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Medicaid SME Business Analyst - Remote
Eden Prairie, Minnesota
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Medicaid SME Business Analyst - Remote
Requisition number: 2352977
Job category: Business & Data Analytics
Primary location: Eden Prairie, MN
Additional locations: Phoenix, Arizona | Colorado Springs, Colorado | Boulder, Colorado | Hartford, Connecticut | Tampa, Florida | Pittsburgh, Pennsylvania | Nashville, Tennessee | Dallas, Texas
Date posted: 05/22/2026
Overtime status: Exempt
Travel: Yes, 25 % of the Time
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Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Medicaid SME Business Analyst plays a pivotal role in the successful implementation of an Enterprise Data Services (EDS) project by serving as the functional authority on Medicaid program operations and data. This role provides deep subject matter expertise across claims, recipient (eligibility), and provider domains, ensuring that business needs are accurately translated into scalable, high-quality data solutions. The analyst works closely with Agency program staff as well as Optum Data architects, ETL developers, QA teams, and Reporting/analytics partners. The role focuses on understanding how Medicaid programs operate end-to-end and ensuring that the data warehouse accurately represents program rules, workflows, and data relationships that support analytics, operations, oversight, and decision-making.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
Serve as the Medicaid SME for core domains, including but noted limited to Claims and encounters, Recipient eligibility and enrollment, Provider enrollment and demographics
Interpret Medicaid policy, program rules, and operational workflows and translate them into data and reporting requirements
Develop and maintain key documentation such as Business Requirement Documents (BRDs), Functional Requirement Documents (FRDs), Data mapping and transformation specifications, Business rules and calculation logic etc.
Define and document:
Source system dependencies (MMIS, Eligibility & Enrollment systems, Provider systems, MCO files)
End-to-end data flows from source to warehouse to analytics
Data quality and completeness expectations
Validate requirements with program, operations, and policy stakeholders
Decompose high level business requirements into detailed work breakdown structures, including user stories, use cases, and implementation tasks.
Collaborate with technical teams to guide the database design aligned to Medicaid business needs and support downstream analytics and reporting
Partner with ETL / ELT developers to review and validate Source-to-target mappings and transformation logic reflecting Medicaid business rules
Partner with data governance teams to define data quality rules, thresholds, and monitoring metrics
Support development of operational, analytic, and performance reporting use cases, such as Utilization and cost analysis, Recipient demographics and enrollment trends, Provider network and service delivery analysis etc.
Ensure data warehouse outputs are usable, well-defined, and aligned with business expectations
Provide SME input to Power BI developers, analysts, and data scientists on proper interpretation of Medicaid data
Act as a key liaison between the different teams such as ETL, Reporting, Data Governance etc.
Facilitate working sessions and design workshops to align on program rules and data usage
Clearly communicate complex Medicaid concepts to technical audiences
Proactively identify risks, dependencies, and gaps in requirements or data readiness
Demonstrates accountability for understanding and aligning with the mission and goals of the role and department; consistently meets objectives while fostering a collaborative, engaged, and high performing team environment.
Leverage enterprise-approved AI tools to streamline workflows, automate tasks, and drive continuous improvement
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
5+ years of experience working with Medicaid programs, MMIS, or healthcare analytics
5+ years of experience in Medicaid Claims Processing or similar systems
5+ years of experience supporting Enterprise Data Warehouse or Large-scale data modernization initiatives
5+ years of experience with Microsoft office applications
3+ years of experience in SQL analyzing large healthcare datasets
Willing to travel up to 25%
Preferred Qualifications:
Experience working directly with state Medicaid agencies or Medicaid system vendors
Experience working in Agile or hybrid delivery environments
Experience working with Azure Dev Ops
Knowledge of Medicaid Enterprise Systems (MES) and modular architectures
Key Skills & Competencies
Medicaid domain expertise (claims, recipient, provider)
Business analysis and requirements management
Data analysis and validation
Clear communication across technical and business audiences
Attention to detail and analytical problem-solving
Ability to translate operational workflows into data logic
Collaborative and proactive mindset
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Apply
Internal apply
Bookmark job
Back to nav
Benefits
Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well.
Life
Resources and support to focus on what matters most to you, in every facet of your life.
Emotional
Education, tools and resources to help you reduce and manage stress, build resilience and more.
Physical
Health plans and other coverage to support wellness for you and your loved ones.
Financial
Benefits for today and to help you plan for the future, including your retirement.
