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

The Lead, Data Quality/Integrity understands end-to-end master data processes and flows and uses that knowledge to design and implement master data management solutions. The Lead, Data Quality/Integrity works on problems of diverse scope and complexity ranging from moderate to substantial.

In this key role on the Quality Systems Integration (QSI) team, the QSI Data Quality/Integrity Lead will leverage their expertise in clinical/healthcare data, data exploration, collaboration, and leadership to guide the daily activities of our comprehensive supplemental and lab data connection and processing operations.  This role will work to mature existing relationships with key internal and external teams, maintain and mature quality control processes for supplemental and lab data connections, deliver key operational reporting to management, and provide support and leadership on the ground for this team. Additionally, this role will be instrumental in our department's continuous process improvement, operational excellence objectives, and quality management.

Primary Responsibilities:

• Provide expertise, leadership, and positivity while helping the team identify, consult on, develop, and maintain key supplemental data connections

• 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 management, markets, and other stakeholders.

• Provide operational reporting on progress, challenges, and achievements to management.

• 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.

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

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

• Partner with internal HEDIS operations and compliance teams on the maintenance of policies, processes, and procedures in support of the 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 8 years experience in data focused role utilizing reporting and analytics applications and tools.

• Minimum 6 years experience working with healthcare data and/or lab data experience

• Minimum 5 years experience of data analytics and business intelligence platform to include but not limited to SQL, PowerBI, and others

• Demonstrated ability to articulate ideas effectively in both written and oral forms

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

Preferred Qualifications

• Knowledge and experience with HCPCS and CPT codes

• Experience presenting information to executive leadership

• Experience in provider engagement, MRA or STAR

• Familiarity with HEDIS measures

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

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 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 business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Ho