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. The current Special Investigations Unit review process has experienced a significant increase in activity and impact, with new provider reviews rising monthly, increasing stop/void checks, and prepay denials. This role will have a significant focus on Fraud and Waste and its substantially expanded fraud detection and payment prevention efforts. Due to our fast growth, this role will lead internal and enterprise improvement projects such as operational improvements, AI integration, automation, platform implementation and Key Performance Indicators/reporting improvements.
Use your skills to make an impact Required Qualifications- Undergraduate degree
- Minimum 8 years of experience in data analysis including enhancing relational data sets for reporting and analytics
- Minimum 2 years of project leadership experience
- Experience with Fraud, Waste, and Abuse in either the healthcare or banking industry
- Advanced experience working with big and complex data sets within large organizations
- Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction
- Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs
- Proficiency in understanding Healthcare related data
- Proficiency in verbal/written communication to senior and executive leadership
Work-At-Home Requirements- 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
- 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
Preferred Qualifications- Advanced Degree
- Advanced in SQL, SAS and other data systems
- Experience with tools such as Tableau and Qlik for creating data visualizations
- Expertise in data mining, forecasting, simulation, and/or predictive modeling
- Experience creating analytics solutions for various healthcare sectors
Additional Information- As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
- If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
Work at Home 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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours40
Pay RangeThe 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.
$117,600 - $161,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of BenefitsHumana, 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
