Federal Reporting Business Analyst - Remote

Optum is a leader in improving the flow of health data and information, aiming to create a more connected healthcare system. The Federal Reporting Business Analyst will serve as a functional bridge between CMS federal reporting requirements and the technical data warehouse solution, translating complex regulatory requirements into clear business and data needs while ensuring compliance with Medicaid programs.

Responsibilities:

• Interpret Federal and regulatory program rules and translate them into data and reporting requirements as they pertain to CMS-64, T-MSIS, PERM
• Develop and maintain key documentation such as Business Requirement Documents (BRDs), Functional Requirement Documents (FRDs), Data mapping and transformation specifications, Business rules and calculation logic etc
• Define and document:
• Source system dependencies (MMIS, Eligibility & Enrollment systems, Provider systems, MCO files)
• End-to-end data flows from source to warehouse to analytics
• Data quality and completeness expectations
• Federal policy communications
• Validate requirements with program, operations, and policy stakeholders
• Support business validation by performing data analysis queries
• Support development of new federal reports and audit requests, as needed
• Decompose high level business requirements into detailed work breakdown structures, including user stories, use cases, and implementation tasks
• Partner with ETL / ETL developers to review and validate Source-to-target mappings and transformation logic reflecting Medicaid business rules
• Ensure data warehouse outputs are usable, well-defined, and aligned with business expectations
• Act as a key liaison between the different teams such as ETL, Reporting, Data Governance etc
• Facilitate working sessions and design workshops to align program rules and data usage
• Proactively identify risks, dependencies, and gaps in requirements or data readiness
• Demonstrates accountability for understanding and aligning with the mission and goals of the role and department; consistently meets objectives while fostering a collaborative, engaged, and high performing team environment
• Leverage enterprise-approved AI tools to streamline workflows, automate tasks, and drive continuous improvement

Requirements:

• 5+ years of experience with Microsoft office applications
• 3+ years of experience working with Medicaid programs or MMIS
• 3+ years of experience in Medicaid Claims Processing or similar systems
• 3+ years of experience working with federal reporting (CMS-64, T-MSIS, PERM)
• 3+ years of experience supporting Enterprise Data Warehouse or Large-scale data modernization initiatives
• 3+ years of experience in SQL analyzing large healthcare datasets
• Experience working directly with state Medicaid agencies or Medicaid system vendors
• Knowledge of Medicaid Enterprise Systems (MES) and modular architectures
• Experience working in Agile or hybrid delivery environments
• Experience working with Azure Dev Ops