[Remote] Encounter Data Management Lead at Humana

Kentucky, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Skills

Key technologies and capabilities for this role

CASX12EDI834835837270/271277SQLSSMSProject LeadershipData AnalyticsPresentationCloud TechnologiesAzure Synapse AnalyticsDatabricksPower PlatformPower BIPower Automate

Questions & Answers

Common questions about this position

What technical skills are required for the Encounter Data Management Lead role?

The role requires minimum 5 years of technical experience in CAS or X12 with working knowledge of EDI formats like 834, 835, 837, 270/271, 277; experience in SQL with SSMS; strong knowledge of Cloud Technologies including Azure Synapse Analytics, Databricks, and Power Platform (Power BI, Power Automate, Power Apps); plus knowledgeable in process improvement, metrics development, and healthcare regulations.

What leadership experience is needed for this position?

Candidates need 2 or more years of project leadership experience and 2+ years' experience in managing change by leading and energizing others through transformation, ambiguity, and complexity.

Is this a remote position or does it require office work?

This information is not specified in the job description.

What is the salary or compensation for this role?

This information is not specified in the job description.

What makes a strong candidate for the Encounter Data Management Lead position?

A strong candidate will have demonstrated experience building and presenting story-driven presentations based on analytics, excellent oral and written communication skills with executive presence, a highly collaborative mindset for engaging diverse stakeholders, and a passion for improving consumer experiences while being proactive and creative in large initiatives.

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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