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The Business Intelligence Lead solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

Location: remote

The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations.

In this pivotal role, you will provide analytical expertise and strategic insights that drive our Stars program success. Your work will directly support leadership decision-making and the advancement of Stars improvement efforts. This is an exciting opportunity for a seasoned professional to influence outcomes that improve member health, enhance plan quality and drive organizational growth.

Key Responsibilities:

Strategic Analysis:

• Analyze the impact of member growth, retention and movement on Star Ratings working with claims, clinical and quality data.

• Develop insights that inform business strategies and operational improvements to support Star Rating goals

• Interpret complex data to evaluate program nuances and their implications on performance

Leadership Support:

• Prepare high-quality, data-driven materials for VP and senior leadership discussions

• Participate in strategic conversations, providing actionable insights and recommendations

• Communicate complex analytical findings in a clear and compelling manner to non-technical audiences

Stars Improvement Initiatives:

• Collaborate with cross-functional teams to assess and enhance Stars performance

• Act as a subject matter expert, explaining the intricacies of Stars methodology and metrics

Data Visualization and Reporting:

• Create executive-level dashboards and presentations that showcase key metrics, trends and improvement opportunities

• Ensure data accuracy, consistency and clarity in all reporting and analysis

Use your skills to make an impact
 

Role Essentials

• Bachelor's degree

• 7 or more years of technical experience in data analysis

• 3+ years of experience in Medicare Advantage, Stars programs or healthcare analytics

• Strong understanding of CMS Star Ratings and Medicare Advantage programs

• Experience with tools such as Tableau, SQL, Power BI and/or QlikView

• Advanced experience working with big and complex data sets within large organizations

• Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction

• Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs

• Excellent communication and presentation skills, with the ability to convey complex concepts clearly to senior leadership

Role Desirables

• Experience with payer claims data

• Advanced Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field

• Advanced in SQL, SAS and other data systems

• Experience with tools such as Tableau and Qlik for creating data visualizations

• Expertise in data mining, forecasting, simulation, and/or predictive modeling

• Experience creating analytics solutions for various healthcare sectors

Additional Information

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