Humana

Senior Professional Business Intelligence Engineer

San Antonio, Texas, United States

Not SpecifiedCompensation
Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Insurance, MedicaidIndustries

Senior Professional Business Intelligence Engineer

Employment Type: Full-time

Position Overview

Humana Medicaid is seeking exceptional candidates to join our Medicaid Insurance Products and Benefits Organization to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a unique opportunity for a motivated individual to influence the mission of a leading healthcare company committed to improving the health of the communities it serves.

The Senior Professional Business Intelligence Engineer solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Medicaid Insurance Products and Benefits team’s purpose is to develop new benefits and wellness programs for members in our Medicaid and Duals health plans. Our goal is to advance personalized solutions that foster whole person care to engage and empower our members in their health journeys. This team supports Medicaid growth opportunities and works across the Company to set actionable product strategy and accelerate development of novel solutions through ideation, concept development, and launch.

We are a diverse set of highly skilled people with deep Medicaid subject matter expertise who work in an agile, collaborative environment. To achieve our goals, we empower associates to pioneer simplicity, rethink routine and seek talent with the following attributes:

  • Creative: Adept at research to determine the opportunity and a structured yet flexible approach to problem solving.
  • Adaptive: Rapidly learn new knowledge, skills and behaviors in response to changing circumstances.
  • Self-sufficient: Ability to navigate complex situations and independently produce high quality deliverables.
  • Consultative: Build/sustain relationships and inform the work of others through actionable, objective insights.
  • Strategic: Forward thinking capable of providing frameworks to maximize available resources to achieve growth.

Responsibilities

Data Management and Modeling

  • Create and monitor benefit and ILOS utilization reports across all Medicaid programs.
  • Collect, integrate, analyze, synthesize, and present data related to benefit utilization, ensuring compliance with state reporting requirements and providing a comprehensive view of product performance.
  • Analyze structured and unstructured data to uncover pain points, establish causality, and recommend prioritized solutions based on insights.

Strategic Analysis and Benefit Design

  • Perform predictive and prescriptive analytics to understand member behavior, identify trends, and recommend strategies for advanced analytics and product design.
  • Drive and develop metrics, KPIs, and visualization opportunities with a strategic lens for optimally structuring and presenting data to end users.

Stakeholder Collaboration & Communication

  • Work cross-functionally with other teams throughout the organization to align business goals with analytics solutions and deliver data-driven insights.
  • Provide timely and accurate information to leadership.

Requirements

The Senior Professional Business Intelligence Engineer is an experienced individual with broad Medicaid Managed Care expertise, deep analytics expertise, and a proven track record of leveraging data to meet compliance requirements and define and drive business value. The Senior Professional will partner across various multi-disciplinary teams at Humana to collect, automate, integrate, analyze, and present data for enhanced benefits and In Lieu of Service (ILOS) utilization across all Medicaid programs. This role involves identifying trends and relationships between various benefits and working cross-functionally with other teams throughout the organization to create insightful and actionable business information.

Company Information

Become a part of our caring community and help us put health first.

Skills

Business Intelligence
Data Analysis
Healthcare Data
Problem Solving
Data Sources Integration
Decision Support
Agile Methodology
Collaboration
Strategic Thinking

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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