Summary

We are seeking a highly skilled Senior Power BI & Databricks ETL Engineer with deep experience working with Medicaid claims, eligibility, provider, and encounter data. This role will design, build, and maintain scalable data pipelines and analytics solutions that support state Medicaid programs, regulatory reporting, and operational performance monitoring. The ideal candidate combines strong technical expertise in Databricks, ETL/ELT development, and Power BI with a solid understanding of Medicaid data structures, program rules, and state‑specific reporting requirements.

Your role in our mission

• Design, develop, and maintain Databricks ETL/ELT pipelines to process Medicaid claims, eligibility, encounters, provider files, and supplemental datasets.
• Ingest data from MMIS systems, state data warehouses, managed care organizations, and other Medicaid program data sources.
• Implement transformation, validation, and enrichment logic aligned to Medicaid data quality standards, including handling of T‑MSIS, HIPAA‑compliant formats, and state‑specific coding rules.
• Optimize Spark jobs for performance and cost efficiency across large Medicaid datasets.
• Build and maintain Data Lake models that support auditability, lineage, and compliance with state and federal Medicaid reporting requirements.
• Develop Power BI semantic models, dashboards, and reports that support Medicaid operations, including claims utilization, eligibility trends, provider network analytics, and program integrity monitoring.
• Implement advanced DAX measures and KPIs tailored to Medicaid program metrics (e.g., enrollment churn, claims lag, encounter completeness).
• Apply dimensional modeling concepts to Medicaid analytics use cases such as service utilization, cost of care, and population segmentation.
• Collaborate with Medicaid program staff, policy teams, actuaries, and data governance groups to translate program requirements into technical solutions.
• Maintain detailed documentation including data mappings, transformation logic, and Medicaid‑specific business rules.
• Support multi‑environment deployment activities across DEV / STG / UAT / PRD.
• Implement data governance and security controls, including PHI/PII protections and role‑based access in Power BI.
• Support CI/CD pipelines for Medicaid data and BI artifacts.
• Monitor data pipelines and proactively resolve data quality issues related to claims completeness, eligibility accuracy, and provider file integrity.
• Leverage experience with PBM/PBA data where relevant to Medicaid pharmacy programs.

What we're looking for

• 6 or more years of experience programming or testing experience working with relevant programming languages, relational databases, operating systems and software
• Experience supporting state Medicaid agencies, MMIS modernization, or Medicaid managed care analytics.
• Familiarity with T‑MSIS, CMS reporting requirements, and state‑specific Medicaid data standards.
• Knowledge of Medicaid claims adjudication, eligibility determination processes, provider enrollment, and encounter submission workflows.
• Experience with Medicaid quality, compliance, or program integrity reporting.

What you should expect in this role

• United States remote opportunity
• Video cameras must be used during all interviews, as well as during the initial week of orientation
• The Deadline to submit applications for this posting is August 14, 2026