Senior Data Quality/Integrity Engineer

San Antonio, Texas, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

Candidates must have 3+ years of experience in healthcare, insurance, or a related industry, along with 3+ years of technical experience in data reporting. Advanced proficiency in SQL, SAS, Python, and other data systems is required, as is successful experience managing complex projects from beginning to end. Strong consultative, collaborative, and analytical skills are necessary, along with proficiency in Microsoft Office applications. Demonstrated ability to articulate ideas effectively in both written and oral forms, along with self-motivation, proactivity, organization, and critical thinking skills, are also essential. Experience with Stars or HEDIS is preferred.

Responsibilities

The Senior Data Quality/Integrity Engineer will support the HEDIS program and related activities, including vendor oversight, process development, and system configurations. Responsibilities include championing a collaborative environment, becoming an expert in HEDIS & Stars specifications, and supporting clinical quality improvement by developing code, creating reports, and enhancing data/analytic capabilities. The role involves data collection and manipulation from numerous sources, analyzing data to solve business problems, and creating data visualizations. Key duties include managing internal and external partnerships to coordinate HEDIS activities, developing and presenting season metrics, identifying opportunities for compliance and audit requirements, and interpreting NCQA technical specifications to guide data and process updates. Ensuring data quality, timeliness, and accuracy, while leveraging expertise to drive efficiency and champion process improvements, are also core responsibilities.

Skills

HEDIS

Data Quality

Data Integrity

SQL

Oracle

Data Analysis

Reporting

Vendor Oversight

Process Development

Regulatory Compliance

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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