Learn more
Back to nav
Previous slide
Being able to connect with so many people that all have the same goal in giving the best care possible is something truly special.
Brooke G.
Senior Pharmacy Technician
At Optum, I receive the support, resources, and flexibility that I want so that I can be the best doctor possible while also finding personal and professional satisfaction.
Dr. Conan T.
Regional Chief of Primary Care
We're applying artificial intelligence to build something that can help people in their most distressed moments. The problems you work on here have an impact on someone's life.
Achala S.
Senior Director and AI Architect
Being able to connect with so many people that all have the same goal in giving the best care possible is something truly special.
Brooke G.
Senior Pharmacy Technician
At Optum, I receive the support, resources, and flexibility that I want so that I can be the best doctor possible while also finding personal and professional satisfaction.
Dr. Conan T.
Regional Chief of Primary Care
We're applying artificial intelligence to build something that can help people in their most distressed moments. The problems you work on here have an impact on someone's life.
Achala S.
Senior Director and AI Architect
Being able to connect with so many people that all have the same goal in giving the best care possible is something truly special.
Brooke G.
Senior Pharmacy Technician
Next slide
Go to slide 1
Go to slide 2
Go to slide 3
Back to nav
We're honored to be recognized for our exceptional work culture
Back to nav
Discover our family of businesses
See how we're structured to help build a modern, high-performing health system.
Learn more
Explore our hiring process
Learn what to expect when you pursue an opportunity with us.
Learn more
How we're transforming care
Find out how we're making care smarter and more personalized.
Learn more
Back to nav
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2026 UnitedHealth Group. All rights reserved.
UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call ... to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.
UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Skip to main content
Blogs
Job seeker resources
Login
Bookmarked jobs ( 0 )
Career areas
Life here
Join our talent community
Keyword or job number
Location
Go
Explore remote jobs
Pursue your passion and potential
Medicaid SME Business Analyst - Remote
Eden Prairie, Minnesota
Apply
Internal apply
Bookmark job
Our values
Job description
Benefits
Testimonial
Awards & recognitions
Related content
Caring. Connecting. Growing together.
With these values to guide us, our people are committed to making a meaningful difference in the lives of those we are honored to serve.
Integrity
Compassion
Inclusion
Relationships
Innovation
Performance
Back to nav
Medicaid SME Business Analyst - Remote
Requisition number: 2352977
Job category: Business & Data Analytics
Primary location: Eden Prairie, MN
Additional locations: Phoenix, Arizona | Colorado Springs, Colorado | Boulder, Colorado | Hartford, Connecticut | Tampa, Florida | Pittsburgh, Pennsylvania | Nashville, Tennessee | Dallas, Texas
Date posted: 05/22/2026
Overtime status: Exempt
Travel: Yes, 25 % of the Time
Share this job
X
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Medicaid SME Business Analyst plays a pivotal role in the successful implementation of an Enterprise Data Services (EDS) project by serving as the functional authority on Medicaid program operations and data. This role provides deep subject matter expertise across claims, recipient (eligibility), and provider domains, ensuring that business needs are accurately translated into scalable, high-quality data solutions. The analyst works closely with Agency program staff as well as Optum Data architects, ETL developers, QA teams, and Reporting/analytics partners. The role focuses on understanding how Medicaid programs operate end-to-end and ensuring that the data warehouse accurately represents program rules, workflows, and data relationships that support analytics, operations, oversight, and decision-making.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
Serve as the Medicaid SME for core domains, including but noted limited to Claims and encounters, Recipient eligibility and enrollment, Provider enrollment and demographics
Interpret Medicaid policy, program rules, and operational workflows and translate them into data and reporting requirements
Develop and maintain key documentation such as Business Requirement Documents (BRDs), Functional Requirement Documents (FRDs), Data mapping and transformation specifications, Business rules and calculation logic etc.
Define and document:
Source system dependencies (MMIS, Eligibility & Enrollment systems, Provider systems, MCO files)
End-to-end data flows from source to warehouse to analytics
Data quality and completeness expectations
Validate requirements with program, operations, and policy stakeholders
Decompose high level business requirements into detailed work breakdown structures, including user stories, use cases, and implementation tasks.
Collaborate with technical teams to guide the database design aligned to Medicaid business needs and support downstream analytics and reporting
Partner with ETL / ELT developers to review and validate Source-to-target mappings and transformation logic reflecting Medicaid business rules
Partner with data governance teams to define data quality rules, thresholds, and monitoring metrics
Support development of operational, analytic, and performance reporting use cases, such as Utilization and cost analysis, Recipient demographics and enrollment trends, Provider network and service delivery analysis etc.
