Home
/
Comprehensive
/
Data & Reporting Professional (Value-Based Programs)
Data & Reporting Professional (Value-Based Programs)-November 2024
Des Moines
Nov 13, 2024
ABOUT HUMANA
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized whole-person healthcare experiences.
10,000+ employees
Healthcare
VIEW COMPANY PROFILE >>
About Data & Reporting Professional (Value-Based Programs)

  Become a part of our caring community and help us put health first

  Humana Healthy Horizons is seeking a Senior Data and Reporting Professional who will generate ad hoc reports and regular datasets and/or report information for end-users using queries and scripts to inform value-based payment (VBP) model design and administration. The Senior Data and Reporting Professional integrates data from multiple sources to produce requested or required data elements. They will program and maintain report forms and formats, information dashboards, data generators, canned reports, and other end-user platforms. The Senior Data and Reporting Professional may create specifications for reports based on business requests. Collaborates with leaders to make decisions on complex issues regarding job duties and related tasks. Uses independent judgment requiring analysis of variable factors and determining the best course of action.

  Analyzes financial, utilization, and performance data to identify opportunities to drive improvements in quality and/or reductions in total cost of care.

  Creates scorecards and reconciliation of provider performance based on contractual terms.

  Analyzes utilization data to reconcile provider disputes.

  Designs and contributes to development of provider reporting packages to help providers understand their overall performance.

  Partners with finance team to conduct impact analysis and modeling for new VBP models.

  Collaborates with cross functional and matrixed teams to operationalize and roll out new VBP models.

  Monitors VBP model performance KPIs to identify opportunities to enhance model design based on internal and external feedback and performance data.

  Designs Return on Investment (ROI) Analyses for new Value Based Payments (VBP) using multiple data sources, including prior authorizations, healthcare claims, Admit/Discharge/Transfer (ADT) data, HEDIS data, etc.

  Assists with the creation of data models to attribute members to providers for new value-based programs and to evaluate program effectiveness.

  Ensures data integrity in program administration for new value-based programs.

  Troubleshoots data integrity issues and offers solutions to solve challenges.

  Use your skills to make an impact

  Required Qualifications

  Bachelor's degree.

  Minimum of three (3) years of technical experience in data reporting.

  Minimum of two (2) years of experience working with large and complex data sets within healthcare organizations.

  Minimum of two (2) years of experience in creating pivot tables, linking pivot tables to external data sources and summarizing data into reports and dashboards.

  Advanced proficiency in Microsoft Excel.

  High level of proficiency in both verbal and writing communication skills, specifically in engaging leadership.

  Strong organizational skills and ability to manage multiple or competing priorities.

  Strong analytical and problem-solving skills.

  Strong attention to detail.

  Preferred Qualifications

  Work experience within the Medicaid/Medicaid managed care setting.

  Experience performing claims data analysis to inform VBP model design.

  Experience in SQL, SAS, and other data systems.

  Experience with tools for creating data visualizations.

  Experience in a system analytics and/or data warehousing environment.

  Additional Information

  Workstyle: This is a remote position.

  Workdays & Hours: Monday - Friday; Eastern Standard Time (EST) with some flexibility.

  Travel: Up to 5% possibly outside of your state of residence.

  Work at Home Criteria

  To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees 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.

  Employees 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 employees 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.

  Interview Format

  As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

  #LI-JW

  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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$71,500 - $98,500 per yearThis 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.

  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 because he or she is a protected veteran. 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.

Comments
Welcome to zdrecruit comments! Please keep conversations courteous and on-topic. To fosterproductive and respectful conversations, you may see comments from our Community Managers.
Sign up to post
Sort by
Show More Comments
SIMILAR JOBS
Storage Engineer - Active TS/SCI with CI Poly
As a Storage Engineer supporting the Government, you will be trusted to work on Platform Engineering Services engineering solutions for storage devices and backup technologies. You͛ will become a cri
SailPoint Developer Senior Consultant (Delivery Center/Remote)
Are you looking to elevate your cyber career? Your technical skills? Your opportunity for growth? Deloitte's Government and Public Services Cyber Practice (GPS Cyber Practice) is the place for you! O
Director Operations
Job Profile Summary Responsible for direction setting and execution of the Peace River Citrus Products (PRCP) for The Coca-Cola Company support team. Partner with PRCP senior leadership to establish
Restaurant General Manager
The pay range for this position is between $20.50-$25.50 per hour depending on experience and availability! DRG is looking for a Dynamic and Experienced Leader who wants to work for a fast growing co
Pharmacist- Sign-On Bonus Available
Job Description: Job Objectives Provides pharmacy consulting services with empathy to patients regarding the effective usage of medications and awareness with drug interactions. Offers preventive and
Mobile Tech
Mobile Tech Job ID 151531 Posted 19-Jan-2024 Service line GWS Segment Role type Full-time Areas of Interest Engineering/Maintenance Location(s) State College - Pennsylvania - United States of America
WMS Division Staff Operations Manager (SOM 3)
What You Will Do The Associate Laboratory Directorate for Weapons Production (ALDWP)'s Weapons Mission Services Division (WMS-DO) is looking for a dedicated professional to join our management team a
Lead Federal Contracts Manager
36608BR Requisition ID: 36608BR Business Unit: FSU Job Description: CDM Smith delivers advanced solutions that enable the U.S. government – civilian and military – to protect lives, communities, and
German Speaking Document Coordinator
HOW MIGHT YOU DEFY IMAGINATION? The Amgen Capability Center in Lisbon, Portugal (ACCP ) will be home to over 300 multi-national and multi-cultural employees, representing a broad range of cross-funct
Installation Superintendent
KONE, founded in 1910, is one of the largest, award-winning elevator companies in the world and our offering for employees is as competitive as our offering for customers. Not only do we provide high
Copyright 2023-2024 - www.zdrecruit.com All Rights Reserved