Senior Healthcare Data Modelling Specialist

2 weeks ago

Remote, India beBeeData Full time ₹ 15,00,000 - ₹ 28,00,000
Healthcare Data Architect

We are seeking an experienced Data Modeler/Lead with deep expertise in health plan data models and enterprise data warehousing to drive our healthcare analytics and reporting initiatives.

The ideal candidate will have hands-on experience with modern data platforms and a strong understanding of healthcare industry data standards.

Key Responsibilities:
  • Data Architecture & Modeling:
  • Design and implement comprehensive data models supporting health plan operations, including member enrollment, claims processing, provider networks, and medical management.
  • Develop logical and physical data models that meet analytical and regulatory reporting requirements such as HEDIS, Stars, MLR, and risk adjustment.
  • Create and maintain data lineage documentation and data dictionaries for healthcare datasets.
  • Establish and enforce data modeling standards and best practices across the organization.
  • Technical Leadership:
  • Lead data warehousing initiatives using platforms such as Databricks or ETL tools like Informatica.
  • Architect scalable data solutions capable of handling large volumes of healthcare transactional data.
  • Collaborate closely with data engineers to optimize data pipelines and ensure data quality.
  • Healthcare Domain Expertise:
  • Apply extensive knowledge of health plan operations, medical coding systems (ICD-10, CPT, HCPCS), and healthcare data standards (HL7, FHIR, X12 EDI).
  • Design data models that support analytics, reporting, and AI/ML applications.
  • Ensure compliance with healthcare regulations including HIPAA and state insurance requirements.
  • Partner with business stakeholders to translate healthcare requirements into technical solutions.
  • Data Governance & Quality:
  • Implement healthcare-specific data governance frameworks to ensure privacy and security of data.
  • Establish data quality monitoring and validation processes for critical health plan metrics.
  • Lead efforts to standardize healthcare data definitions across multiple systems and data sources.
Required Qualifications:

Technical Skills:

  • 10+ years of data modeling experience, with at least 4 years focused on healthcare/health plan data.
  • Expertise in dimensional modeling, data vault methodology, or similar enterprise data modeling techniques.
  • Hands-on experience with Informatica PowerCenter/IICS or Databricks platform for large-scale data processing.
  • Strong SQL proficiency and experience with Oracle Exadata and cloud data warehouses (e.g., Databricks).
  • Proficient with data modeling tools such as Hackolade, ERwin, or equivalents.

Healthcare Industry Knowledge:

  • Deep understanding of health plan data structures: claims, eligibility, provider, and pharmacy data.
  • Experience with healthcare data standards and medical coding systems.
  • Familiarity with regulatory reporting requirements (HEDIS, Medicare Stars, MLR, risk adjustment).
  • Knowledge of healthcare interoperability standards (HL7 FHIR, X12 EDI).

Leadership & Communication:

  • Proven track record leading data modeling projects in complex healthcare environments.
  • Strong analytical and problem-solving skills with the ability to handle ambiguous requirements.
  • Excellent communication skills to effectively convey technical concepts to business stakeholders.
  • Experience mentoring team members and establishing technical standards.

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