Principal, HEDIS Data Quality/Integrity
HumanaAbout the role
Become a part of our caring community and help us put health first
The Principal Data Quality/Integrity Engineer understands end-to-end master data processes and flows and uses that knowledge to design and implement master data management solutions. The Principal Data Quality/Integrity Engineer provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience.Location: remote but strong preference for in person Louisville, KY
The Principal of Data Quality and Integrity will design, implement, and oversee a structured, disciplined approach to data quality and governance, ensuring that our HEDIS data accurately reflects the health status of our members. This role requires assessing data quality across multiple clinical sources, setting up robust performance metrics, and establishing best practices to ensure data accuracy, consistency, and scalability.
In this influential role, the Principal will collaborate extensively with internal teams, enterprise colleagues, and external partners to address both challenges and opportunities in data quality and integration.
Key responsibilities include:
Data Quality and Integrity Assurance: Ensure HEDIS data is captured and interpreted correctly for clinical analysis, overseeing comprehensive quality controls, profiling, and validation processes.
Data Governance Oversight: Implement regular data quality assessments (e.g., for data types, ranges, formats, completeness) and ensure compliance with business rules and regulatory requirements.
Tool and Process Optimization: Identify and deploy leading-edge tools and best practices to enhance data quality frameworks.
Data Normalization and Standardization: Oversee data normalization efforts to maintain alignment with HEDIS auditor and clinical guidelines, supporting consistent data interpretation.
Continuous Improvement in Data Exchange: Drive improvements with connectivity partners to enhance data exchange processes and optimize clinical data capture.
Supplemental Data Health Assessment: Guide efforts to evaluate and strengthen supplemental data connections to improve provider optimization and clinical insights.
Data Infrastructure Advancements: Assess, recommend, and execute on opportunities to refine data infrastructure and processes, such as supplemental datamart and data processing reengineering.
Stakeholder Communication and Reporting: Establish effective channels to report quality performance and communicate key insights to stakeholders.
Compliance and Risk Management: Proactively identify and escalate potential compliance or risk issues, ensuring timely reporting, management, and resolution.
Use your skills to make an impact
Role Essentials
Bachelor’s Degree
8+ years of experience in data management, data operations, or data warehousing, with a proven track record in quality control.
3+ years of experience leading teams or driving initiatives cross-functionally.
Comprehensive understanding of health plan operations and clinical data warehousing, including claims and provider data.
Working knowledge of HEDIS standards, processes, and reporting.
Strong strategic thinking skills with the ability to translate business needs into measurable results.
Proven ability to communicate complex data insights to senior management, business leaders, and external stakeholders.
Demonstrated skills in KPI and metrics development and oversight.
Strong collaboration skills and ability to influence across business areas to align on shared objectives.
Exceptional communication skills (written and verbal) with the ability to convey insights to diverse audiences.
Role Desirables
Master’s degree in a relevant field
Technical proficiency in the software development lifecycle, agile methodologies, ETL processes, and SQL.
Strong knowledge of HEDIS standards and regulatory processes.
Expertise with electronic health record (EHR) technology and industry clinical exchanges.
Technical proficiency in the software development lifecycle, agile methodologies, ETL processes, and SQL.
Additional Information
Humana is an organizatio
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