Senior Medicaid HEDIS Data Professional

Become a part of our caring community and help us put health first
 

The Senior Data and Reporting Professional generates regular datasets for end-users using system tools and database or data warehouse queries and scripts. The Data and Reporting Professional work assignments are often straightforward and of moderate complexity. A successful candidate will be responsible for managing and analyzing data specifically around HEDIS and quality initiatives for Medicaid. This role requires an understanding in Medicaid programs, HEDIS and NCQA requirements.

The Senior Data and Reporting Professional will:

• Collect, analyze, and validate HEDIS data from various sources
• Manage the identification of new connections/sources of data, including timelines and impact on reporting
• Develop and execute project management for new connection builds, including timelines and project plans
• Share updates with markets on status of new connections, data feeds, and issues that arise
• Escalate when timelines are behind and communicate clearly to stakeholders
• Maintain comprehensive documentation of timeliness, impacted measures and key contacts for all HEDIS data sources
• Ensure data accuracy and completeness for HEDIS reports prior to HEDIS engine ingestion
• Work closely with external data partners to resolve HEDIS gaps
• Prepare detailed HEDIS reports for stakeholders
• Investigate data issues related to measure performance or specific data feeds

Use your skills to make an impact
 

Required Qualifications

• Project management experience
• Proficiency in HEDIS measures, Medicaid programs and healthcare quality improvement
• Proficiency in understanding Healthcare related data
• Comprehensive knowledge of Microsoft Office Applications including Word, Excel, Access, PowerPoint and Power BI
• Experience working with big and complex data sets within large organizations and/or the analysis of healthcare data
• Proficiency in verbal and written communication
• Strong organizational skills and ability to manage multiple or competing priorities
• Experience analyzing data to solve a wide variety of business problems

Preferred Qualifications

• Bachelor's degree and 5 or more years of technical experience in data analysis OR Master's degree and 3 or more years of experience with a focus on healthcare and HEDIS reporting
• RN license or 5 years clinical experience
• Proven experience with SQL, ETL processes, and data warehousing
• Proficiency in SQL, Python, or other programming languages
• Proficiency in database management systems (Oracle, SQL Server, MySQL)
• Expertise in data mining, forecasting, simulation, and/or predictive modeling

Work at Home Internet Statement

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 recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Additional Information

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$71,500 - $98,500 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.