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Become a part of our caring community and help us put health firstHumana Healthy Horizons is seeking a Senior Data and Reporting Professional who will generate ad hoc reports and regular datasets and/or report information for end-users using queries and scripts to inform value-based payment (VBP) model design and administration. The Senior Data and Reporting Professional integrates data from multiple sources to produce requested or required data elements. They will program and maintain report forms and formats, information dashboards, data generators, canned reports, and other end-user platforms. The Senior Data and Reporting Professional may create specifications for reports based on business requests. Collaborates with leaders to make decisions on complex issues regarding job duties and related tasks. Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Analyzes financial, utilization, and performance data to identify opportunities to drive improvements in quality and/or reductions in total cost of care.
Creates scorecards and reconciliation of provider performance based on contractual terms.
Analyzes utilization data to reconcile provider disputes.
Designs and contributes to development of provider reporting packages to help providers understand their overall performance.
Partners with finance team to conduct impact analysis and modeling for new VBP models.
Collaborates with cross functional and matrixed teams to operationalize and roll out new VBP models.
Monitors VBP model performance KPIs to identify opportunities to enhance model design based on internal and external feedback and performance data.
Designs Return on Investment (ROI) Analyses for new Value Based Payments (VBP) using multiple data sources, including prior authorizations, healthcare claims, Admit/Discharge/Transfer (ADT) data, HEDIS data, etc.
Assists with the creation of data models to attribute members to providers for new value-based programs and to evaluate program effectiveness.
Ensures data integrity in program administration for new value-based programs.
Troubleshoots data integrity issues and offers solutions to solve challenges.
Use your skills to make an impactRequired Qualifications
Bachelor's degree.
Minimum of three (3) years of technical experience in data reporting.
Minimum of two (2) years of experience working with large and complex data sets within healthcare organizations.
Minimum of two (2) years of experience in creating pivot tables, linking pivot tables to external data sources and summarizing data into reports and dashboards.
Advanced proficiency in Microsoft Excel.
High level of proficiency in both verbal and writing communication skills, specifically in engaging leadership.
Strong organizational skills and ability to manage multiple or competing priorities.
Strong analytical and problem-solving skills.
Strong attention to detail.
Preferred Qualifications
Work experience within the Medicaid/Medicaid managed care setting.
Experience performing claims data analysis to inform VBP model design.
Experience in SQL, SAS, and other data systems.
Experience with tools for creating data visualizations.
Experience in a system analytics and/or data warehousing environment.
Additional Information
Workstyle: This is a remote position.
Workdays & Hours: Monday - Friday; Eastern Standard Time (EST) with some flexibility.
Travel: Up to 5% possibly outside of your state of residence.
Work at Home CriteriaTo 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 business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Interview FormatAs part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire 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.#LI-JWScheduled Weekly Hours40Pay RangeThe 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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$71,500 - $98,500 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About usHumana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.Equal Opportunity EmployerIt is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=HumanaWebsite.
