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Senior HEDIS and Medicaid Data Manager

Company: Humana
Location: Cincinnati
Posted on: May 28, 2023

Job Description:

The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. The Senior Data Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Humana's Health Quality and Stars organization is seeking a Senior HEDIS Data Manager to deliver quality and value in a fast-paced, dynamic environment to support our Medicaid program through engaging in the transformation of clinical data to inform operational and strategic decision making, collaboration with partners across the enterprise and support of the HEDIS program and related activities. This will require building and maintaining strong relationships with corporate and market teams, including IT, Quality Operations and Compliance, and vended partners.

  • Become an expert in HEDIS and Medicaid specifications, processes, and schedules

  • Partner to develop comprehensive Medicaid program to support state measure needs, development, and reporting

  • Drive internal and external partnerships to coordinate, guide, and oversee implementation of clinical measures, as well as all related regulatory activities and reporting

  • Interpretation and presentation of complicated and large data sets to identify trends, data scenarios, and opportunities for improved member health and measure compliance

  • Ability to decipher regulatory literature and effectively communicate impacts and changes

  • Apply critical thinking skills to develop queries, isolate impacts of regulatory changes, and identify patterns in clinical data using Excel, SQL, SAS, etc.

  • Analyze data to solve a wide variety of business problems and creation of data visualizations that drive strategic vison

  • Partnership with IT and HEDIS NCQA-certified vendor on tool and reporting enhancements

  • Establish and maintain effective professional relationships with key upstream and downstream partners

  • Ensure data quality, timeliness and accuracy

  • Champion improvements to existing processes

    Required Qualifications

    • Bachelor's Degree or equivalent experience

    • Proficiency in compiling, analyzing, and interpreting data trends and working with large data sets

    • Data analysis and data interpretation experience

    • Superb communication skills (written and verbal) to effectively communicate across teams, levels and functions

    • Project management experience

    • 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 with exceptional attention to detail

    • Ability to manage multiple simultaneous time-sensitive deliverables

    • Travel - up to 10%

      Preferred Qualifications

      • Master's Degree

      • HEDIS and/or Medicaid Experience

      • Advanced proficiency in Excel, SQL, SAS, or other data systems

        Additional Information
        This position is located at the Humana Tower in Louisville, Kentucky as well as working remote, all nationwide candidates welcome to apply
        Work-At-Home Requirements

        • WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

        • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.

        • Satellite and Wireless Internet service is NOT allowed for this role.

        • A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

          COVID POLICY
          Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
          Scheduled Weekly Hours
          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

Keywords: Humana, Cincinnati , Senior HEDIS and Medicaid Data Manager, Executive , Cincinnati, Ohio

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