Humana is looking to solve the problem of putting health first by leveraging data-centric processes, analyzing and identifying valuable provider data connections, and enabling the company's strategy to become a health-centered organization.
Requirements
- Expertise with SQL, PowerBI, and Azure Devops
- Minimum 3 years of experience in a data focused role utilizing analytics, reporting and business intelligence platforms such as SQL, Tableau, PowerBI, and others.
- Minimum 5 years’ experience working with healthcare or lab data.
- Familiarity with HEDIS measures
- Knowledge and experience with HCPCS and CPT codes
- Experience in provider engagement, MRA or Stars
- Experience with clinical/lab data processing or HEDIS with demonstratable data manipulation and analysis skills.
Responsibilities
- Engage market and Provider offices to establish high value data connections and to educate them on data intake processes and procedures.
- Communicate data processing status and improvement opportunities to markets and Providers.
- Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs data and maximize the quality of the data procured digitally and manually.
- Establish and mature best in class data quality practices that support annual HEDIS season and Humana strategy.
- Support STARs Clinical Team to gather data for pilots and Humana acquisitions.
- Submit FTP requests, approve UAT and post production validation, and partner on most aspects of data acquisition development and deployment of data focused enhancements and functionality.
- Support annual standard and nonstandard supplemental data audit with NCQA and DTS auditor.
Other
- Bachelor's Degree in any of the following disciplines: Computer Science, Management Information Systems, Math, Statistics or at least 5 years of experience specifically in clinical/lab data processing or HEDIS with demonstratable data manipulation and analysis skills.
- Exceptional communication skills; presentation, facilitation, oral, written, listening and conflict resolution.
- Creative thinking focused on solving problems and identifying simple and innovative solutions.
- Ability to assign and complete priorities in a fast-paced and changing environment.
- Willingness to come to local LOU, KY office for occasional meetings
