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The Clinical Vendor Oversight Senior Informaticist supports the development and implementation of reporting and metrics that influence providers, members, market partners, and utilization management vendors. The work will require the ability to integrate data from multiple sources to produce the requested/required data elements needed for vendor reporting and analysis. Supports routine metrics specific to vendors and dashboard reviews to help identify potential process gaps and performance trends. Applies disciplined analytics to optimize vendor programs to maximize revenue growth. Coordinates with other analytics, IT, finance and business areas across the organization to ensure work is completed with insights from knowledge SMEs. Work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Clinical Vendor Oversight Senior Informaticist leverages advanced knowledge of data, modeling, optimization, and tools. Applies disciplined analytics to optimize vended programs and products to maximize revenue growth. Utilizes advanced modeling to develop, test and validate cases that improve the outcomes and quality of the programs we offer. Contributes to more innovative approaches to financial models, while building knowledge of the business. Understands and analyzes complex data, articulates to various units within the company at the appropriate level, impacts the business from mathematical concepts which have a potentially sizeable dollar impact on the business.

• Develop and establish strong and effective working relationships with Clinical Vendor Management Professionals, leadership, and external clinical vendors who aid in managing medical utilization for Medicare, and Medicaid lines of business.

• Master the intricacies of the data fields

• Obtain, validate, and analyze data from internal and external raw sources and finished reports, anticipating the needs of report end users

• Support the design, development, maintenance, and delivery of operational reports, dashboards, and ad hoc requests

• Continually identify ways to improve and enhance current reports, increasing value and usability

• Collect and document business requirements for reporting and analysis initiatives.

• Support ad hoc data request and research necessary to fully understand and correctly utilize the required clinical data

• Aid in deriving observations and insights from metrics to support and improve clinical operations

• Travel may be up to 25%

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Required Qualifications

• Bachelor's degree

• 5+ years of data analytics experience

• 3+ years of experience with data mining, trend identification, and using data to drive business outcomes, recommendations, actionable insights, and decisions

• Experience with data management and analytics tools such as SQL & Saas

• Experience with business intelligence and visualization tools such as Power BI or Tableau and Excel

• Demonstrated ability in verbal and written communication to articulate and present data findings and insights to all levels, including senior leadership

• Strong attention to detail

Role Desirables

• Databricks and/or Snowflake experience

• Experience with data management and analytics tools such as Python & PySpark

• Experience applying Lean and Six Sigma principles and methodologies to drive process efficiency and quality

• Experience using automation tools, like MS Power Automate, to create process efficiencies

• Experience with healthcare authorization data and claims data

• Experience mapping disparate sources of data, and creating relational data models and databases

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 busi