Description

Design and implement technical solutions for Managed Care Transformation, ensuring compliance with Federal and State Medicaid requirements. Own the full lifecycle of data interfaces, reporting, and analytics within the healthcare ecosystem.

Responsibilities

• Research and analyze complex healthcare data from multiple sources to design scalable technical solutions.
• Develop and maintain interfaces across Medicaid internal and external systems, ensuring seamless data exchange.
• Create and deliver reports and metrics using SAS Business Intelligence tools and the NC Analytics Data warehouse.
• Write and optimize SQL queries to analyze data, validate input files, and generate ad-hoc reports for business needs.
• Translate business requirements into technical specifications, managing vendor relationships and stakeholder expectations.

Required Skills

• 5+ years of project management experience in complex technical environments.
• 5+ years of experience developing SQL queries across Oracle (11), MS SQL Server, and DB2 databases.
• 5+ years of SAS programming knowledge, specifically Base SAS 9.4, SAS Macro, SAS BI Suite, Data Integration Studio, and Enterprise Guide.
• Strong understanding of healthcare claims processing, including Claims, Provider, Eligibility, and Members data structures.
• Proficiency with file transfer methodologies and formats including CSV, TXT, and XML.
• Proven track record delivering Business Intelligence solutions and validating data quality assurance.
• Demonstrated ability to gather business requirements, develop business rules, and create process flows.
• Knowledge of Agile methodology for project delivery.

Preferred Skills

• Working knowledge of Medicaid and/or MMIS systems.
• Experience with Single Sign On applications and the State’s NCID system.

Key Skills

Education

Any Graduate