Ensure data warehouse outputs are usable, well-defined, and aligned with business expectations
Provide SME input to Power BI developers, analysts, and data scientists on proper interpretation of Medicaid data
Act as a key liaison between the different teams such as ETL, Reporting, Data Governance etc.
Facilitate working sessions and design workshops to align on program rules and data usage
Clearly communicate complex Medicaid concepts to technical audiences
Proactively identify risks, dependencies, and gaps in requirements or data readiness
Demonstrates accountability for understanding and aligning with the mission and goals of the role and department; consistently meets objectives while fostering a collaborative, engaged, and high performing team environment.
Leverage enterprise-approved AI tools to streamline workflows, automate tasks, and drive continuous improvement
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
5+ years of experience working with Medicaid programs, MMIS, or healthcare analytics
5+ years of experience in Medicaid Claims Processing or similar systems
5+ years of experience supporting Enterprise Data Warehouse or Large-scale data modernization initiatives
5+ years of experience with Microsoft office applications
3+ years of experience in SQL analyzing large healthcare datasets
Willing to travel up to 25%
Preferred Qualifications:
Experience working directly with state Medicaid agencies or Medicaid system vendors
Experience working in Agile or hybrid delivery environments
Experience working with Azure Dev Ops
Knowledge of Medicaid Enterprise Systems (MES) and modular architectures
Key Skills & Competencies
Medicaid domain expertise (claims, recipient, provider)
Business analysis and requirements management
Data analysis and validation
Clear communication across technical and business audiences
Attention to detail and analytical problem-solving
Ability to translate operational workflows into data logic
Collaborative and proactive mindset
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Apply
Internal apply
Bookmark job
Back to nav
Benefits
Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well.
Life
Resources and support to focus on what matters most to you, in every facet of your life.
Emotional
Education, tools and resources to help you reduce and manage stress, build resilience and more.
Physical
Health plans and other coverage to support wellness for you and your loved ones.
Financial
Benefits for today and to help you plan for the future, including your retirement.
Learn more
Back to nav
Previous slide
Being able to connect with so many people that all have the same goal in giving the best care possible is something truly special.
Brooke G.
Senior Pharmacy Technician
At Optum, I receive the support, resources, and flexibility that I want so that I can be the best doctor possible while also finding personal and professional satisfaction.
Dr. Conan T.
Regional Chief of Primary Care
We're applying artificial intelligence to build something that can help people in their most distressed moments. The problems you work on here have an impact on someone's life.
Achala S.
Senior Director and AI Architect
Being able to connect with so many people that all have the same goal in giving the best care possible is something truly special.
Brooke G.
Senior Pharmacy Technician
At Optum, I receive the support, resources, and flexibility that I want so that I can be the best doctor possible while also finding personal and professional satisfaction.
Dr. Conan T.
Regional Chief of Primary Care
We're applying artificial intelligence to build something that can help people in their most distressed moments. The problems you work on here have an impact on someone's life.
Achala S.
Senior Director and AI Architect
Being able to connect with so many people that all have the same goal in giving the best care possible is something truly special.
Brooke G.
Senior Pharmacy Technician
Next slide
Go to slide 1
Go to slide 2
Go to slide 3
Back to nav
We're honored to be recognized for our exceptional work culture
Back to nav
Discover our family of businesses
See how we're structured to help build a modern, high-performing health system.
Learn more
Explore our hiring process
Learn what to expect when you pursue an opportunity with us.
Learn more
How we're transforming care
Find out how we're making care smarter and more personalized.
Learn more
Back to nav
Connect with us
YouTube
Do not sell or share my personal information
Social responsibility
Fraudulent activity
Cookie management
Site map
Privacy Policy Family & Medical Leave Act (PDF) Equal Employment Law Poster (PDF) SMS Terms & Conditions (PDF) Employee Polygraph Protection Act (PDF) E-Verify Participation Poster (PDF) Pay Transparency Nondiscrimination Provision (PDF) Immigrant and Employee Right to Work Poster (PDF) Health Plan Notices (PDF) County of LA Fair Chance Ordinance (PDF)
2026 UnitedHealth Group. All rights reserved.
UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call ... to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.
UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job ID: 522734398
Originally Posted on: 5/28/2026
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