Medicaid Business Intelligence Lead

Humana

4d•$117,600 - $161,700•Remote

About The Position

The Business Intelligence Lead is the primary analytics and enrollment operations expert supporting Medicaid Enrollment. The role leads state implementation readiness, regulatory and contractual reporting support, enrollment analytics, compliance monitoring, and analytics modernization across Medicaid markets. This strategic individual contributor and internal consultant uses internal and external data to solve complex business and operational challenges, providing actionable insights and direction to business leaders. The role partners with business, operations, compliance, and technology teams to design and implement analytics solutions, and exercises independent judgment on complex matters involving state compliance, enrollment operations, contractual reporting, membership reporting, reconciliation, and operational performance. Using platforms such as Databricks, Power BI, SQL, and cloud-based data environments, the position develops reusable, scalable solutions for current and future Medicaid market expansions. The role influences strategy, identifies operational efficiencies, establishes reporting standards, and advances modernization to reduce implementation effort while improving compliance, operational visibility, and business outcomes.

Requirements

Bachelor's degree in Business, Information Systems, Data Analytics, Healthcare Administration, Computer Science, or a related field.
At least 5 years of healthcare analytics experience supporting complex operational processes.
At least 5 years of experience working with large healthcare datasets, data warehouses, and analytic platforms.
At least 5 years of advanced SQL development experience.
At least 5 years of experience designing and delivering Power BI dashboards and reporting solutions.
Demonstrated experience supporting Medicaid business.
Demonstrated expertise with 834 enrollment transactions, membership reporting, and related operational controls.
Experience with Databricks, cloud-based analytics platforms, and modern data architecture practices.
Ability to independently lead cross-functional initiatives.
Strong verbal and written communication skills, including the ability to communicate with executive leadership.
Experience driving process improvement and operational efficiency initiatives through data and analytics.
Ability to function as an internal consultant and trusted advisor to business partners.
Interest in improving member experiences through data-driven decision-making.

Nice To Haves

Medicaid managed care experience.
Experience supporting state implementations, market expansions, or operational readiness initiatives.
Experience supporting state reporting, contractual requirements, compliance monitoring, and audit activities.
Advanced Databricks development experience.
Experience building reusable data products and scalable reporting architectures.
Experience with enrollment systems, eligibility processing, membership reconciliation, and operational workflow optimization.
Expertise in healthcare operational reporting, automation, and process modernization.
Lean, Six Sigma, Agile, or process improvement experience.
Master's degree in Analytics, Information Systems, Public Health, Business Administration, or a related discipline.

Responsibilities

Lead state implementation readiness efforts supporting Medicaid Enrollment.
Support regulatory and contractual reporting obligations, compliance monitoring, and audit activities.
Lead enrollment analytics, membership reporting, reconciliation processes, and operational performance analysis.
Use internal and external data to solve complex business and operational challenges and provide actionable insights to business leaders.
Partner with business leaders, operational teams, compliance organizations, and technology partners to design and implement analytics solutions.
Develop reusable and scalable analytics solutions using Databricks, Power BI, SQL, and cloud-based data environments.
Influence strategy, identify opportunities for operational efficiency, and establish reporting standards.
Drive analytics modernization to reduce implementation effort and improve compliance, operational visibility, and business outcomes.
Independently lead cross-functional initiatives and serve as a trusted internal consultant to business partners.