Data & Reporting Professional (Value-Based Programs)
DescriptionHumana 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.
- Bachelor's degree.
- Minimum 3 years of technical experience in data reporting having advanced Microsoft Excel skills including ability to link pivots to external data sources, creating pivot tables and summarizing data into reports and dashboards.
- Experience working with big and complex data sets within healthcare organizations.
- Proficiency in verbal and written communication to leadership.
- Strong organizational skills and ability to manage multiple or competing priorities.
- Strong analytical and problem-solving skills.
- Strong attention to detail.
Experience in Medicaid and Medicaid managed care.
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.
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.
Health benefits effective day 1. Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:
Paid time off, holidays, volunteer time and jury duty pay, Recognition pay.
401(k) retirement savings plan with employer match.
Tuition assistance, Scholarships for eligible dependents.
Parental and caregiver leave.
Employee charity matching program.
Network Resource Groups (NRGs).
Career development opportunities.
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.
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.
Scheduled Weekly Hours40
Pay RangeThe 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 year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of BenefitsHumana, 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.