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The Business Intelligence Lead solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

The Business Intelligence Lead describes the tools, technologies, applications and practices used to collect, integrate, analyze, and present an organization's raw data to create insightful and actionable business information. This individual advises executives to develop functional strategies (often segment specific) on matters of significance. This individual exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, using independent judgment requiring analysis of variable factors and determining the best course of action. We are seeking a detail-oriented and innovative professional to join our team and support a Medicaid reconciliation project focused on transforming premium capitation reconciliation processes. This role will play a critical part in modernizing methodologies, improving accuracy, and driving automation to ensure compliance and operational efficiency.

Key Responsibilities:

+ Lead initiatives to redesign and optimize premium capitation reconciliation processes

+ Collaborate with finance, operations, and IT teams to streamline data exchange and reporting

+ Analyze current workflows, identify gaps, and implement process improvements

+ Ensure compliance with regulatory requirements and internal controls

+ Develop tools and reporting solutions to enhance transparency and scalability

+ Support continuous improvement efforts to reduce manual intervention and improve timeliness

Use your skills to make an impact

Required Qualifications

+ Minimum 5 years of technical experience in Medicare and/or Medicaid data analysis

+ Minimum 3 years of project leadership or process improvement experience

+ Advanced experience in SQL, SAS, and/or other data systems

+ Experience with tools such as Tableau, Power BI for creating data visualization

+ Expertise in data mining, forecasting, simulation, and/or predictive modeling

+ Experience creating analytics solutions for various healthcare sectors

+ Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction

+ Advanced experience working with big and complex data sets within large organizations

+ Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs

+ Proficiency in verbal/written communication to senior and executive leadership

Work-At-Home Requirements

+ 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

+ Associates 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 associates 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

Preferred Qualifications

+ Master's degree

+ Previous experience with Medicaid Premium Capitation Reconciliation

Additional Information

+ As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

+ If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$117,600 - $161,700 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.

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.

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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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.