Principal Consultant – Medicare and Medicaid

Oracle Oracle · Enterprise · United States

This role focuses on understanding Medicare and Medicaid data, creating analytic designs, partnering with data scientists on predictive models for financial evaluations and fraud vulnerabilities, and communicating findings. It also involves technical writing for federal reporting and developing strategic proposals for public health initiatives, with an emphasis on learning and applying AI methods to current solutions and researching market opportunities.

What you'd actually do

  1. Understand Medicare data, data design, and relationships pertaining to the member, provider, and claim
  2. Create novel and standard insightful and "actionable" analytic designs for Medicare and Medicaid solutions
  3. Partner with data scientists on predictive and engagement models for financial evaluations and fraud vulnerabilities
  4. Communicate with internal and client leadership on findings and material design elements
  5. Learning and applying specific artificial intelligence (AI) methods to current reporting and case worker solutions

Skills

Required

  • Medicare and Medicaid data expertise
  • Analytic design
  • Federal reporting requirements (CMS-64, CMS-21, CMS-37)
  • Technical writing
  • Strategic proposal development
  • Project/program management

Nice to have

  • Product Management
  • PMP certification

What the JD emphasized

  • Expert knowledge of Medicare and Medicaid claims data, which includes financial, provider, and encounter data