Position Summary
We are seeking a highly experienced Enterprise Data Modeler to lead the development of enterprise and domain data models that will serve as the foundation of a strategic enterprise data transformation program.
This role will be responsible for creating and maintaining:
Enterprise Business Data Models
Canonical Data Models
Logical Data Models
Physical Data Models
Domain Data Models across prioritized business domains
Critical Success Factors
Strong Business Domain Knowledge is Essential
This is not a traditional data modeling role focused solely on technical modeling.
The successful candidate must possess deep business domain expertise and be capable of translating complex business concepts into resilient enterprise data models.
The ability to facilitate discussions with business stakeholders and establish common business definitions is as important as technical modeling skills.
Medicare Advantage Experience is Mandatory
Candidates must demonstrate significant experience modeling data within the Medicare Advantage healthcare domain, including:
Members and Enrollment
Providers and Networks
Claims and Encounters
Authorizations and Referrals
Care Management
HEDIS and STARS
Risk Adjustment (RAF/HCC)
CMS Reporting
Delegated and IPA Models
Value-Based Care and Capitation
Candidates without Medicare Advantage data modeling experience will not be considered.
Skills:
Data Modeling
Enterprise Data Modeling
Conceptual Data Modeling
Canonical Data Modeling
Logical Data Modeling
Physical Data Modeling
Domain-Driven Data Modeling
Data Architecture Principles
Business & Facilitation
Business Process Analysis
Requirements Discovery
Workshop Facilitation
Business Glossary Development
Data Stewardship Collaboration
Cross-Functional Stakeholder Engagement
Data Management
Master Data Management (MDM)
Metadata Management
Data Governance
Data Quality Concepts
Data Lineage Concepts
Modern Data Platforms
Cloud Data Platforms
Data Lakehouse Architectures
Databricks or similar modern analytics platforms
Data Product Concepts
Key Responsibilities
Develop and maintain the Enterprise Business Data Model.
Develop phased Domain Data Models aligned to enterprise standards.
Collaborate with business and technical stakeholders to define core business entities and relationships.
Establish canonical data structures across business domains.
Align models with governance, metadata, MDM, analytics, AI, and reporting initiatives.
Support implementation teams in translating business models into technical data solutions.
Ideal Candidate
A senior data modeler who combines:
Strong enterprise data modeling expertise
Deep Medicare Advantage business knowledge
Excellent facilitation and stakeholder management skills
Experience supporting large-scale enterprise data transformation initiatives
The ideal candidate understands that durable data models are built from a deep understanding of the business domain, not simply from source system structures.
