Associate Vice President, Medicaid Data Strategy – Enablement

1 hour ago

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Humana

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Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

📋 Description

• Collaborate with IT teams and business stakeholders to identify, prioritize, and deliver technology solutions that directly support Medicaid strategic objectives. • Oversee the lifecycle management of Business Managed Solutions (BMS) and Robotic Process Automation (RPA) initiatives, ensuring consistency with enterprise architecture, data security, and regulatory compliance. • Define and implement governance principles for distinguishing between BMS and enterprise IT assets, and ensure appropriate documentation and transition when necessary. • Develop, communicate, and execute a comprehensive Medicaid data strategy that aligns with both enterprise-wide and state-specific requirements, including compliance with all relevant regulations. • Assess the need for Medicaid-specific data domains, and establish processes for the consistent use of verified and trusted data sources in all reporting and analytics for both state and enterprise use cases. • Establish clear Medicaid data ownership and stewardship roles to ensure accountability, particularly during new state program implementations and for management of historical claims data. • Create and lead a Medicaid Data Governance Council, providing oversight for data quality, access, and usage standards. • Identify and resolve gaps in data ownership, including those related to files received from external entities and vendors. • Champion a culture within Medicaid operations that recognizes data as a strategic asset critical to organizational success. • Act as a facilitator and translator between business and technical teams, ensuring all cross-domain data needs are clearly understood and addressed. • Lead programs and training initiatives to improve data literacy and analytical skills across all Medicaid teams. • Expand data governance frameworks to include principles of AI ethics, fairness, transparency, and ongoing model monitoring for Medicaid use cases. • Develop a clear roadmap for AI/ML applications in Medicaid, including processes for evaluation, implementation, and compliance with evolving state and federal requirements. • Partner with enterprise AI teams to advocate for and address Medicaid-specific needs and priorities. • Ensure all Medicaid teams understand and consistently apply corporate policies regarding BMS, including documentation, security, and compliance protocols. • Define, communicate, and enforce criteria for determining when a solution qualifies as a BMS versus an enterprise IT asset. • Collaborate to co-develop the strategic roadmap for the Medicaid Data Integration team, focusing on scalability, interoperability, and future-state architecture. • Lead prioritization of integration use cases, and oversee the migration of data from legacy systems to enterprise data platforms or the Medicaid data lake, ensuring data integrity and accessibility. • Direct and mentor the team responsible for Medicaid-focused data visualization and BI reporting, ensuring high standards of accuracy, timeliness, and relevance. • Oversee the delivery of reports and dashboards that support operational, regulatory, and strategic decision-making for Medicaid programs. • Drive the adoption of enterprise BI tools and reporting standards, ensuring consistency and alignment with organizational best practices. • Collaborate with internal and external stakeholders to define and monitor key performance indicators (KPIs) and reporting requirements. • Promote self-service analytics capabilities, while maintaining robust data governance and integrity controls.

🎯 Requirements

• Bachelor's Degree of Business Administration, Computer Science or a related field • 6 or more years of management experience • Experience leading and establishing data governance and executing on a data strategy • Experience working for a Health Plan organization • Experience overseeing the lifecycle management of Business Managed Solutions (BMS) and Robotic Process Automation (RPA) initiatives within an organization • Experience problem solving and consultation within complex environments • Experience facilitating cross-functional teams' efforts • Must be passionate about contributing to an organization focused on continuously improving consumer experiences • Must be able to work EST hours • Ability to travel to Louisville, KY 15%-20% of the time

🏖️ Benefits

• Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Volunteer time off • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Other opportunities