Medicaid Reporting Expert

Job Summary

Serving as a senior business and policy anchor for Medicaid data and federal reporting, the fully remote Medicaid Reporting Expert will guide teams on claims, eligibility, and financial data, lead CMS-64 reporting support, and interpret federal and State policy into actionable business rules.

Key responsibilities

• Guide State and Optum teams on Medicaid program rules and data interpretation
• Lead CMS-64 reporting support, ensuring compliance with expenditure categories and reconciliation processes
• Prepare executive briefings and recommendations for State leadership based on data analysis and trends

Required qualifications

• 15+ years of healthcare experience, including 10+ years with State Medicaid agencies or related programs
• Hands-on experience with CMS-64 reporting and federal CMS reporting such as MARS and T-MSIS
• Strong knowledge of Medicaid and CHIP policy, program rules, and data flow
• Proven ability to present to senior executives with clear and concise briefings
• Ability to query and validate data using SQL or similar tools