Principal Analyst, Medicaid Policy Analysis

Principal Analyst, Medicaid Policy Analysis

Remote (USA)

R&D - Customer Insights /

Full-time /

Remote

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Arcadia is the most trusted healthcare platform powering outcomes. We transform complex healthcare data into trusted intelligence, helping providers, payers, and life sciences organizations act with clarity, make confident decisions, and achieve measurable clinical, operational, and financial outcomes.

Built on a comprehensive data foundation spanning tens of millions of patient lives, Arcadia combines advanced analytics and responsible AI to surface meaningful insights, coordinate action, and improve performance at scale. Our approach to AI and automation is governed and transparent - designed to strengthen human expertise, not replace judgment or obscure responsibility.

Hundreds of organizations rely on Arcadia to improve cost, quality, and outcomes. Backed by Nordic Capital, we continue to invest in our platform, AI capabilities, and people as we pursue our purpose: helping healthcare deliver better outcomes for every person, every community, and every generation.

Why This Role Is Important to Arcadia

Customer Insights takes on the work that doesn't fit a one-size-fits-all product - custom data models, bespoke dashboards, registries, and long-running embedded programs - sitting between a platform and a plan.

This role is the first at Arcadia dedicated to Medicaid policy analysis, and it sits on one of our most visible accounts: a state Medicaid agency that is taking direct responsibility for a much larger fee-for-service population. A broader Arcadia team already serves the agency in a variety of ways - risk stratification, dashboards and reporting, quality measurement, and analytics on the state's Medicaid member and claims data - and that relationship is growing. You will work alongside that team and take the lead on the policy-driven analytic work: interpreting program rules and policy documents into analytic logic, and building the registries, data marts, and dashboards that put it to use.

That takes a rare combination: policy fluency to tell a customer what the data can and cannot support, customer presence to be trusted in the room with state program staff and partners, and the technical skill to build the deliverables yourself. We are looking for someone who can ramp on all three quickly. Just as important, this work moves at a pace that is only possible with AI-assisted development: you will be expected to pick up our AI coding and analysis tools quickly and use them heavily from your first weeks, with careful human review.

What Success Looks Like

In 3 months

• Get productive quickly with the team's AI-assisted workflow - using AI coding and analysis tools to ramp into the state program's eligibility, claims, and provider data, the program rules and policy context behind it, and the analytic logic and deliverables already in production
• Join customer and partner working sessions and begin contributing in the room - answering, in real time, what a proposed definition, threshold, or policy change does to the data and the member population
• Independently deliver your first piece of work end to end - a stratification or registry refinement, a data mart component, or a dashboard - with your own policy interpretation and QA behind it

In 6 months

• Own the day-to-day analytic workstream - the weekly customer cadence, request prioritization, and same-day ad hoc asks - as a credible presence with state program staff, prime-contractor and vendor counterparts, and data owners, with the current owner stepping back to an oversight role
• Own production-grade registries, data marts, and dashboards, with documented methodology, data dictionaries, and calibration against the customer's published figures
• Bring other analysts up to speed on the work - the data, the logic, and the customer context - starting in your first months, so coverage and capacity extend beyond any one person

In 12 months

• Be the recognized expert on Medicaid program policy and its analytic implications for Arcadia's state program work, trusted with the most ambiguous and highest-stakes questions
• Hold the methodology standard for the body of work - reviewing major deliverables, codifying playbooks, and keeping the work resilient so the account's analytic capability keeps running smoothly as the scope and team grow
• Extend the work into the broader analytic roadmap - cost and utilization, access and equity, care management effectiveness, and state program performance - as scope grows

What You'll Be Doing

Medicaid policy analysis

• Interpret state and federal Medicaid program rules, eligibility and aid-code structures, benefit and coverage design, and program guidance - translating them into precise, testable analytic logic (cohort definitions, code sets, exclusions, stratification criteria) and documenting the interpretation so decisions are auditable
• Advise senior customer leadership on what the data can and cannot support - whether a proposed definition is measurable, what the volumes look like, what a threshold does to caseload, cost, or provider capacity - and anticipate how policy changes (fee-for-service transitions, waivers, provider network rules) affect the data and the questions ahead

Technical analytical delivery

• Turn ambiguous policy and operational questions into member and provider data marts, cohort and stratification logic, and registry extracts - in SQL (and Python where needed) on Foundry and Redshift/Athena
• Deliver them in the format the customer needs - dashboards, recurring reports, Excel, and leadership decks
• Root-cause data-quality issues - reconcile counts across sources, trace bad fields to the source, and agree definitions for undocumented fields and codes with the customer's data staff

