Clinical Vendor Oversight Informaticist 2

Profile

Description

The Informaticist 2 obtains data and coordinates with other analytics, IT, external clinical vendors, and business areas across the organization to ensure work is completed with insights from subject matter experts. Assignments are often straightforward and of moderate complexity.

Responsibilities

Location: Remote

The Clinical Vendor Oversight Informaticist 2 leverages knowledge of data, modeling, optimization, and tools. Supports the application of disciplined analytics to predict behavior and optimize programs and products to maximize revenue growth. Aids in development, testing, and validation of cases that improves outcomes and quality of reporting. Contributes to the creation of innovative approaches, while building knowledge of the business. Understands and analyzes complex data, articulates at the appropriate level, impacts the business from mathematical concepts which have a potentially sizeable dollar impact on the business. Understands own work area's professional concepts/standards, regulations, strategies, and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by leader, documented procedures, regulations, professional standards, and may require some interpretation.

The Clinical Vendor Oversight Informaticist 2 supports the development and implementation of reporting and metrics that influence providers, members, market partners, and utilization management vendors. The work will require the ability to integrate data from multiple sources to produce the requested/required data elements needed for vendor reporting and analysis. Support routine vendor metrics and dashboard reviews to help identify potential process gaps and performance trends. Applies disciplined analytics to optimize vendor programs to maximize revenue growth.

In this role you will:

Develop and establish strong and effective working relationships with Clinical Vendor Management Professionals, leadership, and external clinical vendors who aid in managing medical utilization for Medicare, Medicaid, and Commercial lines of business.

Master the intricacies of the data fields

Obtain, validate, and analyze data from internal and external raw sources and finished reports, anticipating the needs of report end users

Support the design, development, maintenance, and delivery of operational reports, dashboards, and ad hoc requests

Continually identify ways to improve and enhance current reports, increasing value and usability

Collect and document business requirements for reporting and analysis initiatives.

Support research necessary to fully understand and correctly utilize the required clinical data

Aid in deriving observations and insights from metrics to support and improve clinical operations

Required Qualifications

Bachelor's degree or equivalent work experience

3 years or more of experience in data analytics

3 years or more of experience in the healthcare or health insurance industry

Understands and analyzes complex data and can articulate to various internal and external partners

SAS, SQL, Excel and/or PowerBI

Excellent written and verbal communication skills

Strong attention to detail

Preferred Qualifications

Experience with claims and authorization data is highly preferred

Data visualization skills

Experience with preferred technologies such as Word, CGX, OneNote, Teams, Outlook, Tableau, or similar tools

Experience with Medicare, Medicaid, and Commercial lines of business

Additional Information

Humana is an organization with careers that change lives-including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.

Interview Format:

As part of our hiring process for this opportunity, we will be using an exciting new technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round screening, you will receive a correspondence inviting you to participate in a Modern Hire process. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 15 - 20 minutes. Your answers will be reviewed and you will subsequently be informed if you will be moving forward to next round.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.

Scheduled Weekly Hours

40

Company info

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