Claims Data Pipelines

Claims Data Pipelines Engineer Jobs

3 jobs found

Today

Data Engineer

Information Technology Senior Management Forum Bloomington, IL 🇺🇸 Remote

Bloomington, IL

Today

$153k - $153k/yr Full time Big Data Claims Data Pipelines Data Analysis

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Job Description

Information Technology Senior Management Forum is seeking a Data Engineer to advance its data-driven approach to claims investigations and fraud detection. Based in Bloomington, IL with the option to work remotely within the United States, this role focuses on designing and implementing knowledge graph structures and applying advanced graph analytics. You will collaborate with cross-functional teams to turn complex data into scalable, compliant solutions across multiple platforms and compute environments.

Location

Bloomington, Illinois, with remote work options available within the United States.

Type

Full-time

Salary

Annual salary: 152,734 USD

Job ID

44799

Responsibilities

Design and implement sophisticated knowledge graph structures to boost claims investigations and fraud detection through advanced graph analytics.
Partner with cross-functional teams to enable data‑driven decision making and drive innovation.
Utilize industry-standard languages and frameworks across coding, testing, security, DevOps, DataOps, and data engineering using graph database technologies.
Develop and maintain reusable, scalable, and compliant data solutions spanning multiple platforms and compute environments.
Identify, acquire, cleanse, profile, and ETL data used in analytic discovery and production deployments across platforms.
Build business domain knowledge for existing State Farm data sources and evaluate, recommend, and initiate data resource acquisition, internally and externally.
Identify and advise on emerging technologies and core systems, including techniques, tools, data sources, and platforms in data engineering.
Handle datasets that combine structured and unstructured data.
Adopt a DataOps mindset to ensure data alignment with enterprise needs and leverage automation to deliver high-quality data solutions.
Gather information to understand customer technical needs, propose solutions, and develop implementation and integration plans.
Oversee analysis, design, deployment, support, and security of technology to ensure efficient management of technology and data assets in line with market best practices and regulations.
Apply a broad range of computer science principles to data engineering solutions.

Requirements

Bachelor’s degree or foreign equivalent in Computer Science or a closely related field.
Minimum 5 years of experience in the offered role or related positions such as Specialist Programmer, Machine Learning Engineer, or Graph Data Engineer.
5 years of experience with graph database management systems (Neo4j or Amazon Neptune) and Cypher Query Language.
5 years of experience with distributed computing frameworks, including Apache Spark.
5 years of experience with programming languages such as Python or Java, and Scala.
5 years of experience with containerization and orchestration (Docker, Kubernetes), leveraging Graph Algorithms Libraries and Neo4j GDS.

Education

Bachelor’s degree or foreign equivalent in Computer Science or a closely related field.

Technologies

Neo4j, Amazon Neptune
Cypher
Apache Spark
Python, Java, Scala
Docker, Kubernetes
Graph Algorithms Libraries, Neo4j GDS

Benefits

Competitive pay with eligibility for an annual raise and bonus.
Comprehensive health and wellbeing programs; most healthcare premiums covered with multiple plan options, including a high deductible plan; 100% in-network preventative care, plus vision, dental, telemedicine, and 24/7 mental health support.
Educational benefits including training programs, tuition assistance, mentoring, and employee resource groups.
Life events support such as fertility/IVF/adoption assistance, college coaching, and financial planning resources, plus access to savings through a credit union.
Generous paid time off, holidays, life leave, bereavement leave, and community service/education days.
Matching Gift Program and Good Neighbor Grant Program to support giving back.
Retirement planning with access to free financial advising and a 401(k) plan with company contributions up to 7% of salary.

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1d ago

Sr. Clinical Informatics Data Engineer

Mingle Health Remote 🌍 Remote

Remote

1d ago

Full time Senior Claims Data Pipelines Clinical Data

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Job Description

Mingle Health seeks a Senior Clinical Informatics Data Engineer to translate CMS specifications into robust database structures for analysis and quality measures. The role involves building data pipelines, ensuring data quality, and supporting CMS submissions and Medicare reporting for healthcare clients. This position is remote and collaborative within a distributed team.

Responsibilities

Understand, interpret, and codify CMS specifications for the Quality Payment Program (QPP)
Analyze accuracy and performance of claims and clinical data using MS SQL and related tools
Utilize internal web based applications to provide data mapping for claims and clinical datasets
Translate measure specifications into database objects used to calculate quality measures
Provide consultative support to assigned clients, including health practices and hospital systems, to facilitate successful CMS submissions
Develop ad hoc SQL reports to support client consulting engagements
Validate data load processes into clinical data repositories
Collaborate with colleagues to document data needs and metric definitions
Perform quality assurance on data integration processes and repository metrics
Operate effectively within a distributed, remote team environment and contribute to both client facing and internal development projects

