Home
/
Comprehensive
/
Data & Reporting Professional (Value-Based Programs)
Data & Reporting Professional (Value-Based Programs)-May 2024
Denver
May 6, 2025
ABOUT HUMANA
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized whole-person healthcare experiences.
10,000+ employees
Healthcare
VIEW COMPANY PROFILE >>
About Data & Reporting Professional (Value-Based Programs)

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

  Humana Healthy Horizons is seeking a Senior Data and Reporting Professional who will generate ad hoc reports and regular datasets and/or report information for end-users using queries and scripts to inform value-based payment (VBP) model design and administration. The Senior Data and Reporting Professional integrates data from multiple sources to produce requested or required data elements. They will program and maintain report forms and formats, information dashboards, data generators, canned reports, and other end-user platforms. The Senior Data and Reporting Professional may create specifications for reports based on business requests. Collaborates with leaders to make decisions on complex issues regarding job duties and related tasks. Uses independent judgment requiring analysis of variable factors and determining the best course of action.

  Analyzes financial, utilization, and performance data to identify opportunities to drive improvements in quality and/or reductions in total cost of care.

  Creates scorecards and reconciliation of provider performance based on contractual terms.

  Analyzes utilization data to reconcile provider disputes.

  Designs and contributes to development of provider reporting packages to help providers understand their overall performance.

  Partners with finance team to conduct impact analysis and modeling for new VBP models.

  Collaborates with cross functional and matrixed teams to operationalize and roll out new VBP models.

  Monitors VBP model performance KPIs to identify opportunities to enhance model design based on internal and external feedback and performance data.

  Designs Return on Investment (ROI) Analyses for new Value Based Payments (VBP) using multiple data sources, including prior authorizations, healthcare claims, Admit/Discharge/Transfer (ADT) data, HEDIS data, etc.

  Assists with the creation of data models to attribute members to providers for new value-based programs and to evaluate program effectiveness.

  Ensures data integrity in program administration for new value-based programs.

  Troubleshoots data integrity issues and offers solutions to solve challenges.

  Use your skills to make an impact

  Required Qualifications

  Bachelor's degree.

  Minimum of three (3) years of technical experience in data reporting.

  Minimum of two (2) years of experience working with large and complex data sets within healthcare organizations.

  Minimum of two (2) years of experience in creating pivot tables, linking pivot tables to external data sources and summarizing data into reports and dashboards.

  Advanced proficiency in Microsoft Excel.

  High level of proficiency in both verbal and writing communication skills, specifically in engaging leadership.

  Strong organizational skills and ability to manage multiple or competing priorities.

  Strong analytical and problem-solving skills.

  Strong attention to detail.

  Preferred Qualifications

  Work experience within the Medicaid/Medicaid managed care setting.

  Experience performing claims data analysis to inform VBP model design.

  Experience in SQL, SAS, and other data systems.

  Experience with tools for creating data visualizations.

  Experience in a system analytics and/or data warehousing environment.

  Additional Information

  Workstyle: This is a remote position.

  Workdays & Hours: Monday - Friday; Eastern Standard Time (EST) with some flexibility.

  Travel: Up to 5% possibly outside of your state of residence.

  Work at Home Criteria

  To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.

  Satellite, cellular and microwave connection can be used only if approved by leadership.

  Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

  Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

  Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

  Interview Format

  As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

  #LI-JW

  Scheduled Weekly Hours

  40

  Pay Range

  The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$71,500 - $98,500 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

  Description of Benefits

  Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

  About us

  Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

  Equal Opportunity Employer

  It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

  Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Comments
Welcome to zdrecruit comments! Please keep conversations courteous and on-topic. To fosterproductive and respectful conversations, you may see comments from our Community Managers.
Sign up to post
Sort by
Show More Comments
SIMILAR JOBS
Commodity Manager- Indirect
...
Market Finance Senior Consultant
Who We Are Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are buildin
Class A CDL - Team Van Truckload truck driver
...
Notice of Filing Assistant Professor of
JOB REQUIREMENTS: Position Summary: The Mechanical Engineering programis looking for full-time, tenure-track Assistant Professor in MechanicalEngineering. Responsibilities include teaching undergradu
General Manager - Dunkin
Dunkin Donuts General Manager You are applying for work with a franchisee of Dunkin' Donuts, not Dunkin' Brands, Inc., Dunkin' Donuts or any of their affiliates. Any information you submit will be pr
Front Office Intern (Element West Bay Doha)
Job Number 24012996 Job Category Management Development Programs/Interns Location Element West Bay Doha, Zone 61, Al Tawawish Street, Doha, Qatar, Qatar Schedule Full-Time Located Remotely? N Relocat
Clin Nurse I
Overview Registered Nurse, Neuro Intensive Care Unit Full-time, 72 hours per pay period, Night Shift Fort Sanders Regional Medical Center is an award-winning, certified, and accredited facility with
Technical Advisor III
Job Summary:Advanced subject matter expert who sets technical design and direction and consults for one or more large, highly complex technical units of a functional domain in the areas of monitoring
Assistant Teacher
Assistant Teacher Share by Email Share on LinkedIn Share on Twitter (http://www.twitter.com/intent/tweet?url=https%3a%2f%2fcareers.learningcaregroup.com%2fsearch%2fjobdetails%2fx%2fd29a2b15-7d2d-4c1d
ASC Market Development Manager - Florida
ASC Market Development Manager - Florida - 2406163654W Description Ethicon, a member of the Johnson & Johnson Family of Companies, is currently recruiting for an Ambulatory Surgery Center (ASC) M
Copyright 2023-2025 - www.zdrecruit.com All Rights Reserved