Senior HEDIS Medicaid Data Manager

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

The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. The Senior Data Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Humana’s Health Quality and Stars organization is seeking a Senior HEDIS Data Manager to deliver quality and value in a fast-paced, dynamic environment to support our Medicaid program through engaging in the transformation of clinical data to inform operational and strategic decision making, collaboration with partners across the enterprise and support of the HEDIS program and related activities. This will require building and maintaining strong relationships with corporate and market teams, including IT, Quality Operations and Compliance, and vended partners.  This is a remote position. #LI-remote.

Use your skills to make an impact
 

Responsibilities:

• Become an expert in HEDIS and Medicaid specifications, processes, and schedules
• Partner to develop comprehensive Medicaid program to support state measure needs, development, and reporting
• Drive internal and external partnerships to coordinate, guide, and oversee implementation of clinical measures, as well as all related regulatory activities and reporting
• Interpretation and presentation of complicated and large data sets to identify trends, data scenarios, and opportunities for improved member health and measure compliance
• Ability to decipher regulatory literature and effectively communicate impacts and changes
• Apply critical thinking skills to develop queries, isolate impacts of regulatory changes, and identify patterns in clinical data using Excel, SQL, SAS, etc.
• Analyze data to solve a wide variety of business problems and creation of data visualizations that drive strategic vison
• Partnership with IT and HEDIS NCQA-certified vendor on tool and reporting enhancements
• Establish and maintain effective professional relationships with key upstream and downstream partners
• Ensure data quality, timeliness and accuracy
• Champion improvements to existing processes

         

Required Qualifications

• 5 years or more of data analysis and data interpretation experience
• Superb communication skills (written and verbal) to effectively communicate across teams, levels and functions
• 2 years or more of project management experience
• Self-starter – comfortable working independently to accomplish components of a larger program
• Strong organizational and time management skills
• Demonstrated excellence in problem solving/critical thinking with exceptional attention to detail
• Ability to manage multiple simultaneous time-sensitive deliverables
• Travel - up to 10%

Preferred Qualifications

• Bachelor’s Degree
• HEDIS and/or Medicaid Experience
• Advanced proficiency in Excel, SQL, SAS, or other data systems

Additional Information

This position is located at the Humana Tower in Louisville, Kentucky as well as working remote, all nationwide candidates welcome to apply.

Work-At-Home Requirements

• WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.  
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Interview Format:

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected, you will receive correspondence inviting you to participate in a HireVue assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 15 - 20 minutes. Your answers will be reviewed, and you will subsequently be informed if you will be moving forward to next round.

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.

 

$97,900 - $133,500 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.

Application Deadline: 02-17-2025

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.