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Humana Medicaid is seeking exceptional candidates to join our Medicaid Insurance Products and Benefits Organization to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a unique opportunity for a motivated individual to influence the mission of a leading healthcare company committed to improving the health of the communities it serves.

Medicaid Insurance Products and Benefits team’s purpose is to develop new benefits and wellness programs for members in our Medicaid and Duals health plans. Our goal is to advance personalized solutions that foster whole person care to engage and empower our members in their health journeys. This team supports Medicaid growth opportunities and works across the Company to set actionable product strategy and accelerate development of novel solutions through ideation, concept development, and launch.

We are a diverse set of highly skilled people with deep Medicaid subject matter expertise who work in an agile, collaborative environment. To achieve our goals, we empower associates to pioneer simplicity, rethink routine and seek talent with the following attributes:

• Creative – Adept at research to determine the opportunity and a structured yet flexible approach to problem solving.
• Adaptive - Rapidly learn new knowledge, skills and behaviors in response to changing circumstances.
• Self-sufficient - Ability to navigate complex situations and independently produce high quality deliverables.
• Consultative – Build/sustain relationships and inform the work of others through actionable, objective insights.
• Strategic – Forward thinking capable of providing frameworks to maximize available resources to achieve growth.

The Senior Professional Business Intelligence Engineer is an experienced individual with broad Medicaid Managed Care expertise, deep analytics expertise, and a proven track record of leveraging data to meet compliance requirements and define and drive business value. The Senior Professional will partner across various multi-disciplinary teams at Humana to collect, automate, integrate, analyze, and present data for enhanced benefits and In Lieu of Service (ILOS) utilization across all Medicaid programs. This role involves identifying trends and relationships between various benefits and working cross-functionally with other teams throughout the organization to create insightful and actionable business information.

Responsibilities:

Data Management and Modeling:

• Create and monitor benefit and ILOS utilization reports across all Medicaid programs.
• Collect, integrate, analyze, synthesize, and present data related to benefit utilization, ensuring compliance with state reporting requirements and providing a comprehensive view of product performance
• Analyze structured and unstructured data to uncover pain points, establish causality, and recommend prioritized solutions based on insights

Strategic Analysis and Benefit Design:

• Perform predictive and prescriptive analytics to understand member behavior, identify trends, and recommend strategies for advanced analytics and product design
• Drive and develop metrics, KPIs, and visualization opportunities with a strategic lens for optimally structuring and presenting data to end users

Stakeholder Collaboration & Communication

• Work cross-functionally with other teams throughout the organization to align business goals with analytics solutions and deliver data data-driven insights
• Provide timely and accurate information to leadership on an ongoing basis, facilitating informed decision-making and strategic planning
• Build and sustain relationships to inform others through actionable, objective insights, fostering collaboration and alignment across cross-functional teams

Process Improvement and Compliance:

• Responsible for Medicaid state reporting requirements, building intuitive reporting constructs and reports to empower stakeholders with data-drive decision making tools
• Exercise considerable latitude in determining objectives and approaches to assignments, pioneering simplicity and rethinking routine to improve and automate processes and compliance
• Implement process improvements to enhance data accuracy, reporting efficiency, and compliance with regulatory requirements, ensuring continuous improvement and innovation

Culture and Approach

• Champions a self-starter mindset and customer centric way of working across the Medicaid segment to meet compliance requirements and optimize Medicaid product data analytics capabiliti