Data Modeler / Lead - Healthcare Data Systems
Data Modeler / Lead - Healthcare Data Systems
Posted on :
21-06-2025
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1 Vacancy
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Job Description
Data Modeler / Lead - Healthcare Data Systems
Position Overview
We are seeking an experienced Data Modeler/Lead with deep expertise in health plan data models and enterprise data warehousing to drive our healthcare analytics and reporting initiatives. The candidate should have hands-on experience with modern data platforms and a strong understanding of healthcare industry data standards.
Key Responsibilities
Data Architecture & Modeling
- Design and implement comprehensive data models for health plan operations including member enrollment claims processing provider networks and medical management
- Develop logical and physical data models that support analytical and regulatory reporting requirements (HEDIS Stars MLR risk adjustment)
- Create and maintain data lineage documentation and data dictionaries for healthcare datasets
- Establish data modeling standards and best practices across the organization
Technical Leadership
- Lead data warehousing initiatives using modern platforms like Databricks or traditional ETL tools like Informatica
- Architect scalable data solutions that handle large volumes of healthcare transactional data
- Collaborate with data engineers to optimize data pipelines and ensure data quality
Healthcare Domain Expertise
- Apply deep knowledge of health plan operations medical coding (ICD-10 CPT HCPCS) and healthcare data standards (HL7 FHIR X12 EDI)
- Design data models that support analytical reporting and AI/ML needs
- Ensure compliance with healthcare regulations including HIPAA/PHI and state insurance regulations
- Partner with business stakeholders to translate healthcare business requirements into technical data solutions
Data Governance & Quality
- Implement data governance frameworks specific to healthcare data privacy and security requirements
- Establish data quality monitoring and validation processes for critical health plan metrics
- Lead efforts to standardize healthcare data definitions across multiple systems and data sources
Required Qualifications
Technical Skills
- 10 years of experience in data modeling with at least 4 years focused on healthcare/health plan data
- Expert-level proficiency in dimensional modeling data vault methodology or other enterprise data modeling approaches
- Hands-on experience with Informatica PowerCenter/IICS or Databricks platform for large-scale data processing
- Strong SQL skills and experience with Oracle Exadata and cloud data warehouses (Databricks)
- Proficiency with data modeling tools (Hackolade ERwin or similar)
Healthcare Industry Knowledge
- Deep understanding of health plan data structures including claims eligibility provider data and pharmacy data
- Experience with healthcare data standards and medical coding systems
- Knowledge of regulatory reporting requirements (HEDIS Medicare Stars MLR reporting risk adjustment)
- Familiarity with healthcare interoperability standards (HL7 FHIR X12 EDI)
Leadership & Communication
- Proven track record of leading data modeling projects in complex healthcare environments
- Strong analytical and problem-solving skills with ability to work with ambiguous requirements
- Excellent communication skills with ability to explain technical concepts to business stakeholders
- Experience mentoring team members and establishing technical standards
Preferred Qualifications
- Experience with Medicare Advantage Medicaid or Commercial health plan operations
- Cloud platform certifications (AWS Azure or GCP)
- Experience with real-time data streaming and modern data lake architectures
- Knowledge of machine learning applications in healthcare analytics
Previous experience in a lead or architect role within healthcare organizations
Data Modeler, US healthcare, modern data platforms ,Databricks or ETL tools like Informatica, data standards (HL7, FHIR, X12 EDI)
Education
BE,Any Graduate
Employment Type
Full Time
Key Skills
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