Claims Data Analyst / Healthcare Data Engineer (1099) - Ewings Associates : Job Details

Claims Data Analyst / Healthcare Data Engineer (1099) Location: Remote (United States); Mid-Atlantic Region Preferred Type: Short-term Contract, 1099 Project Timeline: Starts May-June 2025 Overview EWINGS is seeking a Claims Data Analyst or Healthcare Data Engineer to support a hospital contract modeling initiative for a health plan. This project involves transitioning from a longstanding Maryland state-regulated payment model to a new, value-based reimbursement framework aligned with the AHEAD model. The work will involve the development of reimbursement benchmarks and financial modeling to support contract negotiations with hospital systems. This role is ideal for a healthcare data professional who blends claims or reimbursement data expertise with technical execution skills. The right candidate will be prepared to support data cleansing, transformation, and troubleshooting-particularly if the health plan's claims or reimbursement data requires heavy lifting or normalization for modeling. In this engagement, EWINGS is leading the strategy, modeling, and contracting support to navigate the transition. Responsibilities

• Support the transformation and validation of facility claims and reimbursement data from payer sources.

• Standardize disparate data sources and formats to support benchmark pricing and modeling workflows.

• Identify and flag data quality issues that may impact financial modeling or contract scenario analysis.

• Assist modeling consultants in accessing and preparing files for DRG, APC, and per diem rate calculations.

• Build or optimize repeatable workflows for importing and validating large datasets using tools like Excel, SQL, Python, or Alteryx.

Qualifications

• 3+ years of experience working with healthcare claims data (payer or provider side).

• Familiarity with institutional claim formats (UB-04, 837I) and reimbursement logic (DRG, APC, per diem).

• Proficiency in Excel, SQL, or other data transformation tools (e.g., Python, SAS, Alteryx).

• Experience supporting contracting, actuarial, payment integrity, or pricing teams is highly preferred.

• Comfortable working independently in a fast-paced environment and communicating technical findings clearly.

Ideal Candidates May Have Experience With

• Medicaid health plans, ACO support organizations, or provider enablement firms

• Value-based payment analytics or bundled payment reconciliation

• Data engineering roles

Hiring Process The hiring process will consist of: 1. Prescreening with EWINGS 2. One to two interviews with EWINGS. About EWINGS EWINGS is a leader in helping clients build large-scale healthcare provider networks. Since 2002, we have developed provider networks for clients in over 3,000 cities across all 50 states. A network assignment with EWINGS provides you the opportunity to gain valuable experience developing networks in multiple states for a variety of products with organizations of various sizes. Candidates who input all (relevant) requested information during the registration and application process will increase their chances of being contacted when a position matches their skills and experience. Other Keywords: Claims data analyst, healthcare data engineer, UB-04, 837I, DRG, APC, per diem reimbursement, SQL, Excel, Alteryx, ETL, healthcare analytics, provider contracting data, payer claims processing, Medicare reimbursement, benchmark pricing, value-based care modeling, Medicaid data transformation, CMS payment logic, healthcare BI, AHEAD model, data wrangling.