Performance Enablement Lead – Part D Risk Adjustment

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $117.6k - $161.7k / year

⏰ Full Time

🟠 Senior

🎲 Risk

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • 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.

📋 Description

• Lead business intelligence and reporting for Part D risk adjustment programs • Define KPI measurement logic, business rules, reporting requirements, and analytic specifications • Translate business needs into repeatable dashboards, reports, and analytic datasets • Partner with HTA/IT and data teams to support scalable reporting and analytic solutions and curated datasets • Serve as the team’s subject matter expert for data visualization and best practices • Support automation, recurring performance measurement, and broader team usage of BI outputs • Validate that BI outputs are accurate, usable, and supported by appropriate controls • Communicate complex data concepts to senior and executive leadership • Contribute to Humana’s efforts to improve consumer experiences

🎯 Requirements

• Bachelor’s degree and 8+ years of relevant experience in business intelligence or analytics • Experience working with Databricks or similar cloud analytic environments • Experience in business intelligence, analytics, or reporting using healthcare datasets • 3+ years’ leadership experience in business intelligence or analytics projects • Advanced SQL and data-wrangling skills • Experience defining business logic, metric definitions, and curated reporting datasets with technical teams • Experience with Power BI for enterprise reporting • Ability to translate business requirements into recurring analytic datasets and reporting solutions • Ability to communicate complex data concepts to senior and executive leadership • Passion for contributing to an organization focused on continuously improving consumer experiences • This role is not eligible for work visa sponsorship • Preferred: Master’s degree and 4+ years of relevant experience • Preferred: Advanced degree in a quantitative discipline such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering, or a related field • Preferred: Experience with Python/PySpark for analysis, automation, or data preparation • Preferred: Familiarity with healthcare risk adjustment, medical and Rx claims, membership, or provider analytics • Preferred: Experience operationalizing automated data workflows and reporting data preparation • Preferred: Knowledge of data governance and control practices • Preferred: Expertise in data mining and/or predictive modeling • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Must work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Internet expense payment for employees who live and work from Home in California, Illinois, Montana, or South Dakota • Humana-provided telephone equipment • HireVue interview scheduling flexibility