Lead Encounter Data Management

You will lead the collection, integration, analysis, and transformation of encounter data into actionable insights that improve submission accuracy, compliance, and operational performance. In this senior-level role, you will develop scalable analytical solutions, optimize encounter submission processes, and drive initiatives that improve data quality, acceptance rates, and business outcomes. You will report to an Associate Director., + Lead strategic data and analytics initiatives that support encounter submission performance, compliance, and operational goals.

• Develop and maintain analytical solutions using Python, SQL, Databricks, Power BI, Azure DevOps, and automation tools.

• Analyze complex datasets, perform root cause analysis, and implement solutions to resolve data and process challenges.

• Translate business requirements into technical specifications and communicate actionable insights to stakeholders.

• Partner with cross-functional teams to improve workflows, reporting capabilities, data quality, and data management practices.

• Mentor team members and promote a culture of collaboration, innovation, and continuous improvement.

• 6+ years of experience analyzing complex healthcare data to identify process improvements, operational efficiencies, or business insights

• 4+ years of experience using Python and SQL to perform data analysis, automation, reporting, and data quality validation

• 3+ years of experience developing dashboards, reports, and data visualizations using Power BI or similar reporting tools

• 2+ years of experience applying statistical analysis, forecasting techniques, or quantitative modeling to support business decisions

• 2+ years of experience leading projects, mentoring team members, and presenting recommendations to business leaders and stakeholders

• Experience translating complex data into actionable recommendations that influence operational or strategic decisions

Preferred Qualifications

• Bachelor’s degree in a technical field

• Experience with Databricks, Azure DevOps, healthcare encounter data, data governance frameworks, and data quality best practices

Work at Home Requirements: 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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. 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.

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.

$94,900 - $130,500 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.