Senior Informaticist

Humana

7d•$97,900 - $133,500•Remote

About The Position

The Senior Informaticist serves as a strategic analytics partner to Humana Clinical Pharmacy Review (HCPR) and pharmacy Prior Authorization (PA) operations. The role works across business, clinical, operational, technology, and analytics teams to turn complex or ambiguous challenges into structured analytical questions, investigate performance drivers, and develop practical recommendations. The position uses governed healthcare data and modern analytical tools to evaluate PA activity, operational performance, regulatory reporting, and outcomes in a regulated environment. The role leads analytical programs from problem identification through recommendations, implementation, and measurement. It combines healthcare and pharmacy knowledge, analytical curiosity, and business partnership to clarify complex situations, understand the operational processes behind data, and support informed decisions. The Senior Informaticist also helps modernize HCPR analytics using tools and platforms such as Databricks and Power BI while maintaining data governance and reporting standards. This is a remote role with occasional travel to Humana offices for training or meetings. Employees working from home or a hybrid home/office arrangement must have internet service with at least 25 Mbps download and 10 Mbps upload and a dedicated workspace that protects member PHI/HIPAA information. The position is scheduled for 40 hours per week. The listed annual base pay range is $97,900–$133,500, and the role is eligible for a bonus incentive plan.

Requirements

Bachelor's degree.
At least 5 years of experience solving complex business problems through analytics, healthcare operations, informatics, strategy, consulting, engineering, or related disciplines.
Strong analytical and critical-thinking skills, including the ability to define problems, establish analytical approaches, and develop solutions where an established process may not exist.
Experience translating business and operational goals into measurable analytical approaches and outcomes.
Experience synthesizing information across diverse data sources and identifying trends, relationships, and potential causes.
Strong communication and stakeholder-management skills, including the ability to communicate complex analytical findings to all audiences.
Demonstrated ability to use data and analytical reasoning to influence action, rather than simply produce analyses or reports.
Experience working with healthcare, pharmacy, Medicare, Medicaid, CMS, claims, Prior Authorization, or population health data.
Experience with analytical technologies such as SQL, Databricks, Power BI, Python, Tableau, or similar tools.
Ability to manage complex analytical efforts involving multiple business and technical partners.
Experience working in regulated environments where data accuracy, governance, compliance, and reporting integrity are critical.

Nice To Haves

Experience with pharmacy Prior Authorization or utilization management processes.
Experience supporting Medicare or Medicaid pharmacy operations and regulatory reporting.
Knowledge of pharmacy claims, clinical review, coverage determination, or related pharmacy operational processes.
Experience developing enterprise reporting solutions using Databricks and Power BI.
Advanced degree in a quantitative, analytical, healthcare, business, or technical field.
Experience in informatics, healthcare analytics, process improvement, consulting, strategy, or operations research.

Responsibilities

Lead complex analytical programs supporting HCPR and pharmacy Prior Authorization from problem identification through recommendation, implementation, and measurement of results.
Translate complex or ambiguous PA, clinical, operational, and business questions into structured analytical approaches and applicable recommendations.
Analyze Prior Authorization activity and operational performance to identify trends, potential drivers, process gaps, and improvement opportunities.
Combine information across multiple data sources and operational processes to build a complete view of performance and identify causes.
Partner with HCPR leadership and teams to support regulatory and compliance reporting requirements and evolving pharmacy needs.
Develop analytical frameworks, reporting solutions, and decision-support tools that improve transparency and support informed decision-making.
Communicate complex findings, assumptions, risks, and recommendations to audiences including senior leadership.
Take ownership of analytical projects and independently determine approaches, partner engagement, analytical requirements, and deliverables.
Identify opportunities to improve PA reporting, operational processes, data quality, and analytical capabilities; challenge assumptions and drive sustainable solutions.
Support modernization of HCPR analytics through tools and platforms such as Databricks and Power BI while maintaining data governance and reporting standards.