Data Management Lead

Humana; Georgia (VT); Remote; USD 106,000 - 147,000; Full time

Job summary

Join a leading company as a Data Management Lead, where you'll support configuration control and data management. You will collaborate with leadership to identify AI opportunities and develop solutions while advising on strategies related to billing and enrollment. This role offers a chance to make a significant impact in healthcare data management.

Benefits

Comprehensive benefits

401(k)

Paid time off

Life insurance

Disability insurance

Qualifications

• At least 5 years of healthcare experience.
• Minimum of 2 years of project leadership experience.
• Experience building and maintaining analytic data sets.

Responsibilities

• Identify AI and RPA opportunities, develop BOTs.
• Analyze and resolve complex issues related to eligibility and billing.
• Advise executives on developing functional strategies.

Skills

Healthcare Experience

Project Leadership

SQL

Data Analysis

Education

Bachelor's Degree

Tools

Ad-hoc Query Tools

Data Repositories

Job description

Become a part of our caring community and help us put health first

The Data Management Lead supports all aspects of configuration control, data management, and deficiency reporting. This role involves working on problems of varying scope and complexity, from moderate to substantial. The position includes responsibilities such as describing tools, technologies, applications, and practices used to collect, integrate, analyze, and present organizational raw data from the ECW. The Lead will also attend and become a citizen developer, collaborating with Contact Center, Billing, Enrollment leadership, and IT. Key tasks include identifying AI and RPA opportunities, building and maintaining BOTs, validating benefits from solutions, and advising operational leadership on functional strategies related to billing and enrollment to support enterprise goals.

Key Accountabilities:

1. Attend and become a citizen developer, collaborating with leadership and IT. Identify AI and RPA opportunities, and develop attended and unattended BOTs. (50%)

2. Analyze, coordinate, process, and resolve complex issues related to eligibility, enrollment, billing, claims, referrals/authorizations, network operations, access to care, and TRICARE policies. (25%)

3. Advise executives on developing functional strategies, exercise independent judgment on complex issues, and work with minimal supervision to determine the best course of action. (25%)

Use your skills to make an impact

Required Qualifications:

• U.S. citizenship is required due to Department of Defense contract.
• Ability to obtain interim security clearance (NBIS).
• Must not currently reside in Puerto Rico, as per contract restrictions.
• Bachelor's degree.
• At least 5 years of healthcare experience.
• Minimum of 2 years of project leadership experience.
• Experience building and maintaining analytic data sets.
• Proficiency with ad-hoc query tools and data repositories.
• At least 2 years of SQL experience.
• Experience working with large healthcare data sets.

Work from Home Requirements:

• Minimum internet speed of 25 Mbps download and 10 Mbps upload; wired connection preferred.
• Satellite, cellular, or microwave connections require leadership approval.
• Employees in California, Illinois, Montana, or South Dakota receive internet expense reimbursement bi-weekly.
• Company provides necessary telephone equipment.
• Work in a dedicated, interruption-free space to protect member PHI/HIPAA data.

Occasional travel to Humana offices may be required.

Scheduled Weekly Hours: 40

Pay Range: $106,900 - $147,000 annually, with potential bonuses based on performance.

Benefits: Comprehensive benefits including medical, dental, vision, 401(k), paid time off, disability, life insurance, and more.

About us

Humana Inc. is committed to health and well-being, providing insurance and healthcare services to enhance quality of life for diverse populations.

Equal Opportunity Employer: Humana values diversity and prohibits discrimination based on race, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, and other protected categories. We are committed to affirmative action and fair employment practices.