Humana's Michigan Medicaid plan network optimization requires the generation of ad-hoc reports and regular datasets to support end-users, integrate data from multiple sources, and analyze network adequacy for contracting opportunities.
Requirements
- 5+ years of technical experience in data reporting. (Network Adequacy analytics platforms, such as Quest Analytics)
- Advanced proficiency in SQL, SAS and other data systems.
- Advanced Microsoft Excel skills including ability to link pivots to external data sources, creating pivot tables and summarizing data into reports and dashboards. With the ability to link to external data sources, pass-through queries, data structure and relationship design.
- Advanced experience working with big and complex data sets within large organizations with prior accountability for the analysis of managed care network reporting and healthcare data.
- Experience with tools such as Tableau and Qlik for creating data visualizations.
- Experience in a system analytics and/or data warehousing environment.
Responsibilities
- Generates ad-hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts supporting Humana’s Michigan Medicaid plan network optimization.
- Integrates data from multiple sources to produce requested or required data elements.
- Routinely extracts and analyzes data from information dashboards, data generators, canned reports and other end-user information portals or resources.
- May create specifications for reports based on business requests.
- Write and maintain the team’s data and reporting process documentation, including but not limited to process data flows.
- Schedule automated data processing jobs, manage and triage issues.
- Root cause, document, and work to resolve data issues.
Other
- Subject Matter Expert (SME) on Michigan contractual data and reporting requirements and provider crosswalk/mapping from Humana’s data to state file.
- Identify opportunities to improve current data processes.
- Analyze internal and external data, as well as market intelligence information.
- Monitor network adequacy data to share with Network Optimization team for contracting opportunities.
- Partner with shared services teams to deliver ad-hoc reporting, including provider data to support adequacy and access review and insight.
- Proficiency in verbal and written communication to senior and executive leadership.
- Strong organizational skills and ability to manage multiple or competing priorities.
- Strong analytical and problem-solving skills.
- The applicant must be located in or willing to relocate to Michigan. And report to the Michigan Market office for meetings and trainings as needed.
- To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
- As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability.
- Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file.
- Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