Requirements

Minimum 5 years of experience in healthcare or clinical informatics
Experience with medical or clinical information systems used by clients, such as EHR or Practice Management systems
Familiarity with medical processes and terminology, physician office workflows, or billing including Medicare and other payers
Experience with Quality Reporting and related programs
Understanding of MIPS and APP programs
Ability to review, interpret, compare, and edit clinical documentation, such as CMS Measure Specifications Manual for Claims and Registry Reporting
Capacity to listen to client requirements and translate them into actionable solutions
Guidance for clients to construct queries, extract data, assess quality, and continually improve data quality, flow, and metrics
Strong programming skills with proficiency in SQL
Ability to develop, execute, and evaluate Microsoft SQL queries
Experience building and optimizing data pipelines
Develop pipelines to transform raw data into reliable information for analysis
Build data migration scripts and procedures using SSIS and/or Python
Facilitate importing third party data into data structures using database, programming, and ETL tools to maintain efficient loading processes
Investigate exceptions in data migrations
Contribute to planning, analysis, design, and development of data management, data integration, data warehouse, and BI solutions
Ability to analyze large datasets in detail to resolve issues, including reading error logs, executing stored procedures, and understanding data structures
Basic understanding of best practices for effective database design and maintenance
Comfort with a rapidly changing environment, incomplete documentation, and fluid roles
Strict adherence to HIPAA privacy and security policies

Technologies

SQL, SQL Server, SSIS, Python

Location

Remote

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19d ago

Data Engineer – Healthcare Analytics Platform

Guidehouse Washington, DC

Washington, DC

19d ago

$77k - $129k/yr Full time Analytics Business Intelligence Claims Data Pipelines

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Job Description

Guidehouse is seeking a Data Engineer to design and develop an enterprise Contract Performance Analytics platform for a large healthcare system. The role focuses on data architecture, ELT/ETL pipelines, and the integration of clinical, claims, and operational data for analytics. This onsite opportunity in Washington, DC offers a salary range of USD 77,000 to 129,000 per year and a comprehensive benefits package.

Benefits

Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave and Adoption Assistance
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Student Loan PayDown
Tutition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program
Mobility Stipend

Responsibilities

Design, develop, and maintain robust ETL/ELT pipelines to ingest, transform, and load healthcare data from diverse structured and unstructured sources
Build pipelines to process data from CMS and payer files (CCLF, paid claims, PUG) as well as Epic Caboodle and Clarity data models and extracts
Create and optimize analytics-ready data models to support analytics, reporting, and downstream BI consumption
Transform raw data into standardized canonical data models and curated data marts
Develop lakehouse or medallion architectures, data ingestion patterns, and orchestration frameworks
Implement and maintain CI/CD pipelines for data workflows, including scheduled jobs, using version control and automation tools
Collaborate with DBAs, analysts, and application teams to integrate data sources, design schemas, and support downstream consumers
Ensure data quality, integrity, and accuracy through validation, monitoring, logging, and alerting
Support data migration, integration, and modernization initiatives, including legacy upgrades, large-scale ETL optimization, query performance, and cloud adoption
Troubleshoot and resolve issues in development and production environments to maintain reliable data pipelines
Document data flows, pipelines, test cases, and technical solutions to support knowledge sharing and compliance
Stay current with emerging tools, technologies, and best practices in data engineering and cloud platforms

Requirements

US Citizenship or a Green Card is required
Bachelor’s degree in Computer Science, Data Analytics, Software Engineering, Information Systems, or related fields
Minimum of five (5) years of experience in data engineering, ETL/ELT development, or data platform engineering in a healthcare setting
Experience with healthcare data, including claims, clinical, payer, or population health datasets
Experience with healthcare interoperability standards such as FHIR and HL7
Proficiency in Python and SQL for data engineering and transformation workloads
Hands-on experience designing and building ETL/ELT pipelines and data ingestion frameworks
Experience with modern cloud data platforms or ETL/ELT tools (Databricks, Azure Data Factory, AWS Glue)
Experience with lakehouse or medallion architectures for analytics platforms
Strong knowledge of relational database design, data warehouses, and/or data lakes with star/snowflake schemas
Experience with relational and distributed data systems, including data modeling
Experience in a cloud environment (AWS or Azure) supporting data solutions
Experience with CI/CD practices and version control tools (Git)
Experience using monitoring and logging tools to support data pipeline reliability
Experience with PHI and healthcare data privacy/security requirements
Ability to work effectively in an Agile development environment
Strong analytical and troubleshooting skills and the ability to communicate technical concepts clearly to clients, engineers, and business stakeholders
Ability to work independently in a fast-paced, client-facing environment

Technologies

Python
SQL
Databricks
Azure Data Factory
AWS Glue
Git
Tableau
Power BI
AWS
Azure

Nice to have

Previous experience with Epic and/or Athena in a data engineering role
Experience with Exasol or similar analytics platforms
Certifications in AWS, Azure, Databricks, Snowflake, or related data engineering tools
Experience with data visualization or analytics tools (Tableau, Power BI)
Exposure to microservices architectures or AI/ML enabled data pipelines
Prior consulting experience

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Claims Data Pipelines Engineer Jobs

Data Engineer

Sr. Clinical Informatics Data Engineer

Data Engineer – Healthcare Analytics Platform

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