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Humana’s Health Quality and Stars organization is seeking a Senior Data Quality/Integrity Engineer to deliver quality and value in a fast-paced, dynamic environment. The successful candidate will be self-directed, highly-engaged, and will demonstrate expertise and business intelligence in supporting execution of the HEDIS program and related activities, all within tightly regulated requirements and timelines. This will require building and maintaining strong relationships with corporate and market teams, including IT, Quality Operations and Compliance, and Risk Adjustment, as well as vended partners.

The Senior Data Quality/Integrity Engineer 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, and management of efforts to maximize HEDIS results.  The Senior Data Quality/Integrity Engineer champions a collaborative environment where the team and connected partners align on appropriate strategies for each successful season, ensuring all regulatory submissions of data collection and reporting are accurate, complete and timely. 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 Senior Data Quality/Integrity Engineer is responsible for the following:

• Become an expert in HEDIS & Stars specifications, processes, and schedules
• Support clinical quality improvement by developing code, creating reports, and improving data/analytic capabilities for the broader Health Quality and Stars organization
• Data collection and manipulation from numerous sources (Oracle, SQL, Excel, etc.) with an understanding of database structure design
• Analyze data to solve a wide variety of business problems and creation of data visualizations that drive strategic vison
• Internal and external partnerships to coordinate, guide, direct and oversee day-to-day HEDIS activities, including: contingency planning and mitigation, communications, metrics, reporting and prioritization
• Development, tracking and presentation of season metrics and reporting
• Identify opportunities across HEDIS processes to ensure compliance and audit requirements are satisfied, while also simultaneously maximizing gap closure
• Interpretation of the NCQA technical specifications and regulatory audit requirements to partner on data/process updates; and to provide insights, impacts and guidance to the enterprise

Professional Maturity

• Passion for contributing to a cross-functional team focused on continuously improving member experiences and clinical outcomes though data analysis and interpretation
• Establish and maintain effective professional relationships with key upstream and downstream partners

Operational Execution

• Ensure data quality, timeliness and accuracy
• Leverage existing talent and expertise within department to drive efficiency and effectiveness
• Champion improvements to existing processes

Use your skills to make an impact
 

Required Qualifications

• 3+  years experience in healthcare, insurance or related industry
• 3+ years of technical experience in data reporting
• Advanced proficiency in SQL, SAS, Python and other data systems
• Successful experience managing complex projects beginning-to-end
• Proficiency in compiling, analyzing, and interpreting data trends
• Strong consultative and collaborative skills working with a variety of teams and internal/external partners
• Strong analytical skills and experience with large, complicated datasets
• Self-motivated, proactive, highly organized, and demonstrated critical thinking skills
• Demonstrated ability to articulate ideas effectively in both written and oral forms
• Proficiency in Microsoft Office applications, including Word, Excel, PowerPoint and Visio

Preferred Qualifications

• Stars or HEDIS Experience
• Process proficiency with ability to develop new end-to-end processes and effectively optimize existing work processes to predict, address and resolve efficiency and accuracy constraints
• Background in metrics/KPI development and management

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 required; wireless, wired