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:

Collects, analyzes, and validates HEDIS data from various sources

Ensures data accuracy and completeness

Prepares detailed HEDIS reports and summaries for stakeholders

Maintains comprehensive documentation of all HEDIS related processes

Understands own work area professional concepts/standards, regulations, strategies, and operating standards

Makes decisions regarding own work approach/priorities and follows direction

Develops robust data extraction, transformation and loading process to support HEDIS reporting requirements

Creates and manages complex SQL queries and scripts to extract and manipulate data from various sources

Integrates data from multiple sources including claims, clinical and provider data, ensure data integrity and consistency.

Use your skills to make an impact

Required Qualifications

Proficiency in HEDIS measures, Medicaid programs and healthcare quality improvement

Proficiency in understanding Healthcare related data

Experience analyzing data to solve a wide variety of business problems

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

Preferred Qualifications

Bachelors degree and 5 or more years of technical experience in data analysis OR Masters 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

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. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

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 yearThis 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.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=HumanaWebsite.