Washington, DC, United States
Oct 22, 2021
Feb 04, 2022
In this key role on the Quality Systems Integration (QSI) team, the QSI Lead Data Quality / Integrity Engineer will leverage their Humana, clinical data, market, and healthcare expertise to develop and execute a comprehensive supplemental and lab data strategy that enables the Data team to analyze, identify, and engage the most valuable Provider data connections to procure data driving HEDIS gap closures and enabling Humana's strategy to become a health centered company. This role will work to mature existing relationships with STARs and market teams and establish and mature quality control processes and mechanisms for supplemental and lab data connections.
Develop and execute a comprehensive supplemental and lab data procurement and quality strategy in partnership with the data intake and extraction leaders and Associates
Engage market and Provider offices to establish high value data connections and to educate them on data intake processes and procedures.
Communicate data processing status and improvement opportunities to markets and Providers.
Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs data and maximize the quality of the data procured digitally and manually.
Establish and mature best in class data quality and procurement strategy and tactics that support annual HEDIS season and Humana strategy.
Support STARs Clinical Team to gather data for pilots and Humana acquisitions.
Submit FTP requests, approve UAT and post production, and partner on most aspects of data acquisition development and deployment of data focused enhancements and functionality.
Partner with Quality Improvement Market Quality Operations (QOCA) on creation of policies, processes, and procedures in support of annual HEDIS roadmap.
Support annual standard and nonstandard supplemental data audit with NCQA and DTS auditor.
Minimum 5 years experience in data focused role utilizing reporting and analytics applications and tools.
Minimum 5 years experience working with healthcare / lab data.
Experience with knowledge management, business transformation, and change management.
Excellent written and oral communication and presentation skills with the ability to speak and communicate effectively with both senior leaders, cross department leaders, and all levels inside and outside of Humana.
Bachelor's degree in business or related field, Master's degree a plus.
Ability to assign and complete priorities in a fast-paced and changing environment.
Knowledge and use of various reporting tools and systems to include but not limited to SQL, Tableau, Qlikview, Power BI, and others.
Adept at evaluating alternatives and deciding on a plan of action.
Exceptional communication skills; presentation, facilitation, oral, written, listening and conflict resolution.
Creative thinking focused on solving problems and identifying simple and innovative solutions.
Leadership abilities across cross functional areas and in a multiple project environments, with proven collaboration with team members and key stakeholders.
Scheduled Weekly Hours
Website : http://www.humana.com