Medicaid Data Specialist

Description

At CSpring, we believe that data—when thoughtfully managed—has the power to shape policy, improve lives, and elevate public service. We’re looking for a seasoned Medicaid Data Specialist to lead one of the most critical and complex efforts in healthcare: supporting the State of Illinois in implementing and sustaining its Enterprise Data Warehouse (EDW) for Medicaid.

You’ll serve as the expert voice in aligning data strategy, state Medicaid goals, and warehouse operations. If you’re a trusted advisor with a passion for public health data, process improvement, and cross-functional problem solving, this role offers the scope, mission, and impact you’re looking for.

Why You’ll Love Working Here

• Purpose-Driven Impact – Shape the tools and data that influence healthcare outcomes for millions of Illinois residents.
• People-First Culture – At CSpring, we invest in your whole self—your growth, wellbeing, and purpose—not just your resume.
• Strategic Influence – You’ll provide trusted guidance to both business and technical teams on complex Medicaid systems and data flows.
• Collaborative Leadership – Work closely with state agencies, vendors, and stakeholders to deliver clarity, quality, and real-world results.

What You’ll Do

• Serve as a data and subject matter expert for the Illinois EDW supporting the state’s Medicaid and CHIP programs.
• Translate Medicaid policies and data requirements into actionable strategies for implementation and optimization.
• Lead internal and external stakeholders in understanding and enhancing systems related to claims, eligibility, providers, and third-party liability.
• Proactively assess gaps and recommend improvements rooted in Medicaid best practices, CMS compliance, and system knowledge.
• Partner with technical and business teams to ensure appropriate data usage, model development, and warehouse alignment.
• Deliver insights and tools—interfaces, dashboards, visualizations—that drive decision-making and communicate value to stakeholders.
• Support operational excellence by guiding defect resolution, process change, and system evolution across teams.
• Mentor colleagues on Medicaid data topics, contribute to business case development, and present to leadership and agency clients.

Requirements

• 10+ years of experience in information technology, including 5+ years directly supporting state Medicaid agencies or equivalent entities.
• Deep understanding of claims adjudication, recipient eligibility, and provider enrollment data processes.
• Proficient in SQL and Excel for analyzing large, complex datasets in enterprise data warehouse environments.
• In-depth knowledge of CMS programs and reporting requirements (e.g., T-MSIS, CMS-64/21).
• Exceptional communication and presentation skills across all levels of an organization, including C-level stakeholders.
• Strong collaboration and leadership capabilities; demonstrated mentoring and cross-functional coordination. 
• Ability to travel to Springfield, IL 2–4 times annually for client meetings.

Preferred Qualifications

• Master’s degree in a related field
• 2+ years of experience with:
  • CMS Federal Reporting (PERM, T-MSIS, CMS-64/21)
  • Quality metrics such as HEDIS, Adult/Child Core Measures, or CHIPRA
  • Teradata or equivalent database management systems
  • Agile tools like JIRA, Rally, or Azure DevOps
  • Large-scale Medicaid system implementations
• Residing within a 3–5 hour driving radius of Springfield, IL

Join CSpring and Make a Difference

At CSpring, we unlock the power of people and data to serve communities. This role offers an opportunity to be a part of a high-stakes public health data transformation. If you’re ready to lead with knowledge, partner with purpose, and grow with a company that puts relationships first—apply today.