Senior Data Quality Engineer

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $89k - $121.4k / year

⏰ Full Time

🟠 Senior

🚰 Data Engineer

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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

• Understand end-to-end data processes and flows and implement and execute operations for critical, data-centric processes • Develop and execute a supplemental and lab data strategy • Analyze, identify, and engage valuable Provider data connections to procure data driving HEDIS gap closures • Mature relationships with STARs and market teams • Establish and mature quality control processes and mechanisms for supplemental and lab data connections • Engage market and Provider offices to establish high-value data connections and 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 STARs data feeds and maximize procured data quality • Establish and mature data quality practices supporting annual HEDIS season and Humana strategy • Support the STARs Clinical Team in gathering data for pilots and Humana acquisitions • Submit FTP requests, approve UAT and post-production validation, and partner on data acquisition development and deployment of data-focused enhancements and functionality • Support annual standard and nonstandard supplemental data audits with NCQA and DTS auditors

🎯 Requirements

• Bachelor's Degree • Minimum 5 years’ experience working in the healthcare field and/or lab data • Minimum 3 years of experience in a data focused role utilizing analytics, reporting and business intelligence platforms such as SQL and others • Expertise with SQL, PowerBI, and Azure Devops • Exceptional communication skills; presentation, facilitation, oral and written • Preferred: Master’s degree • Preferred: 5 years of experience specifically in clinical/lab data processing or HEDIS with demonstratable data manipulation and analysis skills • Preferred: Experience in provider engagement, MRA or Stars • Preferred: Familiarity with HEDIS measures • Preferred: Knowledge and experience with HCPCS and CPT codes • Ability to assign and complete priorities in a fast-paced and changing environment • Louisville Kentucky, Indiana area candidates highly preferred for occasional in person meetings • Minimum 25 Mbps download and 10 Mbps upload internet speed for Home or Hybrid Home/Office employees • Ability to work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

🏖️ Benefits

• Bonus incentive plan based upon company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Internet expense payment for employees working from home in California, Illinois, Montana, or South Dakota • Telephone equipment appropriate to business requirements for Home or Hybrid Home/Office employees

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