Key Responsibilities:Data Architecture & Design- Design and maintain enterprise data architecture for structured and semi-structured healthcare data.
- Define logical, conceptual, and physical data models.
- Establish data standards, naming conventions, and metadata management practices.
- Support event-driven and API-based data architectures.
- Align data architecture with CMS interoperability mandates (FHIR, HL7).
Data Analysis & Insights- Analyze large healthcare datasets to identify patterns, trends, and anomalies.
- Support fraud, waste, and abuse (FWA) detection efforts through data analysis.
- Develop analytical datasets and data marts for reporting and investigations.
- Partner with business stakeholders to translate requirements into data solutions.
API & Streaming Integration- Support data design for API Gateway integrations (MuleSoft or similar).
- Ensure data consistency across Kafka streaming pipelines and batch sources.
- Define data contracts and schemas for real-time data exchange.
- Validate data transformations and mappings across source and target systems.
Data Governance & Quality- Implement data governance, lineage, and stewardship practices.
- Monitor and improve data quality, accuracy, and completeness.
- Support data audits, validations, and remediation efforts.
- Ensure compliance with HIPAA, CMS, FISMA, and NIST standards.
Reporting & Visualization- Design and support reports, dashboards, and analytics for program integrity and operations.
- Support ad-hoc data requests from investigators and oversight teams.
Collaboration & Documentation- Work closely with architects, developers, QA, and security teams.
- Participate in Agile ceremonies and data design reviews.
- Maintain comprehensive documentation of data models, mappings, and architecture decisions.
Required Qualifications:- Bachelor's degree in Computer Science, Data Science, Information Systems, or related field.
- 5+ years of experience in data architecture and/or data analysis.
- Strong experience with data modeling (ER, dimensional, normalized models).
- Proficiency in SQL and data analysis techniques.
- Experience working with large enterprise data environments.
Preferred Qualifications:- Experience supporting CMS, Medicaid, or federal healthcare programs.
- Knowledge of HL7 FHIR and healthcare data standards.
- Knowledge of CMS CPI systems like PECOS; APS.
- Understanding of CMS Medicare Program Integrity Manual.
- Experience with API-driven data integration (MuleSoft preferred).
- Familiarity with Kafka or streaming data platforms.
- Experience with cloud data platforms like AWS.
Key Skills:- Data Architecture & Modeling
- Healthcare Data & Interoperability
- Fraud Analytics & Data Validation
- API & Streaming Integration
- Data Governance & Quality
- Federal Compliance Standards
Residency Requirement:Must be eligible to obtain and maintain a Public Trust clearance. In accordance with federal background investigation requirements, candidates must have physically resided in the United States for at least three (3) of the preceding five (5) years.
Salary & Benefits Information:- The actual salary offer will carefully consider a wide range of factors, including your skills, qualifications, experience, and location.
- C-HIT offers Healthcare Benefits, Remote Working Options, Paid Time Off, PTO cash-out, Training/Certification opportunities, Healthcare Savings Account & Flexible Savings Account, Paid Life Insurance, Short-term & Long-term Disability, 401K Match & Profit sharing, Employee Assistance Program, Paid Holidays, and much more perks and Voluntary benefits!
- Employees of C-HIT shall, as an enduring obligation throughout their term of employment, adhere to all information security requirements as documented in company policies and procedures.
