Principal Analyst, Medicaid Policy Analysis
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Job Description
Principal Medicaid policy analyst translating program rules into data marts, registries, and dashboards. Advising state healthcare stakeholders through Arcadia’s trusted healthcare data platform.
Responsibilities:
- 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
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