Senior Professional Business Intelligence 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 should possess broad Medicaid Managed Care expertise, deep analytics expertise, and a proven track record of leveraging data to meet compliance requirements and drive business value. Experience with data collection, automation, integration, analysis, and presentation for enhanced benefits and In Lieu of Service (ILOS) utilization across all Medicaid programs is required. Proficiency in performing predictive and prescriptive analytics to understand member behavior, identify trends, and recommend strategies is also necessary.

Responsibilities

The Senior Professional Business Intelligence Engineer will create and monitor benefit and ILOS utilization reports across all Medicaid programs. This role involves collecting, integrating, analyzing, synthesizing, and presenting data related to benefit utilization, ensuring compliance with state reporting requirements and providing a comprehensive view of product performance. The engineer will analyze structured and unstructured data to uncover pain points, establish causality, and recommend prioritized solutions. They will also perform predictive and prescriptive analytics, drive metrics and KPIs, and collaborate cross-functionally with other teams to align business goals with analytics solutions and deliver data-driven insights. Additionally, the role requires providing timely and accurate information to leadership, building relationships to inform others through actionable insights, and ensuring compliance with Medicaid state reporting requirements by building intuitive reporting constructs and reports.

Skills

Medicaid

Managed Care Analytics

Data Analytics

Data Analysis

Agile

Data-driven decision making

Business Intelligence

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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