Business Intelligence Lead Claims Cost Management

Profile

Description

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.

Responsibilities

The Business Intelligence Lead, Claims Cost Management describes the tools, technologies, applications, and practices used to collect, integrate, analyze, and present an organization's raw data in order to create insightful and actionable business information. The Lead will advise executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

Primary Role Functions

Support implementation of senior level strategic initiatives

Assess and quantify financial impacts for process changes, new technology needs, etc.

Manage and cultivate vendor relationship.

Collaborate with internal business and external stakeholders.

Update leadership on roadmap initiatives, product progress, milestones, and transition progress.

Oversee and develop a team of 6 Product Owners and Project Managers

Requirements gathering, project management oversight, user acceptance testing, production support, training and education.

Create and present project status updates, financial impacts, etc. to senior level executives

Manage and support leader with multiple high priority projects

Lead cross-functional initiatives

Required Qualifications

Minimum 2 years of project leadership experience

Minimum 2 years of experience working with cross-functional teams and translating requirements between business, project management and technical projects or programs

Proficiency in understanding Healthcare related data

Experience analyzing data to solve a wide variety of business problems

Proficiency in verbal/written communication to senior and executive leadership

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

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 experience in process design and evaluation for large scale organization

Minimum 3 years of Claims Cost Management experience

Experience in leading large-scale cross-functional projects that span multiple years

Experience in external vendor oversight

Experience with Agile and vendor product implementation

PMP Certification

Covid-19 Vaccine Policy

According to Humana's COVID-19 policy, vaccination and masking is required regardless of vaccination status (with exception for eating and drinking) for associates working in a clinical setting where patients receive care (e.g., pharmacy retail locations, clinics, home care). The policy only requires the primary series alone (first and second vaccine). Boosters are encouraged, but not required. Associates have the option to request an accommodation for medical, religious, or other personal needs.

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 Modern Hire. Modern Hire 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. This is a remote role - #LI-Remote.

Scheduled Weekly Hours

40

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.

Company info

Humana Inc.
Website : http://www.humana.com