Location: Remote-MO
Position Purpose: Provides in-depth business knowledge and advanced technical support to one or more business areas through developed and ad hoc analysis/reporting , as well as designing and programming complex, new processes/reports. Acts as subject matter expert for department or business unit on business systems/applications. This role is focused on translating Medicare Advantage and Medicaid Risk Adjustment business requirements into production-ready technical solutions, including Encounter RA Prioritization and Encounter RA Chart Process support.
Analyzes company functions, processes, and activities to improve computer-based business applications for the most effective use of money, materials, equipment, and people. Performs application/system design and implementation. Documents development requirements. Consults with end users to test and debug applications to meet client needs. The ideal candidate brings advanced SQL, Snowflake, Databricks knowledge, healthcare data integration experience, data quality, regulatory compliance, and reusable documentation experience.
Develops ad-hoc reports to conduct data analysis and validation.
Partners with business analysts, Risk Adjustment stakeholders, IT, and vendor teams to understand provided Medicare Advantage and Medicaid business requirements, translate them into technical specifications, and support process improvements through SAS solutions and future Snowflake capabilities.
Conducts business analysis and recommends technical alternative solutions to management as to course of action that best meets the organization's goals.
Analyzes provided requirements, procedures, and data needs to automate processing, improve existing business systems, and support production-ready SAS code for Encounter Risk Adjustment Prioritization and Encounter Risk Adjustment Chart Process workflows, with future Snowflake migration support.
Creates multi-user, real-time, robust database solutions by integrating complex healthcare datasets, including claims, enrollment, provider, pharmacy, clinical records, and vendor chart data.
Acts as a technical subject matter expert to convert provided business requirements into system analysis, technical design, advanced SAS/SQL programming, Snowflake modernization, and documentation of business applications/systems.
Modernizes legacy SAS ETL workflows into scalable Snowflake architecture using Snowflake SQL, Snowpark Python, and automated pipeline orchestration concepts such as Tasks and Streams.
Implements validation, reconciliation, and data quality frameworks to support CMS audit standards, state Medicaid requirements, and compliant Risk Adjustment encounter submissions.
Builds reusable SAS, SQL, and Snowflake data assets, modular code libraries, and technical documentation to reduce development time and support knowledge transfer across data and actuarial teams.
Research, evaluate and assess the financial impact of issues identified in data/processes
Analyzes requirements, procedures, and problems to automate processing or to improve existing business systems
Creates multiuser, real-time, robust database solution
Acts as subject matter expert to provide business and technical expertise in requirements solicitation, system analysis, technical design, programming and documentation of business applications/systems
May be responsible for monitoring and reporting to management on the status of departmental projects: Anticipates and identifies issues that could inhibit achieving the project goals and objectives, and implementing corrective actions and mitigation strategies.
Provides oversight and resolves complex issues, optimizing performance, resolving problems, and providing timely follow-up on identified issues.
Provides guidance and training to staff on process, procedures and issue resolution
Performs other duties as assigned.
Complies with all policies and standards
Education/Experience
Required A Bachelor's Degree in a related field: Required or equivalent work experience in technical data analysis, conducting system analysis meetings, developing system design documents, developing project plans with achievable milestones and deadlines, and mediating different department demands to gain approvals on system scope and design.
Preferred Educational/Experience
Master's degree in a related field, i.e., Mathematics, Computer Science, etc
May be considered in lieu of some of the required experience (not to exceed 2 years)
Candidate Skills/Experience
Required Skills
- 4+ years of experience in SQL
- 4+ years of experience in Snowflake
- Databricks knowledge
- SAS knowledge
Preferred Skills
- Preferred 1+ year of experience in Healthcare
- Preferred experience modernizing SAS ETL workflows into Snowflake using Snowflake SQL, Snowpark Python, and automated pipeline orchestration.
- Preferred experience with Medicare Advantage, Medicaid, Risk Adjustment, encounter submissions, claims, enrollment, provider, pharmacy, clinical, and vendor chart data.
Licenses and Certifications
A license in one of the following is preferred
SnowPro Certification
SAS Certification
Pay Range: $87,700.00 - $157,800.00 per year
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Additional Locations: Remote-TN, Remote-NE, Remote-KS, Remote-AZ, Remote-SD, Remote-ND, Remote-IN, Remote-AR, Remote-SC, Remote-NC, Remote-IL, Remote-AL, Remote-RI, Remote-MT, Remote-ID, Remote-PA, Remote-MS, Remote-IA, Remote-WY, Remote-OR, Remote-WV, Remote-OK, Remote-MN, Remote-GA, Remote-WI, Remote-OH, Remote-MI, Remote-FL, Remote-NY, Remote-ME, Remote-DE, Remote-VT, Remote-NV, Remote-MD, Remote-DC, Remote-VA, Remote-NM, Remote-MA, Remote-CT, Remote-UT, Remote-NJ, Remote-LA, Remote-CO, Remote-TX, Remote-NH, Remote-KY, Remote-CA
Job description provided by Centene.
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