Functional Lead - Healthcare Data Systems

Analytica

$100K — $130K *
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Healthcare, Business, IT, or related field.
  • 8+ years in federal health IT or large-scale data systems.
  • Experience with Medicare Fee-for-Service programs (CLFS, ASP).
  • Background in supporting CMS or federal healthcare programs.
  • Ability to convert policy and business requirements into system functionality.
  • Expertise in data validation and functional/UAT testing.
  • Hands-on with requirements management tools like Jira or Azure DevOps.

Responsibilities

  • Act as the main point of contact between CMS business stakeholders and the technical team.
  • Convert Medicare payment policies into actionable, testable system requirements.
  • Document and manage business rules and data validation logic for CLFS, ASP, and GADCS.
  • Ensure traceability from policy to system deployment and testing.
  • Lead functional and User Acceptance Testing, creating and validating test cases.
  • Oversee incident triage and maintain system accuracy.
  • Authorize system releases based on functional assessments.

Benefits

  • Remote work opportunity with weekly onsite attendance required in Bethesda, MD.
  • Participation in modernization initiatives to enhance system functionality.
  • Collaborative work environment with cross-functional teams.
  • Focus on professional growth within a crucial sector of healthcare.
Full Job Description
Analytica is seeking a Functional Lead to support a mission-critical CMS application that enables the Center for Medicare's rate-setting activities through the collection, validation, and processing of market-based data. The Functional Lead will play a key role in ensuring that system functionality accurately reflects Medicare payment policy across the Clinical Laboratory Fee Schedule (CLFS), Average Sales Price (ASP), and Ground Ambulance Data Collection System (GADCS) domains.

This role requires strong expertise in federal healthcare systems, data validation, and business rules management, along with the ability to translate complex policy and operational requirements into scalable, compliant system functionality. The Functional Lead will support both ongoing operations and modernization initiatives within a secure, FISMA-compliant AWS cloud environment.

This role is primarily remote but requires 1x a week onsite attendance at our Bethesda, MD headquarters

Responsibilities include (but not limited to):
  • Serve as the primary liaison between CMS business stakeholders and the technical delivery team.
  • Translate Medicare payment policy and operational requirements into clear, actionable, and testable system requirements.
  • Define, document, and govern business rules and data validation logic across CLFS, ASP, and GADCS modules.
  • Ensure end-to-end traceability from policy through system implementation, testing, and deployment.
  • Lead functional testing and User Acceptance Testing (UAT), including development and validation of test cases.
  • Support incident triage and data validation efforts to maintain system accuracy and integrity.
  • Approve system releases from a functional and business perspective.
  • Collaborate with UX, engineering, and data subject matter experts to improve usability while maintaining compliance and accuracy.
  • Support modernization initiatives aimed at enhancing validation logic, improving user experience, and reducing reporting burden.
  • Facilitate stakeholder workshops and requirements gathering sessions.
  • Ensure adherence to FISMA, ATO, and other federal compliance and data governance standards.
Basic Qualifications:
  • Bachelor's degree in Healthcare, Business, Information Technology, or related field.
  • 8+ years of experience in federal health IT or large-scale data systems.
  • Demonstrated experience supporting Medicare Fee-for-Service programs (CLFS, ASP, or similar payment systems).
  • Experience supporting CMS or federal healthcare programs.
  • Proven ability to translate policy and business requirements into system functionality.
  • Strong expertise in data validation, business rules management, and functional/UAT testing.
  • Hands-on experience with requirements management and backlog tools (e.g., Jira, Azure DevOps).
  • Proficiency in SQL and advanced Excel for data analysis.
  • Experience working in Agile delivery environments.
  • Ability to lead stakeholder engagement and requirements workshops.
  • Strong written and verbal communication skills, including development of functional specifications.
  • Experience working in secure, compliance-driven environments (FISMA/ATO).
  • Must be a U.S. Citizen.
  • Must be able to obtain and maintain a Public Trust clearance.
Preferred:
  • Familiarity with AWS cloud environments.
  • Experience with large-scale data collection or regulatory reporting systems.
  • Background in data analytics, reporting, or data engineering environments.

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