Data Modeler

Position Overview
We are seeking an experienced Data Modeler/Lead with deep expertise in health plan datamodels and enterprise data warehousing to drive our healthcare analytics and reportinginitiatives. The candidate should have hands-on experience with modern data platformsand a strong understanding of healthcare industry data standards.

Key ResponsibilitiesData Architecture & ModelingDesign and implement comprehensive data models for health plan operations, including member enrollment, claims processing, provider networks, and medical managementDevelop logical and physical data models that support analytical and regulatoryreporting requirements (HEDIS, Stars, MLR, risk adjustment)Create and maintain data lineage documentation and data dictionaries for healthcare datasetsEstablish data modeling standards and best practices across the organization Technical LeadershipLead data warehousing initiatives using modern platforms like Databricks or traditional ETL tools like InformaticaArchitect scalable data solutions that handle large volumes of healthcare transactional dataCollaborate with data engineers to optimize data pipelines and ensure data qualityHealthcare Domain ExpertiseApply deep knowledge of health plan operations, medical coding (ICD-10, CPT,HCPCS), and healthcare data standards (HL7, FHIR, X12 EDI)Design data models that support analytical, reporting and AI/ML needsEnsure compliance with healthcare regulations including HIPAA/PHI, and stateinsurance regulationsPartner with business stakeholders to translate healthcare business requirementsinto technical data solutions

Data Governance & QualityImplement data governance frameworks specific to healthcare data privacy and security requirementsEstablish data quality monitoring and validation processes for critical health plan metricsLead eUorts to standardize healthcare data definitions across multiple systems and data sources.

Required QualificationsTechnical Skills10+ years of experience in data modeling with at least 4 years focused on healthcare/health plan dataExpert-level proficiency in dimensional modeling, data vault methodology, or otherenterprise data modeling approachesHands-on experience with Informatica PowerCenter/IICS or Databricks platform forlarge-scale data processingStrong SQL skills and experience with Oracle Exadata and cloud data warehouses(Databricks)Proficiency with data modeling tools (Hackolade, ERwin, or similar)Healthcare Industry KnowledgeDeep understanding of health plan data structures including claims, eligibility, provider data, and pharmacy dataExperience with healthcare data standards and medical coding systemsKnowledge of regulatory reporting requirements (HEDIS, Medicare Stars, MLRreporting, risk adjustment)Familiarity with healthcare interoperability standards (HL7 FHIR, X12 EDI)Leadership & CommunicationProven track record of leading data modeling projects in complex healthcare environmentsStrong analytical and problem-solving skills with ability to work with ambiguousrequirementsExcellent communication skills with ability to explain technical concepts to business stakeholdersExperience mentoring team members and establishing technical standards.

Preferred QualificationsExperience with Medicare Advantage, Medicaid, or Commercial health planoperationsCloud platform certifications (AWS, Azure, or GCP)Experience with real-time data streaming and modern data lake architecturesKnowledge of machine learning applications in healthcare analyticsPrevious experience in a lead or architect role within healthcare organizations.

Locations : Mumbai, Delhi / NCR, Bengaluru , Kolkata, Chennai, Hyderabad, Ahmedabad, Pune, Remote