Principal Analyst, Medicaid Policy Analysis

Job Description:

• Interpret state and federal Medicaid program rules, eligibility and aid-code structures, benefit and coverage design, and program guidance
• Translate policy into precise, testable analytic logic, including cohort definitions, code sets, exclusions, and stratification criteria
• Document interpretations so decisions are auditable
• Advise senior customer leadership on data limitations, measurable definitions, volumes, thresholds, caseload, cost, and provider capacity
• Anticipate how policy changes affect data and future questions
• Build member and provider data marts, cohort and stratification logic, and registry extracts using SQL and Python on Foundry and Redshift/Athena
• Deliver dashboards, recurring reports, Excel outputs, and leadership decks
• Root-cause data-quality issues and reconcile counts across sources
• Serve as the senior analytic voice for state program leadership, policy and data staff, prime contractors, and vendor partners
• Set priorities, scope, and timelines with Customer Management
• Create client-facing leadership summaries, methodology decks, decision memos, and technical explainers
• Own the day-to-day analytic workstream, customer cadence, request prioritization, and ad hoc requests
• Own production-grade registries, data marts, and dashboards with documented methodology and data dictionaries
• Mentor and bring other analysts up to speed
• Review major deliverables, codify playbooks, and establish methodology standards

Requirements:

• Working knowledge of how health programs and managed care plans work
• Ability to turn policy documents and program rules into analytic logic
• Clinical code and claims fluency, including ICD-10, CPT/HCPCS, and revenue codes
• Experience with claims, eligibility, and provider/NPI data, including NPPES and enrollment files
• Hands-on fluency with AI coding and analysis tools such as Claude Code, Cursor, or similar
• Advanced SQL, including CTEs, window functions, and performance on large claims and eligibility tables
• Data modeling to an engineering standard
• Hands-on experience building dashboards and reports in QuickSight, Power BI, Tableau, and Excel
• Executive-ready presentation decks
• Direct customer-facing experience with senior stakeholders
• Experience scoping ambiguous requests, navigating competing priorities, and exercising analytical judgment
• Track record of leading an analytic program end to end for senior customer or executive audiences
• Sound judgment with sensitive data and PHI
• Direct experience with a state Medicaid agency, Medicaid-serving prime contractor or consultancy, or Medicaid managed care plan is a plus
• California Medi-Cal experience is a plus
• Familiarity with population health concepts including risk stratification, registries, care management, network adequacy, and access and equity analysis
• Experience with Python and dbt
• Familiarity with AWS analytics tools such as Athena, Redshift, and QuickSight
• Comfort with orchestration tooling, Jira, Confluence, and GitHub-based workflows
• Experience mentoring less experienced analysts

Benefits:

• Employee driven programs and initiatives for personal and professional development
• Flexible, remote-friendly company
• Unlimited FTO
• Competitive compensation
• Amazing benefits
• Opportunity to work on a high-visibility state Medicaid program serving millions of members
• Opportunity to build methodology standards, playbooks, and data assets