[Hiring] Medicaid Business Intelligence Lead @Humana

Role Description

The Business Intelligence Lead serves as the primary analytics and enrollment operations expert supporting Medicaid Enrollment. This role is responsible for:

• Leading state implementation readiness efforts
• Regulatory and contractual reporting support
• Enrollment analytics
• Compliance monitoring
• Analytics modernization across Medicaid markets

The Business Intelligence Lead solves complex business problems and operational challenges using internal and external data sources to provide actionable insights and strategic direction to business leaders. This role serves as the primary analytics lead supporting Medicaid Enrollment Operations initiatives, with responsibility for:

• State implementation readiness
• Enrollment analytics
• Compliance monitoring
• Scalable solution architecture

This associate functions as a strategic individual contributor and internal consultant, partnering with:

• Business leaders
• Operational teams
• Compliance organizations
• Technology partners

The Business Intelligence Lead exercises independent judgment and decision-making authority on complex issues affecting:

• State compliance
• Enrollment operations
• Contractual reporting obligations
• Membership reporting
• Reconciliation processes
• Operational performance

The role leverages modern analytics platforms including:

• Databricks
• Power BI
• SQL
• Cloud-based data environments

This associate is expected to influence strategy, identify opportunities for operational efficiencies, establish reporting standards, and drive modernization efforts that reduce implementation effort while improving compliance, operational visibility, and business outcomes.

Qualifications

• Bachelor's degree in Business, Information Systems, Data Analytics, Healthcare Administration, Computer Science, or related field
• 5+ years of healthcare analytics experience supporting complex operational processes
• 5+ years of experience working with large healthcare datasets, data warehouses, and analytic platforms
• 5+ years of advanced SQL development experience
• 5+ years of experience designing and delivering Power BI dashboards and reporting solutions
• Demonstrated experience supporting Medicaid business
• Demonstrated expertise with 834 enrollment transactions, membership reporting, and related operational controls
• Experience with Databricks, cloud-based analytics platforms, and modern data architecture practices
• Ability to independently lead cross-functional initiatives
• Strong verbal and written communication skills with demonstrated ability to communicate to executive leadership
• Experience driving process improvement and operational efficiency initiatives through data and analytics
• Ability to function as an internal consultant and trusted advisor to business partners
• Passion for improving member experiences through data-driven decision making

Requirements

• Medicaid managed care experience
• Experience supporting state implementations, market expansions, or operational readiness initiatives
• Experience supporting state reporting, contractual requirements, compliance monitoring, and audit activities
• Advanced Databricks development experience
• Experience building reusable data products and scalable reporting architectures
• Experience with enrollment systems, eligibility processing, membership reconciliation, and operational workflow optimization
• Expertise in healthcare operational reporting, automation, and process modernization
• Lean, Six Sigma, Agile, or process improvement experience
• Master's degree in Analytics, Information Systems, Public Health, Business Administration, or related discipline

Benefits

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance
• Many other opportunities

Company Description

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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.