Job Description:

· The State of New York seeks a highly skilled Healthcare Consultant with extensive expertise in healthcare data analysis, reporting, and system integration to support enterprise-level programs within the NY State health exchange and related systems. The consultant will play a pivotal role in ensuring accurate eligibility, enrollment, and coverage data for Medicaid, Child Health Plus (CHP), and Essential Plan programs, with a primary focus on ACA compliance and state-specific healthcare regulations.

Requirements:

· 42 months of experience with developing reports specializing on Eligibility/Enrollment/Coverage data generated through NYS health exchange or other state-based or federal health exchange for Medicaid, CHP, and Essential Plan programs; NOT claims data.

· 42 months of experience with NYS health exchange, or other State- based or Federal health exchange, with specific focus on eligibility determination rules and NYS Affordable Care Act (federal) rules, NOT claims data.

· 42 months of experience in developing reports used for resolving data discrepancies between the NYS health exchange and other NYS state-based systems, including eMedNY, WMS, KIDS, and OTDA.

· 42 months of experience designing and developing complex analytic/reporting systems for NYS Affordable Care Act (ACA), or other State-based or Federal health exchanges.

· 84 months of experience with enterprise strategic BI DW Assessment that includes data interrogation/data profiling by writing complex PL/SQL procedures and SQL queries, and based on the assessment outcome, preparing Enterprise BI DW roadmap.

· 84 months of experience with various reporting and data transformation tools by providing support to business community with various data requests and issue analysis.