Become a part of our caring community and help us put health first
 

The Senior Data Quality/Integrity Engineer understands end-to-end data processes and flows and uses that knowledge to implement and execute best-in-class operations for critical, data-centric processes.

Location: Remote

In this key role on the Quality Systems Integration (QSI) team, the QSI Senior Data Quality / Integrity Engineer will leverage their Humana, clinical data, market, and healthcare expertise to develop and execute a comprehensive supplemental and lab data strategy that enables the Data team to analyze, identify, and engage the most valuable Provider data connections to procure data driving HEDIS gap closures and enabling Humana’s strategy to become a health centered company. This role will work to mature existing relationships with STARs and market teams and establish and mature quality control processes and mechanisms for supplemental and lab data connections.

Primary Responsibilities:

• Develop and execute a comprehensive supplemental and lab data procurement and quality strategy in partnership with the data intake and extraction leaders and Associates

• Engage market and Provider offices to establish high value data connections and to educate them on data intake processes and procedures.

• Communicate data processing status and improvement opportunities to markets and Providers.

• Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs data and maximize the quality of the data procured digitally and manually.

• Establish and mature best in class data quality and procurement strategy and tactics that support annual HEDIS season and Humana strategy.

• Support STARs Clinical Team to gather data for pilots and Humana acquisitions.

• Submit FTP requests, approve UAT and post production, and partner on most aspects of data acquisition development and deployment of data focused enhancements and functionality.

• Partner with Quality Improvement Market Quality Operations (QOCA) on creation of policies, processes, and procedures in support of annual HEDIS roadmap.

• Support annual standard and nonstandard supplemental data audit with NCQA and DTS auditor.

Use your skills to make an impact
 

Required Qualifications

• Bachelor's Degree

• Minimum 5 years’ experience working with healthcare or lab data

• Minimum 3 years of experience in a data focused role utilizing analytics, reporting and business intelligence platforms such as SQL, Tableau, PowerBI, and others

• Experience specifically in clinical/lab data processing or HEDIS with demonstratable data manipulation and analysis skills

• Exceptional communication skills; presentation, facilitation, oral, written, listening and conflict resolution.

• Creative thinking focused on solving problems and identifying simple and innovative solutions

Preferred Qualifications

• Master’s degree

• Experience in provider engagement, MRA or STAR

• Familiarity with HEDIS measures

• Knowledge and experience with HCPCS and CPT codes

• Ability to assign and complete priorities in a fast-paced and changing environment.

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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

• Associates 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 associates 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

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.

 

$89,000 - $121,400 per year

 

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