Stars Population Health Measure Optimization Lead

Humana Inc; Pierre (SD); Remoto; USD 118.000 - 162.000; Tempo pieno

Descrizione del lavoro

Humana Inc. is seeking a Stars Population Health BI Lead to translate reporting into actionable intelligence that improves Stars performance and member health outcomes.

You'll develop dashboards, define population definitions, and conduct analyses across geography, contracts, and measures while partnering with strategy, clinical, operations, and analytics teams to embed insights into enterprise tools.

Competenze

• Bachelor's degree and 8+ years of technical, analytics, BI, or equivalent experience.
• Experience analyzing complex data to solve business problems and guide strategic direction.
• Experience handling large, complex data sets in a large organization.
• Proficiency in SQL and Microsoft Office, including Excel and PowerPoint.
• Experience creating data visualizations and BI solutions, including Power BI.
• Understanding of healthcare data and linking analytics to outcomes.
• Ability to evaluate data, form a point of view, and make actionable recommendations.
• Ability to influence through cross-functional collaboration and present to leadership.
• Strong written and verbal communication, tailoring technical info for audiences.
• Ability to manage multiple priorities in a fast-moving environment.

Mansioni

• Analyze member-level data to identify performance drivers and opportunities.
• Develop code, reports, dashboards, and analytics capabilities for population strategy and monitoring.
• Create clear visualizations and executive summaries for stakeholders and senior leadership.
• Collate data from multiple sources and document data quality and gaps.
• Define population segments, baselines, targets, and measurement frameworks.
• Conduct performance and demographic analyses across geography, contract, product, and segments.
• Own holistic reporting for priority initiatives and provide executive rollups.
• Measure initiative effectiveness and recommend strategy adjustments from evidence.
• Monitor program performance and coordinate outreach to improve effectiveness.
• Use forecasting and scenario analysis to prioritize focus areas and allocate resources.
• Become an expert in Stars measure specs and related data.
• Partner with strategy, clinical, operations, technology, and analytics teams to embed insights.
• Provide data-supported recommendations and foster shared accountability.
• Support longitudinal strategies for hard-to-reach populations.

Conoscenze

Advanced analytical thinking

Strong communication

Strategic storytelling

Cross-functional influence

Executive communication

Prioritization

Formazione

Bachelor's degree and 8+ years of experience

Strumenti

SQL

Excel

Power BI

Oracle

Descrizione del lavoro

Become a part of our caring community

The Stars Population Health Business Intelligence Lead will help the team move from reporting activity to generating actionable intelligence. Success in this role will be reflected in stronger population visibility, clearer performance accountability, faster identification of improvement opportunities, more rigorous evaluation of initiatives, and better-informed decisions that support Stars performance and member health outcomes.

Description

Health Quality and Stars (HQS) is responsible for improving health outcomes and advancing the care experience of members and provider partners through quality solutions. HQS is committed to caring for customers and delivering high plan quality as rated by the Centers for Medicare & Medicaid Services (CMS).

The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans across measures that include preventive care screenings, health condition management, health outcomes, patient experience, and plan operations.

The Stars Population Health Business Intelligence Lead will provide advanced analytics, population insights, and reporting capabilities that enable the Stars Population Health Strategy team to improve performance among priority populations. The role will translate complex data into a clear understanding of performance drivers, member needs, program effectiveness, and opportunities for action across unpaneled members, new members, multi-gap members, and the Annual Preventive Visit enterprise strategy.

This role will partner across Stars and the enterprise to strengthen data availability, define meaningful performance measures, monitor outcomes, and create decision-ready insights. The role requires both deep technical expertise and strong business judgment, with the ability to influence stakeholders, establish shared accountability, and connect analytics directly to population-specific strategy and execution.

Key Responsibilities

• Analyze member-level Stars, demographic, engagement, program, and operational data to identify performance drivers, emerging trends, and opportunities within priority populations.

• Develop code, reports, dashboards, and repeatable analytical capabilities that support population strategy, initiative performance monitoring, and executive decision-making.

• Create clear data visualizations, executive summaries, and strategic narratives for immediate colleagues, enterprise partners, and senior leadership.

• Collate and manipulate data from multiple sources, including Oracle, SQL, Excel, and enterprise reporting environments, while documenting available data, dependencies, quality considerations, and gaps.

• Build population definitions, segmentation approaches, baselines, targets, and measurement frameworks for unpaneled members, new members, Pragmatic Planner segments, multi-gap members, and Annual Preventive Visit performance.

• Conduct Stars performance and demographic analyses across relevant perspectives such as geography, contract, product, measure, member segment, intervention, and channel.

• Own deep, holistic operational reporting for priority initiatives and provide regular executive-level rollups that clarify performance, risks, opportunities, and recommended actions.

• Measure initiative effectiveness and member outcomes, identify what is and is not working, and recommend strategy adjustments based on evidence.

• Monitor performance of critical populations within existing programs and assess how outreach and engagement efforts can be better coordinated to reduce unnecessary touchpoints and improve effectiveness.

• Use forecasting, scenario analysis, and predictive techniques, where appropriate, to estimate opportunity, prioritize focus areas, and support resource allocation decisions.

• Become a subject matter expert in member-level Stars measure specifications and the underlying data used to identify performance drivers and improvement opportunities.

• Partner with strategy, clinical, operations, technology, member-facing, provider-facing, and analytics teams to improve data accessibility and embed population insights into enterprise tools and routines.

• Provide independent, data-supported recommendations and influence cross-functional partners to create shared accountability for Stars Population Health priorities and results.

• Support the design and evaluation of targeted, longitudinal strategies for hard-to-reach populations, balancing optimization of existing programs with selective innovation.

Key Competencies

• Advanced analytical thinking and data interpretation

• Business intelligence and data visualization

• Population segmentation and opportunity sizing

• Performance measurement and outcomes evaluation

• Strategic storytelling and executive communication

• Cross-functional influence and relationship management

• Independent judgment and strategic decision-making

• Prioritization and execution in a fast-moving environment

Use your skills to make an impact

Required Qualifications

• Bachelor's degree and 8 or more years of technical, analytics, business intelligence, or equivalent experience

• Experience analyzing complex data to solve a wide variety of business problems and shape strategic direction

• Advanced experience working with large, complex data sets in a large organization

• Proficiency in SQL and Microsoft Office applications, including Excel and PowerPoint

• Experience developing data visualizations and business intelligence solutions, including Power BI or a comparable platform

• Advanced understanding of healthcare-related data and the ability to connect analytic findings to business and member outcomes

• Demonstrated ability to evaluate data, develop a clear point of view, tell a compelling story, and make actionable recommendations

• Ability to lead through influence, build trust across partner teams, and confidently present to senior and executive leadership

• Strong written and verbal communication skills, with the ability to tailor technical information to the audience

• Ability to manage multiple priorities, accelerate work, and deliver under tight deadlines

Preferred Qualifications

• Advanced degree in a quantitative, business, public health, or related discipline

• Advanced proficiency in SQL, SAS, Python, or other analytical programming and data systems

• Expertise in data mining, forecasting, simulation, predictive modeling, experimentation, or causal evaluation

• Experience creating analytics solutions in healthcare, managed care, or Medicare Advantage

• Knowledge of Medicare Stars measures, HEDIS, preventive care, member engagement, and/or quality improvement

• Experience developing population segmentation, program measurement, and executive reporting for complex initiatives

• Agile, product management, or project management certification

Work at Home Requirements: 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 10-20-2026

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

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.