Role Description - Analyze large volumes of Medicaid healthcare data, including claims, enrollment, provider, eligibility, encounter, and pharmacy data. - Gather, analyze, and document business and data requirements from Medicaid business stakeholders. - Develop and maintain complex SQL queries, stored procedures, and data validation scripts for data extraction and analysis. - Perform detailed analysis of Medicaid claims adjudication, member eligibility, provider networks, and reimbursement processes. - Design, develop, and maintain dashboards, scorecards, and reports using BI tools such as Tableau, Power BI, or Cognos. - Conduct data profiling, data quality assessments, and root cause analysis to ensure accuracy and completeness of Medicaid data. - Collaborate with business teams to support Medicaid regulatory reporting, including CMS, state-specific mandates, and quality measures. - Analyze healthcare KPIs, utilization trends, cost containment opportunities, and operational metrics. - Support Medicaid programs such as Managed Care, Fee-for-Service (FFS), Dual Eligible, LTSS, and Value-Based Care initiatives. - Work closely with ETL and data engineering teams to validate source-to-target mappings and data transformations. - Perform impact analysis for system enhancements, regulatory changes, and Medicaid policy updates. - Create functional specifications, business requirement documents (BRDs), and data mapping documents. - Participate in Agile ceremonies including sprint planning, backlog grooming, daily stand-ups, and retrospectives. - Ensure compliance with HIPAA regulations and healthcare data security standards. - Provide mentorship and guidance to junior analysts and team members. Qualifications - Strong experience in Medicaid programs and healthcare payer systems. - Deep understanding of Medicaid claims processing lifecycle. - Experience with: - Member Eligibility and Enrollment - Claims Adjudication - Provider Management - Encounters and Capitation - Prior Authorization - Care Management - Pharmacy and PBM data - ICD-10, CPT, HCPCS, DRG, NDC coding systems - CMS and State Medicaid reporting Requirements - 10+ Years of experience. Company Description

Role Description We are looking for a Predictive Analytics Analyst to join a newly established, high-impact team focused on transforming enterprise decision-making. This team is at the forefront of delivering timely, accurate, and forward-looking financial and operational insights by combining advanced analytics, actuarial concepts, automation, and AI-enabled capabilities. In this role, you will help build predictive analytics capabilities from the ground up in a fast-paced, “startup-like” environment within a large organization. You will play a key role in designing and implementing data-driven solutions that drive profitable growth, improve operational efficiency, and strengthen business intelligence across the enterprise. This is an excellent opportunity for a data-driven professional who enjoys autonomy, thrives in ambiguous environments, and wants to influence how analytics is built and scaled. What You’ll Do - Develop and implement predictive models using advanced statistical and machine learning techniques (e.g., regression, clustering, decision trees, neural networks) - Build and maintain programs for predictor and response variables, ensuring model accuracy and scalability - Partner with business stakeholders to understand needs, translate them into analytical solutions, and communicate actionable insights clearly - Present analytical findings to non-technical audiences, explaining methodologies, data sources, and business impact - Explore, prepare, and structure large datasets (internal and external) to support model development and enhancement - Contribute to the design and continuous improvement of modeling frameworks, processes, and best practices - Ensure data quality and model integrity through rigorous validation and review processes - Develop a strong understanding of the data landscape, including sourcing, mapping, and integrating data across systems - Support enterprise data initiatives (e.g., data migration and transformation programs) - Collaborate with and mentor junior analysts, sharing knowledge and promoting best practices - Stay current on industry trends, particularly within insurance analytics and predictive modeling Qualifications - 6+ years of experience in predictive analytics, data science, or related field - Bachelor’s degree in Mathematics, Statistics, Computer Science, or related field - Professional experience in insurance or pricing analytics is a strong plus Requirements - Strong experience with Python, R, and SQL - Experience with SAS is a plus - Advanced knowledge of predictive modeling and machine learning techniques - Statistical analysis and data mining - Data preparation and feature engineering - Strong understanding of data ecosystems and ability to navigate complex data environments - Ability to translate complex data into clear, actionable insights - Excellent communication skills, with the ability to present analytical findings to diverse audiences - Problem-solving mindset with the ability to work independently in a fast-evolving environment - Experience contributing to or building analytics capabilities from scratch is highly valued - Collaborative and proactive approach, with a willingness to share knowledge and mentor others - Experience working with cross-functional teams in data-driven environments Benefits - Competitive compensation and benefits package - Comprehensive benefits package - Career development and training opportunities - Flexible work arrangements - Dynamic and inclusive work culture within a globally renowned group - Private Health Insurance - Pension Plan - Paid Time Off - Training & Development

• Preparing and maintaining operational performance reports, dashboards, MIS, and progress trackers. • Developing new reports aligned to business requirements. • Analyzing key indicators and translating data into actionable insights and improvement recommendations. • Supporting data quality issue identification and remediation. • Tracking project milestones, actions, and deliverables across multiple stakeholders and geographies. • Preparing executive-ready PowerPoint presentations and visual reporting packs. • Supporting Operational Excellence projects and performance management reviews.

• Design and scale AI-driven HR solutions, including chatbot/agent capabilities that automate HR service delivery and workflows • Lead Workday-based analytics and reporting, delivering actionable insights on headcount, attrition, recruiting, and workforce planning • Develop and maintain executive-facing dashboards in Power BI • Ensure data quality, governance, and integration across HR systems (Workday, ServiceNow, and enterprise platforms) • Partner across HR and IT to translate business needs into scalable data and AI solutions • Evaluate and apply emerging AI technologies to modernize HR operations