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Humana’s Health Quality and Stars organization is seeking a Senior Data Quality/Integrity Engineer to deliver quality and value in a fast-paced, dynamic environment. The successful candidate will be self-directed, highly-engaged, and will demonstrate expertise and business intelligence in supporting execution of the HEDIS program and related activities, all within tightly regulated requirements and timelines. This will require building and maintaining strong relationships with corporate and market teams, including IT, Quality Operations and Compliance, and Risk Adjustment, as well as vended partners.

The Senior Data Quality/Integrity Engineer is accountable for engaging in and supporting all aspects of the HEDIS program and regulatory operations, including: vendor oversight, process development, system and technical configurations, and management of efforts to maximize HEDIS results. The Senior Data Quality/Integrity Engineer champions a collaborative environment where the team and connected partners align on appropriate strategies for each successful season, ensuring all regulatory submissions of data collection and reporting are accurate, complete and timely.

Responsibilities include:

• Become an expert in HEDIS & Stars specifications, processes, and schedules
• Interpretation of the NCQA technical specifications and regulatory audit requirements to partner on data/process updates; and to provide insights, impacts and guidance to the enterprise
• Development and maintenance of operational workflows, processes, use of technology and systems
• Support clinical quality improvement by championing continuous improvements to operational processes and systems/tools development
• Partner to drive and oversee comprehensive program to support quality improvements and holistic data capture
• Manage multiple data sets from varying systems to inform resource needs, data value, and report metrics
• Interpretation and presentation of complicated and large data sets to identify trends, data scenarios, and opportunities for improved member health and measure compliance
• Internal and external partnerships to coordinate, guide, direct and oversee day-to-day HEDIS activities, including: contingency planning and mitigation, communications, metrics, reporting and prioritization
• Development, tracking and presentation of metrics to ensure data quality, timeliness, and accuracy
• Identify opportunities across HEDIS processes to ensure compliance and audit requirements are satisfied, while also simultaneously maximizing gap closure

Professional Maturity

• Passion for contributing to a cross-functional team focused on continuously improving member experiences and clinical outcomes though data analysis and interpretation
• Establish and maintain effective professional relationships with key upstream and downstream partners

Operational Execution

• Ensure data quality, timeliness and accuracy
• Leverage existing talent and expertise within department to drive efficiency and effectiveness
• Champion improvements to existing processes

Required Qualifications

• 3+ years experience in healthcare, insurance or related industry
• Bachelor’s Degree or equivalent experience
• Successful experience managing complex projects beginning-to-end
• Proficiency in compiling, analyzing, and interpreting data trends
• Strong analytical skills and experience with large, complicated datasets
• Strong consultative and collaborative skills working with a variety of teams and internal/external partners to influence and align on business objectives
• Self-starter – comfortable working independently to accomplish components of a larger program
• Strong organizational and time management skills
• Self-motivated, proactive, with demonstrated professional maturity and emotional resilience
• Comfortable working in fast-paced environment with an ability to manage multiple simultaneous time-sensitive deliverables
• Demonstrated excellence in problem solving/critical thinking with exceptional attention to detail
• Demonstrated ability to articulate ideas effectively in both written and oral forms to effectively communicate across teams, levels and functions
• Proficiency in Microsoft Office applications, including Word, Excel, PowerPoint and Visio

Preferred Qualifications

• 3+ years of technical experience in data reporting
• Stars or HEDIS Experience
• Process proficiency with ability to develop new end-to-end processes and effectively optimize existing work processes to predict, address and resolve efficiency and accuracy constraints

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.