Senior Medicaid Business Data Analyst – EDW & SQL
Remote:
Continental U.S.
Contract Opportunity (not open to third parties)
Occasional travel to Springfield, IL
Core hours: Monday–Friday, 8:00 AM–5:00 PM Central
Important
This position requires real hands‑on experience working with healthcare data and SQL. Candidates with a traditional Business Analyst background but no Medicaid/public‑sector healthcare or SQL experience are unlikely to be a match.
We’re looking for an experienced Senior Medicaid Business Data Analyst to support a large‑scale State Medicaid Enterprise Data Warehouse (EDW) environment. This is not a traditional Business Analyst role. We need someone who combines strong BA skills with hands‑on SQL and a solid understanding of Medicaid healthcare data. The right person will work with business and technical teams to gather requirements, analyze data, support Medicaid reporting, investigate data issues, and assist with testing and UAT.
What You’ll Do:
Gather and document business requirements for EDW reports, extracts, enhancements, and Medicaid reporting initiatives
Develop business requirements, business rules, use cases, user stories, acceptance criteria, data mappings, and process flows
Work with Medicaid reporting initiatives including CMS‑64/CMS‑21, MARS, T‑MSIS, and PERM
Translate Medicaid policy and reporting needs into clear business and data requirements
Write SQL to analyze and validate Medicaid claims, encounters, eligibility/enrollment, provider, and financial data
Research data questions, anomalies, and reporting variances
Work closely with ETL, BI, QA, and business teams to resolve data issues
Facilitate business and technical working sessions
Document decisions, action items, risks, dependencies, and follow‑ups
Support testing and UAT, including test scenarios, acceptance criteria, and defect follow‑up
Maintain requirements traceability through design, testing, and delivery
Prepare project summaries, presentations, and status updates
Support change requests, impact analysis, documentation, and trainingWhat We’re Looking For 8+ years of Business Analysis experience
5+ years working with healthcare data, including claims, encounters, eligibility/enrollment, provider, or financial data
3+ years of Medicaid or public‑sector healthcare experience
3+ years of hands‑on SQL experience analyzing and validating data
Experience with State Medicaid, CHIP, MMIS/MES, Medicaid data warehouses, or Medicaid managed care
Understanding of Fee‑for‑Service and managed care claim adjudication
Understanding of eligibility/enrollment, claims processing, managed care encounters, and healthcare funding/finance
Basic understanding of CMS Medicaid reporting requirements
Experience writing use cases, user stories, acceptance criteria, and supporting UAT
Strong requirements gathering and stakeholder facilitation experience
Strong written and verbal communication skills
Bachelor’s degree in Business, Information Systems, Public Health, or a related field, or equivalent experience
Ability to travel to Springfield, IL up to three times per year or as neededPreferred ExperienceCMS‑64/CMS‑21, MARS, T‑MSIS, and/or PERM
Medicaid Enterprise Systems (MES) or MMIS
Medicaid Enterprise Data Warehouse projects
Tableau, Power BI, or Business Objects
ETL and enterprise reporting processes
Azure DevOps or JIRA
Agile/Scrum
CMS Core Set, HEDIS, or CHIPRA
CBAP, CCBA, or PMI‑PBA certification
Located within driving distance of Springfield, IL