[Hiring] Senior HEDIS Data Manager @Humana

Role Description

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 Medicare Stars and Medicaid programs 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.

The HEDIS Senior Data Manager is accountable for engaging in and supporting all aspects of the HEDIS program and regulatory operations, including:

• Vendor oversight
• Process development
• System and technical configurations
• Management of efforts to maximize HEDIS results

This position requires demonstration of a high level of business acumen as well as cultivating and maturing partnerships within the enterprise. Through individual and team contributions, the HEDIS Senior Data Manager is responsible for the following:

• Become an expert in HEDIS, Stars, and Medicaid specifications, processes, and schedules
• Drive internal and external partnerships to coordinate, guide, and oversee implementation of clinical measures, as well as all related regulatory activities and reporting
• Interpretation 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
• Analyze data to solve a wide variety of business problems and creation of data visualizations that drive strategic vision
• Partnership with IT and HEDIS NCQA-certified vendor on tool and reporting enhancements
• Development, tracking and presentation of HEDIS, Stars, and Medicaid programs, metrics and reporting
• Establish and maintain effective professional relationships with key upstream and downstream partners
• Ensure data quality, timeliness and accuracy
• Champion improvements to existing processes

Qualifications

• Bachelor's degree
• 5 or more years of technical experience
• Demonstrated ability to proactively initiate and drive projects and tasks with minimal supervision, consistently delivering high-quality results
• Strong analytical skills with the ability to evaluate complex issues, identify patterns, and develop innovative, abstract solutions
• Proven experience in working efficiently under tight deadlines, managing multiple priorities, and maintaining high productivity in a fast-paced environment
• Comfortable with rapid change and ambiguity; able to quickly pivot and adjust priorities as business needs evolve
• Excellent interpersonal and communication skills, with a consistent track record of collaborating effectively across teams and maintaining confidentiality and integrity
• Exceptional ability to execute tasks with precision, thoroughly reviewing work to ensure accuracy and quality in all deliverables
• Apply critical thinking skills to develop queries, isolate impacts to regulatory changes and identify patterns in clinical data using Excel, SQL, etc.

Requirements

• Master's degree in Statistics, Mathematics, Computer Science, Engineering and/or related field (preferred)
• Healthcare or managed care experience (preferred)
• Experience with data extraction and analysis technologies such as SQL, CQL, Power BI, Powershell or similar tools (preferred)

Benefits

• 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
• Many other opportunities

Additional Information

• This role is not eligible for work visa sponsorship
• To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service must meet the following criteria: minimum download speed of 25 Mbps and upload speed of 10 Mbps
• 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
• As part of our hiring process, we will be using an interviewing technology called HireVue
• Humana values personal identity protection; applicants may be asked to provide their Social Security Number
• Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required
• Scheduled Weekly Hours: 40
• Pay Range: $97,900 - $133,500 per year
• This job is eligible for a bonus incentive plan based upon company and/or individual performance