Remote Claims Processor Jobs in Sun Prairie, WI (NOW HIRING)

This position is fully-embedded in the Wisconsin Department of Health Services (DHS), Division of Medicaid Services (DMS), Bureau of Fiscal Accountability and Management (BFAM), Integrated Data & Analytics Section (IDAS) and is maintained through a contract and ongoing partnership with the UW Institute for Research on Poverty (IRP).

The Institute for Research on Poverty (IRP) seeks a Data Scientist who will serve as a data expert for Medicaid health policy research in the Medicaid Evaluation and Research (MER) operational area at IRP. The position will work closely with DMS to prepare DMS data for evaluation and policy analysis and will support complex data projects and policy initiatives for Wisconsin's Medicaid and FoodShare programs. Working alongside DMS staff and contracted Medicaid Management Information System (MMIS) vendors, this role is responsible for the end-to-end lifecycle of data analysis and reporting-from gathering requirements with stakeholders to the technical development and analysis of ad hoc and standard reports. The ideal candidate bridges the gap between policy research and technology, ensuring all data outputs further Medicaid and Foodshare operations and implementation.

We aim to hire Data Scientists with expertise and experience with Medicaid claims data. When you join our team, you're not just bringing your expertise. We are committed to fostering your professional development goals and supporting your career advancement through continued learning opportunities.

This role is currently eligible for remote work. Continued remote work eligibility will follow University of Wisconsin-Madison policies and any future updates. Also this position requires reliable transportation for occasional onsite work if needed.

• Develop expertise in the content, structure, and idiosyncrasies of Medicaid/ FoodShare data by understanding the origin and interpretation of variables, as well as learning about policy issues related to the data

• Prepares data sets for analysis including cleaning/quality assurance, transformations, restructuring, and integration of multiple data sources

• Documents approaches to address research questions

• Review and analyze changes in federal and state regulations for impact on Medicaid/Foodshare policy and processes, especially those necessary for data collection and reporting. Implement necessary revisions to reporting frameworks to ensure compliance with shifting regulations

• Implements appropriate data science techniques under the guidance of other data scientists, statisticians, and/or other researchers to find data patterns and answer research questions chosen by the lead researcher including data visualization, statistical analysis, machine learning, and data mining

• Organizes and automates project steps for data preparation and analysis

• Composes and assembles reproducible workflows and reports to clearly articulate patterns to researchers and/or administrators

College of Letters & Science | Institute for Research on Poverty (IRP)

The expected salary range for this position is $75,000 - $100,000 for highly experienced candidates. Actual pay within this range will depend on experience and qualifications.

Employees in this position can expect to receive benefits such as generous vacation, holidays, and sick leave; competitive insurances and savings accounts; retirement benefits. Please review the summary of benefits for more information.

• Data science experience including: data extraction, transformation (wrangling, cleaning, and merging), and loading; computer systems capability; and programming languages for databases such as SQL, SAS, R, or Python
• Knowledge of the Medicaid Enterprise System (MES) and Income Maintenance (IM) databases, their design, and capabilities
• Experience providing data visualization and analysis using software such as SAS, R, and/or Tableau
• Knowledge of statistical methodologies and system analyses to conceptualize effects of program and policy alternatives
• Ability to translate policy into user-friendly logic flows and actionable project recommendations
• Knowledge of and skill with MS Office Suite (MS Excel, MS Word, MS Outlook, MS Access, and MS Visio)
• Strong written and oral communication skills
• Strong organizational skills and attention to detail

• Minimum one year of experience manipulating and merging large, complex administrative datasets
• Minimum one year of data life cycle management (DLM) experience including: data acquisition or collection, use, and long-term storage
• Experience working with administrative medical claims and enrollment data, with preference for Medicaid claims experience
• Ability to work with programmers and develop cooperative interpersonal relationships
• Working knowledge of the organization and functions of related Department of Health Services divisions and other State of Wisconsin agencies

Required:

Bachelor's Degree in social science, public/population health, data science/engineering/analytics, or related field

Preferred:

Master's Degree in social science, public/population health, data science/engineering/analytics, or related field

Click the "Apply" button to start the application process.

To be considered for this recruitment, you must upload:

-Resume

-Cover Letter

The materials should address your experience relating to the qualifications referenced above.

There is only one attachment field; please upload all application materials here. All listed application materials must be submitted for your application to be considered. Please submit only the materials specified; additional materials will not be reviewed.
Selected applicants will receive an invitation to participate in interviews within 10-14 business days following the application deadline.

Please note that successful applicants are responsible for ensuring their eligibility to work in the United States (i.e. a citizen or national of the United States, a lawful permanent resident, a foreign national authorized to work in the United States without need of employer sponsorship) on or before the effective date of appointment.

Tim Connor, Tim.Connor@wisc.edu or (608) 261-1578

Relay Access (WTRS): 7-1-1. SeeRELAY_SERVICEfor further information.

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