Business Intelligence Lead

Humana

23h • Remote

About The Position

Become a part of our caring community and help us put health first The Business Intelligence Lead solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Business Intelligence Lead describes the tools, technologies, applications and practices used to collect, integrate, analyze, and present an organization's raw data to create insightful and actionable business information. This individual advises executives to develop functional strategies (often segment specific) on matters of significance. This individual exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, using independent judgment requiring analysis of variable factors and determining the best course of action. We are seeking a detail-oriented and innovative professional to join our team and support a Medicaid reconciliation project focused on transforming premium capitation reconciliation processes. This role will play a critical part in modernizing methodologies, improving accuracy, and driving automation to ensure compliance and operational efficiency.

Requirements

• Minimum 5 years of technical experience in Medicare and/or Medicaid data analysis
• Minimum 3 years of project leadership or process improvement experience
• Advanced experience in SQL, SAS, and/or other data systems
• Experience with tools such as Tableau, Power BI for creating data visualization
• Expertise in data mining, forecasting, simulation, and/or predictive modeling
• Experience creating analytics solutions for various healthcare sectors
• Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction
• 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 verbal/written communication to senior and executive leadership
• 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
• Associates 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 associates 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

Nice To Haves

• Master's degree
• Previous experience with Medicaid Premium Capitation Reconciliation

Responsibilities

• Lead initiatives to redesign and optimize premium capitation reconciliation processes
• Collaborate with finance, operations, and IT teams to streamline data exchange and reporting
• Analyze current workflows, identify gaps, and implement process improvements
• Ensure compliance with regulatory requirements and internal controls
• Develop tools and reporting solutions to enhance transparency and scalability
• Support continuous improvement efforts to reduce manual intervention and improve timeliness

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees