Description

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.

Responsibilities

Humana’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-Remote

This is a remote position nationwide

Scheduled Weekly Hours

40

Pay Range

The 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 year