84 applicants

Company

Humana · 6 hours ago

Senior Data Quality/Integrity Engineer

Remote Nationwide

Full-time

Remote

Mid, Senior Level

$89K/yr - $121K/yr

5+ years exp

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Responsibilities

Develop and execute a comprehensive supplemental and lab data procurement and quality strategy in partnership with the data intake and extraction leaders and Associates

Engage market and Provider offices to establish high value data connections and to educate them on data intake processes and procedures.

Communicate data processing status and improvement opportunities to markets and Providers.

Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs data and maximize the quality of the data procured digitally and manually.

Establish and mature best in class data quality and procurement strategy and tactics that support annual HEDIS season and Humana strategy.

Support STARs Clinical Team to gather data for pilots and Humana acquisitions.

Submit FTP requests, approve UAT and post production, and partner on most aspects of data acquisition development and deployment of data focused enhancements and functionality.

Partner with Quality Improvement Market Quality Operations (QOCA) on creation of policies, processes, and procedures in support of annual HEDIS roadmap.

Support annual standard and nonstandard supplemental data audit with NCQA and DTS auditor.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Computer ScienceManagement Information SystemsStatisticsHealthcare dataLab dataSQLClinical data processingHEDISData manipulationData analysisTableauPowerBIProvider engagementMRASTARHEDIS measuresHCPCS codesCPT codes

Required

Bachelor's Degree in any of the following disciplines: Computer Science, Management Information Systems, Math, Statistics

Minimum 5 years’ experience working with healthcare or lab data

Minimum 3 years of experience in a data focused role utilizing analytics, reporting and business intelligence platforms such as SQL, Tableau, PowerBI, and others

Experience specifically in clinical/lab data processing or HEDIS with demonstratable data manipulation and analysis skills

Exceptional communication skills; presentation, facilitation, oral, written, listening and conflict resolution.

Creative thinking focused on solving problems and identifying simple and innovative solutions

Preferred

Master’s degree

Experience in provider engagement, MRA or STAR

Familiarity with HEDIS measures

Knowledge and experience with HCPCS and CPT codes

Ability to assign and complete priorities in a fast-paced and changing environment.

Benefits

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

Company

Humana

Glassdoor

3.8

Humana is a health insurance provider for individuals, families, and businesses.

Founded in 1964

Louisville, Kentucky, USA

10001+ employees

http://www.humana.com

H1B Sponsorship

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2020 (107)