Value-Based Programs Lead (Data and Analytics)
Role details
Job location
Tech stack
Job description
The Value-Based Programs Lead (Data and Analytics) supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Value-Based Programs Lead provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience.
The Value-Based Programs Lead (Data and Analytics) works with senior executives to develop and drive segment or enterprise-wide functional strategies. Advises one or more areas, programs or functions and provides recommendations to senior executives on matters of significance, and as an advanced subject matter expert competent to work at very high levels in multiple knowledge and functional areas across the enterprise.
The Value-Based Programs Lead job constitutes creating and implementing the program's data framework and developing and managing ongoing data creation and maintenance for a newly developed Hospital-focused Value-based initiative, including measure development/creation. The associate will:
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Develops and implements a scalable data framework for hospital-focused quality measures for enterprise-consumption
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Develops and implements processes and procedures that synthesize multiple disparate data sources from across the enterprise into a single source for program operations and analytics
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Develops, monitors, and maintains program operational logic
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Develops processes that ensure proper program and payment integrity
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Leads program measure design and logic development for the initiative
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Develops and leads established measure management process
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Partners with and advise leadership and key stakeholders; operate independently to ensure deadlines are met by effectively planning, organizing, prioritizing, and coordinating with peer organizations, + 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.
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Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
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Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Requirements
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8+ years of Database Management Systems experience (must have significant experience reading/writing/manipulating SQL or SAS)
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8+ years of Healthcare or managed care experience
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8+ years of data analysis and data extraction analysis experience
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3+ years of experience in Value-Based Care or CMS/Managed Care Hospital Payment Strategies
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3+ years of working with standardized Quality Metrics from entities like AHRQ, NCQA, or NQF
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Experience utilizing PowerPlatform Tools and MS Suite particularly Excel
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Clear oral and written communication skills
Preferred Qualifications
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Bachelor's Degree
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Experience with Databricks
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Experience working with Humana's EDW and Quality Data
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Experience working with and understanding technical resources & specifications related to Quality Measures
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Experience building and maintaining Quality Measure sets
Benefits & conditions
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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$104,000 - $143,000 per year
This 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.