[Remote] Business Intelligence Lead Clinical Care Management at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

MBA in Healthcare Administration, Business Analytics, Information Systems, or related field
4 years’ experience in healthcare analytics and project management, with a focus on Medicare/Medicaid and/or care management operations
2 years of hands-on experience building Power BI reports and dashboards leveraging advanced DAX expressions
Proven ability to understand how data relates to business goals, with a demonstrated capacity to identify opportunities for improvement and growth
Experience utilizing SQL or Tableau for data analysis, reporting, and visualization
Demonstrated experience in project management, including organizing projects, managing timelines, facilitating effective meetings, and adapting strategies to achieve project objectives
Demonstrated familiarity with care management metrics, including productivity, quality, regulatory compliance, and program effectiveness for Medicare/Medicaid
Advanced proficiency with Power BI, Tableau, DAX, and Microsoft Excel
Experience with SQL or other analytics platforms
Preferred Qualifications: Experience building custom DAX solutions for healthcare or Medicare/Medicaid analytics
Knowledge of Medicare/Medicaid care management reporting and performance metrics
Experience with additional analytics platforms (e.g., Python, Azure)

Responsibilities

Develop, optimize, and maintain Power BI dashboards using advanced DAX to measure productivity, quality outcomes, and other program KPIs
Lead multiple analytics and reporting projects, ensuring alignment of project timelines, deliverables, and business goals
Collaborate with stakeholders to define specifications for care management metrics, business requirements, and continuous improvement initiatives
Analyze large datasets using Power BI and DAX to deliver timely, accurate insights for regulatory reporting, operational monitoring, and strategic decision support
Communicate findings and recommendations based on dashboard results to executive leadership and operational teams
Provide training and technical assistance to colleagues regarding optimal use of Power BI and interpretation of care management analytics
Maintain project documentation, data quality checks, and ensure compliance with Medicare/Medicaid program reporting standards
Utilize SQL or other analytics platforms to support data analysis, reporting, and visualization
Collaborate with stakeholders to define and implement care management metrics and KPIs
Develop and maintain reports and dashboards to support business decision-making and operational efficiency

Skills

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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