
- Perform and support quality assurance of analytic outputs and deliverables, including independent code review and reconciliation of results
- Summarize analytic findings and methodology for technical and non-technical audiences, including memos, tables, and presentation materials for CMS
- Share Medicaid data knowledge with colleagues and review their work as needed
Skills
- Master's degree or higher in public health, public policy, health services research, economics, statistics, epidemiology, data science or another relevelant field, with 6+ years of relevant professional experience; or a Bachelor's degree in a relevant field with 8+ years of relevant professional experience
- 2+ years of direct experience working with T-MSIS data
- Experience working in the CMS Integrated Data Repository (IDR) in Snowflake or Databricks environments
- Experience turning payment model or program policy into data specifications and code, such as attribution, payment, benchmark, or quality measure calculations
- Proficiency programming in SQL, including building analytic files from large claims and enrollment datasets
- Solid working knowledge of Medicaid eligibility, enrollment, and claims data, including known data quality issues and differences in state reporting
- Understanding of Medicaid policy and delivery systems, including fee-for-service and managed care, sufficient to interpret how policy choices affect data and results
- Demonstrated ability to independently structure ambiguous analytic assignments, manage competing priorities, and drive work to completion
- Solid written and verbal communication skills, with the ability to explain data and methodology clearly to technical and non-technical audiences
- Demonstrated attention to detail and ability to produce accurate, well-documented, high-quality work in a fast-moving client-service environment
- Ability to work effectively both independently and collaboratively in a multidisciplinary project environment
- Experience working with Medicaid data across multiple states
- Programming experience in Python
- Experience supporting a CMS Innovation Center model or another federal healthcare demonstration
- Experience with alternative payment models, accountable care, or total cost of care methodologies
- Experience working in or directly supporting a state Medicaid agency, CMS, CMCS, CMMI, a Medicaid managed care organization, or a Medicaid data or policy contractor
- Consulting experience managing multiple concurrent assignments and responding to evolving federal client priorities
Benefits
- 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)
- 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
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