Data Engineer (Remote)

Resp & Qualifications

PURPOSE:

The Data Engineer is responsible for developing, maintaining, and supporting cloud-based data solutions that enable Risk Adjustment operations, regulatory reporting, and healthcare analytics across the enterprise.

This role builds and supports data pipelines, integrations, and data products using technologies such as Snowflake, Azure Data Factory (ADF), Microsoft Fabric, and Informatica IDMC/IICS, ensuring accurate, timely, and compliant processing of claims, diagnosis, membership, provider, and clinical data.

The Data Engineer partners closely with business and technical teams supporting Risk Adjustment programs, including EDGE submissions, risk score generation, coding and diagnosis capture processes, data validation, and CMS reporting requirements.

ESSENTIAL FUNCTIONS:

• Writes and executes ETL code, primarily complex SQL/NoSQL script, but with a strong ability to leverage other technologies.
• Analyzes and validates existing routines and communicates impacts. Assists with data transformation, manipulation, and presentation to users.
• Works with Business Analysts, Business Intelligence Developers, Infrastructure Architects, and key business users to review, design, and develop data models and ETL processes.
• Supports the Software Engineering team with data analysis and validation with extensive SQL queries.
• Designs, configures, implements, monitors, and manages all aspects of Data Integration Framework.
• Provides detailed guidance and performs work related to Modeling Data Warehouse solutions in the cloud OR on-premise. Understands Dimensional Modeling, Denormalized Data Structures, OLAP, and Data Warehousing concepts.
• Defines Data Integration best practices for the data management environment.

SUPERVISORY RESPONSIBILITY

This position has no direct reports, however, may informally lead teams in a matrix environment.

QUALIFICATIONS

Education Level: Bachelor's Degree in Information Technology or Computer Science or Engineering OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience: 3 years Hands-on experience with database management systems, ELT/ETL systems, business intelligence tools, defect management and system testing.

Knowledge, Skills and Abilities (KSAs)

• Strong knowledge of data engineering development using SQL and Python, with experience building and supporting data solutions using cloud data platforms and tools such as Snowflake, Azure Data Factory (ADF), Microsoft Fabric, and Informatica Intelligent Data Management Cloud (IDMC/IICS).
• Strong understanding of data architecture, data modeling, database design, and implementation concepts across relational, non-relational, cloud-based, and analytical data environments.
• Knowledge of data integration and interoperability concepts, including ETL/ELT frameworks, APIs, messaging platforms, and common data exchange formats.
• Knowledge of data movement, orchestration, and automation concepts, including batch and near real-time data pipelines, workflow scheduling, CI/CD practices, and DataOps principles.
• Strong knowledge of healthcare payer data domains, including claims, enrollment, provider, diagnosis, procedure, and clinical data, with an understanding of how data quality and completeness impact Risk Adjustment outcomes and financial performance.
• Working knowledge of Risk Adjustment business processes, including diagnosis capture, coding accuracy, HCC models, risk score generation, chart review programs, prospective and retrospective workflows, and related analytics processes.
• Working knowledge of healthcare regulatory reporting and submission processes, including EDGE Server submissions, Risk Adjustment reporting, RADV audit support, and CMS data requirements.
• Knowledge of data quality, reconciliation, validation, metadata management, and lineage practices necessary to support accurate Risk Adjustment, regulatory, and analytical reporting.
• Strong technical, analytical, and problem-solving skills with the ability to troubleshoot and resolve data, integration, and production support issues affecting Risk Adjustment and healthcare analytics processes.
• Working knowledge of Agile software development methodologies, DevOps/DataOps practices, and collaborative product delivery models.
• Ability to develop and maintain technical documentation, source-to-target mappings, data specifications, operational procedures, and support documentation.
• Strong written and verbal communication skills with the ability to collaborate effectively across technical, operational, and business teams while managing multiple priorities.
• Ability to follow established engineering standards, participate in peer reviews, and contribute to continuous improvement of data engineering practices, data quality controls, and operational processes.
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $80,136 - $159,159

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration.

It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location.

In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Data Engineering

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects.

The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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