Senior HEDIS Data Manager

** Become a part of our caring community*
* Humana's Health Quality and Stars organization is seeking a Senior HEDIS Data Manager to deliver quality and value in a fast-paced, dynamic environment to support our Medicare Stars and Medicaid programs through engaging in the transformation of clinical data to inform operational and strategic decision making, collaboration with partners across the enterprise and support of the HEDIS program and related activities.

This will require building and maintaining strong relationships with corporate and market teams, including IT, Quality Operations and Compliance, and vended partners.

The HEDIS Senior Data Manager is accountable for engaging in and supporting all aspects of the HEDIS program and regulatory operations, including: vendor oversight, process development, system and technical configurations, and management of efforts to maximize HEDIS results.  The HEDIS Senior Data Manager champions a collaborative environment where the team and connected partners align on appropriate strategies for each successful season, ensuring all regulatory submissions of data collection and reporting are accurate, complete and timely.

This position requires demonstration of a high level of business acumen as well as cultivating and maturing partnerships within the enterprise. Through individual and team contributions, the HEDIS Senior Data Manager is responsible for the following:

+ Become an expert in HEDIS, Stars, and Medicaid specifications, processes, and schedules

+ Drive internal and external partnerships to coordinate, guide, and oversee implementation of clinical measures, as well as all related regulatory activities and reporting

+ Interpretation of complicated and large data sets to identify trends, data scenarios, and opportunities for improved member health and measure compliance

+ Ability to decipher regulatory literature and effectively communicate impacts and changes

+ Analyze data to solve a wide variety of business problems and creation of data visualizations that drive strategic vison

+ Partnership with IT and HEDIS NCQA-certified vendor on tool and reporting enhancements

+ Development, tracking and presentation of HEDIS, Stars, and Medicaid programs, metrics and reporting

+ Establish and maintain effective professional relationships with key upstream and downstream partners

+ Ensure data quality, timeliness and accuracy

+ Champion improvements to existing processes

** Use your skills to make an impact*
* ** Required Qualifications*
* + Bachelor's degree.

+ 5 or more years of technical experience.

+ Demonstrated ability to proactively initiate and drive projects and tasks with minimal supervision, consistently delivering high-quality results.

+ Strong analytical skills with the ability to evaluate complex issues, identify patterns, and develop innovative, abstract solutions.

+ Proven experience in working efficiently under tight deadlines, managing multiple priorities, and maintaining high productivity in a fast-paced environment.

+ Comfortable with rapid change and ambiguity; able to quickly pivot and adjust priorities as business needs evolve.

+ Excellent interpersonal and communication skills, with a consistent track record of collaborating effectively across teams and maintaining confidentiality and integrity.

+ Exceptional ability to execute tasks with precision, thoroughly reviewing work to ensure accuracy and quality in all deliverables.

+ Apply critical thinking skills to develop queries, isolate impacts to regulatory changes and identify patterns in clinical data using Excel, SQL, etc.

** Preferred Qualifications*
* + Master's degree in Statistics, Mathematics, Computer Science, Engineering and/or related field

+ Healthcare or managed care experience

+

Experience with data extraction and analysis technologies such as SQL, CQL, Power BI, Powershell or similar tools

** Additional Information*
* ** This role is not eligible for work visa sponsorship.*
* 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…