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DescriptionThe 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.ResponsibilitiesHumana's Health Quality and Stars organization is seeking a Data Quality Lead to deliver quality and value in a fast-paced, dynamic environment to support our enterprise HEDIS reporting through the transformation of clinical data to inform operational and strategic decision making, collaboration with partners across the enterprise and support of HEDIS related activities. This will require building and maintaining strong relationships with corporate and market teams, including IT, HEDIS Clinical, Medicaid Operations, Stars, and vended partners.Responsibilities:
Become an expert in HEDIS guidelines and specifications across all product lines, processes, and internal systems
Drive internal and external partnerships to coordinate, guide, and oversee the enterprise's interpretation and implementation of HEDIS regulatory guidelines
Support clinical quality improvement by defining metrics and reporting needs to highlight gaps or opportunities in clinical data
Help define requirements for IT enhancements in collaboration with other stakeholders
Support Stars clinical teams on strategy and initiative implementation
Partner with areas throughout the enterprise to align with care management initiatives to support HEDIS reporting purposes
Assist in researching Humana systems and policies to demonstrate compliance with measure specifications
Ability to decipher regulatory literature, translate that into technical requirements, and effectively communicate requirements, impacts and changes to the enterprise
Able to complete self-directed data analysis from numerous sources (Oracle, SQL, Excel, etc.) with an understanding of database structure design
Establish and maintain effective professional relationships with key regulatory partners and maintain library of regulatory guidance received
Help oversee and facilitate the HQS compliance committee discussions to align clinical and business teams on specification interpretation and strategy
Champion improvements to existing processes
Required Qualifications
Bachelor's Degree or equivalent experience
Two years of HEDIS experience
Proficiency in compiling, analyzing, and interpreting data trends
Data analysis and interpretation experience
Superb communication skills (written and verbal) to effectively communicate across teams, levels and functions
Self-starter - comfortable working independently to accomplish components of a larger program
Strong organizational and time management skills
Demonstrated excellence in problem solving/critical thinking
Ability to manage multiple simultaneous time-sensitive deliverables
Preferred Qualifications
Master's Degree
Five years HEDIS experience
HEDIS and/or Medicaid Experience
Advanced proficiency in Excel, SQL, SAS, or other data systems
Additional Information#LI-ER1#LI-RemoteThis is a remote position nationwideScheduled 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.$104,800 - $144,250 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.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.
