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HEDIS Data and Reporting Lead, Medicaid Quality
HEDIS Data and Reporting Lead, Medicaid Quality-June 2024
Frankfort
Jun 16, 2025
ABOUT HUMANA
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About HEDIS Data and Reporting Lead, Medicaid Quality

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

Humana is seeking a HEDIS Data and Reporting Lead to join the National Medicaid Quality team. The HEDIS Data and Reporting Lead reports to the National Medicaid Quality Director and oversees and coordinates all aspects of HEDIS data collection strategy, analytics, and reporting for the Humana Healthy Horizons Medicaid business, and leads the National Medicaid Quality Analytics team.

The HEDIS Data and Reporting Lead's responsibilities include:

Managing a team of Data and Reporting Professionals, BI Engineers, and Data Scientists, all dedicated to Humana's Medicaid business at the national level.

Overseeing the development and maintenance of BI reporting solutions for topics including but not limited to: HEDIS/Quality measure rate trending and forecasting, pay-for-performance (withhold) program monitoring, Provider HEDIS/Quality measure performance, CAHPS and survey analytics, Health Equity, and other needed Quality reporting.

Overseeing the coordination of HEDIS data ingestion activities and driving strategy to optimize HEDIS data ingestion, EHR/HIE interoperability, supplemental data, and record review for the Medicaid line of business.

Supporting market level Quality Analysts and Quality teams to ensure all state and NCQA deliverables are met in a timely fashion.

Coordinating study designs for pilots and innovations by managing data science personnel within the National Medicaid Quality Analytics team.

Supporting Medicaid Business Development efforts by assisting in data parade preparation and response development for all Medicaid RFP activities.

Use your skills to make an impact

Required Qualifications

Five (5) or more years of technical experience in data reporting.

Two (2) or more years of project leadership experience.

Experience with HEDIS and Quality data and process, with strong understanding of industry standard reporting requirements, measures, and specifications.

Advanced Microsoft Excel skills including ability to link pivots to external data sources, creating pivot tables and summarizing data into reports and dashboards.

Advanced Power BI skills including ability to link to external data sources, pass-through queries, data structure and relationship design.

Experience working with big and complex data sets within large organizations and/or the analysis of healthcare data.

Preferred Qualifications

Bachelor's degree.

Prior people leader experience.

Medicaid Quality Experience, preferably in the managed care setting.

Advanced Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field.

Advanced in SQL, SAS and other data systems.

Experience with tools such as Tableau and Qlik for creating data visualizations.

Prior experience working in a system analytics and/or data warehousing environment.

Additional Information:

Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.

Travel: up to 10%

Typical Work Days/Hours: Monday - Friday, 8:00 am - 5:00 pm, preferably EST.

Direct Reports: 2 direct reports with potential for growth.

Nationwide Remote - This is a remote nationwide position.

WAH Internet Requirements

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.

Benefits

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:

Health benefits effective day 1

Paid time off, holidays, volunteer time and jury duty pay

Recognition pay

401(k) retirement savings plan with employer match

Tuition assistance

Scholarships for eligible dependents

Parental and caregiver leave

Employee charity matching program

Network Resource Groups (NRGs)

Career development opportunities

HireVue

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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-JP1

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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$95,300 - $131,200 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.

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