Enterprise Data Modeler (Medicare Advantage)

As an Enterprise Data Modeler (Medicare Advantage) , you will make an impact by designing and establishing enterprise-wide data models that serve as the foundation for a large-scale healthcare data transformation program. You will be a valued member of the Data & Analytics team and work collaboratively with business leaders, data architects, governance teams, and healthcare domain stakeholders to create scalable, business-aligned data structures that enable analytics, reporting, AI, and operational excellence.

In this role, you will:

• Develop and maintain enterprise business data models that align with organizational data strategy and business objectives.

• Create conceptual, canonical, logical, physical, and domain data models across key Medicare Advantage business domains.

• Facilitate workshops and collaborate with business and technology stakeholders to establish common business definitions, data standards, and entity relationships.

• Align data models with data governance, metadata management, master data management (MDM), analytics, reporting, and AI initiatives.

• Partner with implementation teams to translate business-driven data models into scalable technical solutions on modern cloud-based data platforms.

Work model

We strive to provide flexibility wherever possible. Based on this role’s business requirements, this is a remote position open to qualified applicants in the United States . Regardless of your working arrangement, we are here to support a healthy work-life balance through our various wellbeing programs.

The working arrangements for this role are accurate as of the date of posting. This may change based on the project you’re engaged in, as well as business and client requirements. Rest assured; we will always be clear about role expectations.

• Extensive experience in enterprise data modeling, including conceptual, canonical, logical, physical, and domain-driven modeling methodologies.

• Demonstrated expertise within the Medicare Advantage healthcare domain , including Members & Enrollment, Providers & Networks, Claims & Encounters, Authorizations & Referrals, Care Management, HEDIS/STARS, Risk Adjustment (RAF/HCC), CMS Reporting, Delegated/IPA Models, and Value-Based Care.

• Proven ability to translate complex business concepts into enterprise data models and establish consistent business definitions across multiple stakeholder groups.