Healthcare Data Systems Lead

Job Summary

Serving as the primary liaison between CMS business stakeholders and the technical delivery team, the full-time Functional Lead - Healthcare Data Systems will translate Medicare payment policy into actionable system requirements while ensuring compliance and accuracy in a primarily remote role with weekly onsite attendance in Bethesda, MD.

Key responsibilities

• Translate Medicare payment policy and operational requirements into clear, actionable, and testable system requirements
• Define, document, and govern business rules and data validation logic across CLFS, ASP, and GADCS modules
• Lead functional testing and User Acceptance Testing (UAT), including development and validation of test cases

Required qualifications

• Bachelor's degree in Healthcare, Business, Information Technology, or related field
• 8+ years of experience in federal health IT or large-scale data systems
• Demonstrated experience supporting Medicare Fee-for-Service programs (CLFS, ASP, or similar payment systems)
• Strong expertise in data validation, business rules management, and functional/UAT testing
• Proficiency in SQL and advanced Excel for data analysis