Senior Data Quality/Integrity Engineer - Humana
Annapolis, MD
About the Job
Become a part of our caring community and help us put health first
The Senior Data Quality/Integrity Engineer understands end-to-end data processes and flows and uses that knowledge to implement and execute best-in-class operations for critical, data-centric processes.
Location: Remote
In this key role on the Quality Systems Integration (QSI) team, the QSI Senior Data Quality / Integrity Engineer will leverage their Humana, clinical data, market, and healthcare expertise to develop and execute a comprehensive supplemental and lab data strategy that enables the Data team to analyze, identify, and engage the most valuable Provider data connections to procure data driving HEDIS gap closures and enabling Humana’s strategy to become a health centered company. This role will work to mature existing relationships with STARs and market teams and establish and mature quality control processes and mechanisms for supplemental and lab data connections.
Primary 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.
Use your skills to make an impact
Required Qualifications
+ Bachelor's Degree in any of the following disciplines: Computer Science, Management Information Systems, Math, Statistics or equivalent work experience
+ 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 Qualifications
+ 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.
Work-At-Home Requirements
To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
+ Satellite, cellular and microwave connection can be used only if approved by leadership
+ Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$89,000 - $121,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, 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.
Application Deadline: 01-30-2025
About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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=Humana_Website.
The Senior Data Quality/Integrity Engineer understands end-to-end data processes and flows and uses that knowledge to implement and execute best-in-class operations for critical, data-centric processes.
Location: Remote
In this key role on the Quality Systems Integration (QSI) team, the QSI Senior Data Quality / Integrity Engineer will leverage their Humana, clinical data, market, and healthcare expertise to develop and execute a comprehensive supplemental and lab data strategy that enables the Data team to analyze, identify, and engage the most valuable Provider data connections to procure data driving HEDIS gap closures and enabling Humana’s strategy to become a health centered company. This role will work to mature existing relationships with STARs and market teams and establish and mature quality control processes and mechanisms for supplemental and lab data connections.
Primary 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.
Use your skills to make an impact
Required Qualifications
+ Bachelor's Degree in any of the following disciplines: Computer Science, Management Information Systems, Math, Statistics or equivalent work experience
+ 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 Qualifications
+ 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.
Work-At-Home Requirements
To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
+ Satellite, cellular and microwave connection can be used only if approved by leadership
+ Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$89,000 - $121,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, 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.
Application Deadline: 01-30-2025
About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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=Humana_Website.
Source : Humana