Medicaid Health Management Organization (HMO) Enterprise Data Warehouse

A Medicaid HMO serving approximately 33,000 District of Columbia beneficiaries was contractually required by state and federal regulators to operate an enterprise data warehouse but lacked any functional data management system—placing its government contract at immediate risk.

As Chief Information Officer, I was responsible for establishing the organization’s regulatory-compliant data management capabilities and serving as the primary technical authority in regulator-facing engagements.

• Active executive resistance to funding and acknowledging required data infrastructure
• Immediate regulatory scrutiny while core claims and cost-management processes were already live

I designed and led delivery of an enterprise data warehouse that consolidated claims, financial, and utilization data into a single analytics platform. The solution defined end-to-end data ingestion, transformation, and reporting pipelines while supporting regulatory reporting, financial oversight, and operational decision-making under continuous audit pressure.

• Passed a federal CMS audit, securing continuation of the Medicaid contract for the subsequent five-year period
• Delivered financial and claims analytics that enabled identification and correction of key cost drivers
• Implemented a fully operational claims and cost-management data platform using a cloud-only architecture under active regulatory oversight

This project demonstrates my ability to deliver regulator-defined technical solutions in one of the most complex U.S. industries under extreme time, regulatory, and organizational pressure.