Healthcare Data SME - Medicare/Medicaid

Who We Are:

Tria Federal delivers digital services and technology solutions that support the health and safety of veterans, service members and civilians. For two decades, federal agencies have relied on Tria companies to advance their critical missions and modernize their systems, so that they can uphold their commitment to the American people. Today, we are pushing the boundaries of possibility through partnerships and investments in artificial intelligence and emerging technologies, developing solutions for the biggest challenges that will face government tomorrow.

Job Description:

The Healthcare Data SME will provide subject matter expertise and coaching related to the use of data at the Centers for Medicare & Medicaid Services (CMS) in support of a data warehouse team and analytical users. The ideal candidate is an accomplished subject matter expert with superior familiarity with CMS data and who is passionate about coaching data users, conducting data analysis, and advising the team on data issues and governance. The Data SME/Coach should be able to explain, simplify and present complex technical functions to staff, users, and management.

Basic Requirements:

• Ability to obtain a U.S. Federal Position of Trust clearance designation.
• Must reside in and be able to perform work in the United States.
• Must have lived in the United States for 3 of the last 5 years.
• Bachelor's Degree or higher
• 5+ years of experience with Medicare and/or Medicaid Part A, B, & DME claims, coding, and reimbursement procedures, service and coverage policies, coordination of benefits, as well as provider and beneficiary eligibility.
• 5+ years of experience and demonstrated performance with data analysis using SQL queries.
• Experience with business intelligence tools such as Tableau, BusinessObjects, and MicroStrategy.
• Superior communication and organization skills are a must with ability to handle multiple tasks in a fast-paced work environment and thrive in an environment with regularly changing priorities.
• Experience coaching users of CMS data warehouse systems
• Experience with a Snowflake data environment
• Experience with Databricks.

Responsibilities:

• Provide expert consultations to the system development team and analytical users on the Medicare and Medicaid claims, provider, beneficiary, quality, and other data.
• Contributes expertise to the data team on strategic issues related to data governance and the data environment.
• Conducts data analysis and reporting using available tools and data sources to support data exploration and analytical measure development.
• Provide expert consultations on CMS enterprise data environments and platforms as well as their effective use for analytics.
• Provides support for data, tools and analytics used to prevent healthcare fraud, waste and abuse.
• Works closely with the team to draft and execute an effective end user support and training strategy.
• Identifies and recommends policy, procedure, and system changes to enhance project outcomes and performance.
• Identifies areas for improvement and makes recommendations to increase the quality and effectiveness based on best practices.
• Maintains positive, productive relationships with colleagues, managers, partners, customer, and users to foster collaboration and consensus.

Public Trust Clearance: This role will require the hired candidate to go through public trust clearance. A minimum of 3 years of stay in the U.S. within the last 5 years is required to be eligible to qualify for public trust clearance sponsorship.

As partners in our team's success, we offer a comprehensive compensation structure that includes competitive base salaries, performance-based incentives, spot bonuses, referral bonuses, and more.

Why Tria?
What defines the Tria brand is more than just our dedication to excellence in our craft; it's our incredible team of dedicated, talented, and passionate people that make Tria so exceptional. As people powering possible, we are all partners in our team's shared success.

As a company that cares about people, we seek to cultivate a culture in which all can thrive personally and professionally. We offer a top-tier benefits package to invest in your physical, mental, and financial health and wellness so that you can be your best self - at work and in life. At Tria, we are growth-minded, entrepreneurial in spirit, and committed to fostering a culture of inclusion and opportunity for all. Whatever your background, your role, your department, or stage in your professional journey, here you will have opportunities to learn new skills, seize new challenges, and advance your career as we grow.

California Consumer Privacy Act (CCPA)

We are committed to protecting your privacy. As part of our compliance with the California Consumer Privacy Act (CCPA), we want to inform you about how we collect, use, and protect your personal information during the job application process. For more details, please review https://www.oag.ca.gov/privacy/ccpa .

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