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The Senior Professional Business Intelligence Engineer solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Engineer work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Humana Medicaid is seeking exceptional candidates to join our Medicaid Insurance Products and Benefits Organization to support the strategic direction and growth of the Medicaid and Duals lines of business. This is a unique opportunity for a motivated individual to influence the mission of a leading healthcare company committed to improving the health of the communities it serves.

Medicaid Insurance Products and Benefits team’s purpose is to develop new benefits and wellness programs for members in our Medicaid and Duals health plans. Our goal is to advance personalized solutions that foster whole person care to engage and empower our members in their health journeys. This team supports Medicaid growth opportunities and works across the Company to set actionable product strategy and accelerate development of novel solutions through ideation, concept development, and launch.

We are a diverse set of highly skilled people with deep Medicaid subject matter expertise who work in an agile, collaborative environment. To achieve our goals, we empower associates to pioneer simplicity, rethink routine and seek talent with the following attributes:

• Creative – Adept at research to determine the opportunity and a structured yet flexible approach to problem solving.
• Adaptive - Rapidly learn new knowledge, skills and behaviors in response to changing circumstances.
• Self-sufficient - Ability to navigate complex situations and independently produce high quality deliverables.
• Consultative – Build/sustain relationships and inform the work of others through actionable, objective insights.
• Strategic – Forward thinking capable of providing frameworks to maximize available resources to achieve growth.

The Senior Professional Business Intelligence Engineer is an experienced individual with broad Medicaid Managed Care expertise, deep analytics expertise, and a proven track record of leveraging data to meet compliance requirements and define and drive business value. The Senior Professional will partner across various multi-disciplinary teams at Humana to collect, automate, integrate, analyze, and present data for enhanced benefits and In Lieu of Service (ILOS) utilization across all Medicaid programs. This role involves identifying trends and relationships between various benefits and working cross-functionally with other teams throughout the organization to create insightful and actionable business information.

Responsibilities:

Data Management and Modeling:

• Create and monitor benefit and ILOS utilization reports across all Medicaid programs.
• Collect, integrate, analyze, synthesize, and present data related to benefit utilization, ensuring compliance with state reporting requirements and providing a comprehensive view of product performance
• Analyze structured and unstructured data to uncover pain points, establish causality, and recommend prioritized solutions based on insights

Strategic Analysis and Benefit Design:

• Perform predictive and prescriptive analytics to understand member behavior, identify trends, and recommend strategies for advanced analytics and product design
• Drive and develop metrics, KPIs, and visualization opportunities with a strategic lens for optimally structuring and presenting data to end users

Stakeholder Collaboration & Communication

• Work cross-functionally with other teams throughout the organization to align business goals with analytics solutions and deliver data data-driven insights
• Provide timely and accurate information to leadership on an ongoing basis, facilitating informed decision-making and strategic planning
• Build and sustain relationships to inform others through actionable, objective insights, fostering collaboration and alignment across cross-functional teams

Process Improvement and Compliance:

• Responsible for Medicaid state reporting requirements, building intuitive reporting constructs and reports to empower stakeholders with data-drive decision making tools
• Exercise considerable latitude in determining objectives and approaches to assignments, pioneering simplicity and rethinking routine to improve and automate processes and compliance
• Implement process improvements to enhance data accuracy, reporting efficiency, and compliance with regulatory requirements, ensuring continuous improvement and innovation

Culture and Approach

• Champions a self-starter mindset and customer centric way of working across the Medicaid segment to meet compliance requirements and optimize Medicaid product data analytics capabilities
• Approach problems with curiosity, creativity, and a solution-driven mindset
• Employs empathy and human centered design thinking to define scalable product solutions by deeply understanding utilization trends, product design, and members’ needs and behaviors
• Utilizes advanced data management processes and tools such as: predictive modeling, data visualization, and business intelligence frameworks
• Leverages foundational project management skills such as: documented decisions, plans, and timelines, progress reporting, and artifact collection to ensure successful project execution

Use your skills to make an impact

Required Qualifications:

• Bachelor’s degree in data science, statistics, computer science, health informatics, business, or a related field with a strong record of academic achievement
• 4+ years of technical experience in business intelligence, data systems, reporting and data analysis
• 3+ years of health care experience for Medicare and/or Medicaid populations
• Proven experience with tools such as PowerBI, Tableau or Qlik for creating data visualizations

• Proven experience with SQL, SAS, or other data systems.
• Experience working with big and complex healthcare data sets within large organizations
• Ability to gather, analyze, interpret, and present complex data and create accurate and meaningful information for data reporting and decision support to senior leadership
• Excellent written, verbal, and interpersonal communication skills, and ability to relate to internal and external customers
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences while delivering value to the organization
• Ability to operate in a fast-paced environment under tight deadlines
• Flexible scheduling (i.e., occasional nights and weekends)

Preferred Qualifications:

• Master’s degree in data science, statistics, computer science, information systems, health informatics, business administration (with a focus on data analytics or healthcare management), or public health (with a focus on health data analytics)
• Expertise in data mining, forecasting, simulation, and/or predictive modeling
• Experience creating analytics solutions for various healthcare sectors
• Experience working with government and state agencies
• Proven ability to work with remote teams and foster a cohesive and creative work environment

Additional Information

• Workstyle: Hybrid Office if you live within commuting distance of our office locations in Tampa, FL or Louisville, KY, or Remote if you live outside of Tampa, FL and Louisville, KY
• Travel: Up to 15%
• Core Work Days & Hours: Monday – Friday; Eastern Standard Time (EST) with flexible scheduling (i.e. – occasional nights and weekends)

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The 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.

$89,000 - $121,400 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 06-01-2025

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.