[Remote] Stars Technology Business Intelligence Lead Product Owner at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor's degree
8+ years of experience in data flow & analysis and software application building & enhancements
2+ years of project leadership experience
Strong experience with healthcare data, particularly clinical and claims data used in HEDIS measurement
Familiarity with CMS Stars programs, NCQA standards, and quality performance metrics
Advanced experience working with big and complex data sets within large organizations
Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs
Proficiency in understanding Healthcare related data
Proficiency in verbal/written communication to senior and executive leadership

Responsibilities

Define and maintain the vision, strategy, and roadmap for data products that enable CMS Stars and HEDIS reporting
Own, groom, and prioritize the product backlog for one or more agile teams
Elicit detailed requirements from stakeholders and translate them into clear user stories with defined acceptance criteria
Act as the primary liaison between business stakeholders and technical teams
Facilitate communication and alignment across data engineering, analytics, compliance, and QA teams
Work closely with data architects and engineers to design and validate data flows, mappings, and transformations
Collaborate with governance teams to establish data quality benchmarks and implement testing protocols
Ensure data products adhere to CMS mandates and NCQA standards
Advocate for the resolution of technical debt and architectural improvements
Monitor evolving CMS, NCQA, and HEDIS requirements and coordinate necessary updates

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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