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Humana logo
Humana

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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.

Senior BI Engineer – Medicaid Value Based Programs

Business Intelligence DeveloperBusiness Intelligence DeveloperOtherRemoteSeniorTeam 10,001+Since 1961H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

96 days ago

Salary

$89K - $121.4K / year

Seniority

Senior

Bachelor Degree5 yrs expExperience acceptedEnglishSQL

Job Description

Senior BI Engineer – Medicaid Value Based Programs

Humana

• Analyze financial, utilization, and performance data to identify opportunities to drive improvements in quality and/or reductions in total cost of care • Analyze utilization data to reconcile provider disputes • Design and contribute to the development of the provider reporting packages to help providers understand their overall performance • Contribute to the development of data models to attribute members to providers for new and enhancements to existing value-based programs and to evaluate program effectiveness • Perform quality assurance checks with peers and lead Business Intelligence associates to ensure development of the program meets business requirements • Partner with finance team to conduct impact analysis and modeling for new VBP models • Collaborate with cross functional and matrixed teams to operationalize and roll out new VBP models • Monitor VBP model performance KPIs to identify opportunities to enhance model design based on internal and external feedback and performance data • Design and develop 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. • Ensure data integrity in program administration for new value-based programs • Troubleshoot data integrity issues and offer solutions to solve challenges

Job Requirements

  • Bachelor's degree
  • 5 or more years of technical experience in data analysis OR Master's degree and 3 or more years of experience in data analysis
  • Advanced in SQL, SAS and other data systems
  • Experience with tools such as Power BI and DAX language for creating data visualizations
  • Proficiency in verbal and written communication to senior and executive leadership
  • Advanced experience working with big and complex data sets within large organizations
  • Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction
  • Comprehensive knowledge of Microsoft Office Applications including Word, Excel, Access and PowerPoint
  • Strong organizational skills and ability to manage multiple or competing priorities
  • Proficiency in understanding Healthcare related data
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  • Strong attention to detail

Benefits

  • Health benefits effective day 1
  • Paid time off, holidays, volunteer time and jury duty pay
  • Recognition pay
  • 401(k) retirement savings plan with employer match
  • Tuition assistance
  • Scholarships for eligible dependents
  • Parental and caregiver leave
  • Employee charity matching program
  • Network Resource Groups (NRGs)
  • Career development opportunities

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