Enterprise Data Modeler Medicare Advantage

We are looking for a Senior Enterprise Data Modeler with deep healthcare domain expertise to lead the development of enterprise and domain data models for a strategic data transformation program. You will bridge the gap between business stakeholders and technical execution teams to build resilient, enterprise-wide data structures.

Key Responsibilities

• Design and maintain Enterprise, Logical, Physical, and Canonical Data Models.

• Translate complex business concepts into robust domain data models.

• Partner with business and IT stakeholders to define core entities, data governance standards, and business glossaries.

• Align data models with MDM, analytics, modern cloud platforms, and reporting initiatives.

Mandatory Qualifications

• Medicare Advantage Expertise (Required): Hands-on experience modeling data within Medicare Advantage domains (e.g., Members & Enrollment, Claims & Encounters, Risk Adjustment/RAF/HCC, HEDIS & STARS, Care Management, CMS Reporting).

  (Note: Candidates without Medicare Advantage data modeling experience will not be considered).

• Data Modeling: Proven track record in Enterprise, Conceptual, Logical, Physical, and Domain-Driven Data Modeling.

• Modern Data Platforms: Experience with Cloud Data Platforms, Data Lakehouse Architectures, Databricks, or Master Data Management (MDM).

• Business & Facilitation: Strong stakeholder engagement, workshop facilitation, and data stewardship capabilities.