Customer presence and engagement

• Serve as the senior analytic voice for state program leadership, policy and data staff, prime contractors, and vendor partners - participating in recurring working sessions and translating between policy, operational, and technical audiences
• Set priorities, scope, and timelines with Customer Management, and hold real authority to push back on what is and isn't feasible or worth building
• Create client-facing materials - leadership summaries, detailed methodology decks, decision memos, technical explainers - tailored to audiences from highly technical data counterparts to policy and executive stakeholders

What You'll Need To Have

• Working knowledge of how health programs and managed care plans work, and the ability to turn policy documents and program rules into analytic logic. Direct Medicaid or managed care plan experience is a plus
• Clinical code and claims fluency - ICD-10, CPT/HCPCS, and revenue codes to build clinical cohorts; claims, eligibility, and provider/NPI data (NPPES, enrollment files); and judgment about claims timing and completeness
• Hands-on, demonstrable fluency with AI coding and analysis tools (Claude Code, Cursor, or similar) as the core of how you work. Picking these tools up quickly and using them heavily is central to how you will onboard and how much you can deliver in this role. Be ready to show us what you have built with AI assistance, how fast you turn work around, and how you review and validate it
• Advanced SQL (CTEs, window functions, performance on large claims and eligibility tables) and data modeling, to a real engineering standard
• Hands-on experience building dashboards and reports in a BI tool (QuickSight, Power BI, Tableau) and Excel, plus executive-ready decks

Direct customer-facing experience with senior stakeholders - comfortable scoping ambiguous requests, navigating competing priorities, and exercising sound analytical judgment about what to build and what the data can support, on short timelines and without close oversight

A track record of leading an analytic program end to end for senior customer or executive audiences - setting your own priorities, and operating without a project manager or close direction

• Sound judgment with sensitive data and PHI

What "Principal" means here

This is the most senior analytic role on the Customer Insights team. It is expected that you can:

• Set your own priorities and make the call with incomplete information
• Act as the senior analytic voice with agency and partner leadership
• Raise the bar for the analysts around you - through standards, review, and example
• Don't need a project manager or close direction

We are hiring for the combination of policy fluency, customer presence, and technical skill - we understand candidates may be strongest in one or two of these areas and will build the rest quickly, and speed of ramp matters more to us than any one credential. Tell us where you are strongest and how you have ramped before.

Would Love For You To Have

• Direct experience with a state Medicaid agency, a Medicaid-serving prime contractor or consultancy, or a Medicaid managed care plan - California Medi-Cal experience is a real plus
• Familiarity with population health concepts: risk stratification, registries, care management, network adequacy, and access and equity analysis
• Experience with Python and dbt; familiarity with the AWS ecosystem and its analytics tools (e.g., Athena, Redshift, QuickSight); comfort with orchestration tooling, Jira, Confluence, and GitHub-based workflows
• Experience mentoring less experienced analysts

Note: this list spans skills relevant to several facets of the role - we don't expect any given candidate to have all of them. Bring what you have; we'll talk through the rest during the interview process.

What You'll Get

• Become a member of the talented, energized, diverse and purpose-driven Arcadian Community with decades of collective experience in population health, product development, and data science
• Employee driven programs and initiatives for personal and professional development
• A flexible, remote-friendly company with personality and heart
• Competitive Compensation, Amazing Benefits including Unlimited FTO

The opportunity to:

• Be the senior analytic and policy voice on a high-visibility state Medicaid program serving millions of members, at a pivotal moment for the program
• Build the practice - the methodology standards, playbooks, and data assets a growing team will inherit - on problems where analytic choices directly shape which members get reached and how care is delivered and funded

$190,000 - $215,000 a year

About Arcadia

Arcadia.io helps innovative providers and payers across the country transform healthcare to reduce cost while improving patient health. We do this by aggregating large amounts of disparate data, applying algorithms to identify opportunities to provide better patient care, and making those opportunities actionable by physicians at the point of care in near-real time. We are passionate about helping our customers drive meaningful outcomes. We are growing fast and have emerged as a market leader in the highly competitive population health management software market and have been recognized by industry analysts KLAS, IDC, Forrester, and Chilmark for our leadership. For a better sense of our brand and products, please explore our website.

Protect Yourself

If you have concerns about the authenticity of a job offer or recruitment-related communication claiming to be from Arcadia, verify it by calling us directly at (781) 202-3600 and selecting option 3. You can find more information at Arcadia Careers.

In this role, you are responsible for following all security policies and procedures to protect all PHI under Arcadia's custodianship, as well as Arcadia intellectual property. For security-specific roles, the hiring manager defines any additional responsibilities.

Arcadia does not discriminate based on race, color, sex (including pregnancy and related conditions, sexual orientation, or transgender status), national origin, religion, age (40 and older), equal pay, disability or genetic information (including family medical history or genetic tests or services), and retaliation for filing a charge, reasonably opposing discrimination, or participating in a discrimination lawsuit, investigation, or proceeding.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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