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The Senior Data Quality/Integrity Engineer understands end-to-end data processes and flows and uses that knowledge to implement and execute best-in-class operations for critical, data-centric processes. The Senior Data Quality/Integrity Engineer work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
In this key role on the Quality Systems Integration (QSI) team, the QSI Senior 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.
Primary Responsibilities:
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 practices 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 validation, and partner on most aspects of data acquisition development and deployment of data focused enhancements and functionality.
Support annual standard and nonstandard supplemental data audit with NCQA and DTS auditor.
Use your skills to make an impact
Required Qualifications
Bachelor's Degree
Minimum 5 years’ experience working in the healthcare field and/or lab data
Minimum 3 years of experience in a data focused role utilizing analytics, reporting and business intelligence platforms such as SQL and others
Expertise with SQL, PowerBI, and Azure Devops
Exceptional communication skills; presentation, facilitation, oral and written
Preferred Qualifications
Master’s degree
5 years of experience specifically in clinical/lab data processing or HEDIS with demonstratable data manipulation and analysis skills
Experience in provider engagement, MRA or Stars
Familiarity with HEDIS measures
Knowledge and experience with HCPCS and CPT codes
Ability to assign and complete priorities in a fast-paced and changing environment.
Louisville Kentucky, Indiana area candidates highly preferred for occasional in person meetings
Additional Information
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.
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 HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you…