Location
Evansville, IN, United States
Posted on
Nov 17, 2021
Profile
Job Information
Humana
Senior Market Data Professional - Remote
in
Evansville
Indiana
Description
The Senior Market Data Professional provides support to assigned health plan and/or specialty companies relative to Medicare, Medicaid, and Commercial product implementation, operations, contract compliance, and federal contract application submissions. The Senior Market Data Professional work assignments involve moderately complex to complex data issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Responsibilities
Senior Market Data Professional
serves as the primary resource on all policies and filings related to network adequacy and regulations for all health plans in your designated region of the continental US.
Medicare work
Builds working relationships with the rest of the team and regional Health Service Delivery (HSD) Subject Matter Experts (SMEs) across the continental US
Periodically, offers trainings to regional HSD SMEs on various topics around the HSD process
Analyzes regulations, policies, and large data sets on a regular basis
Works independently on national HSD projects or entire lines of business
Makes connections to peers and other areas of the business to develop more streamlined ways to work and/ or understand data
Follows established guidelines/ procedures in a fast paced agile department
Ability to pivot projects depending on the direction of the governing body
Hosts small to large group meetings on various HSD topics
Oversees and runs data processing for proprietary programs used to manage large Medicare data sets
Presents, explains, and communicates large data sets to large and small audiences analyses of data sets: likely to senior leadership
Commercial work
Oversees from start to finish commercial group filings for a subset of US states addressing all objections from the state
Ensures that Access Plan owners are meeting or exceeding state and organizational requirement for adequacy member access to services
Oversees and runs data processing for New Network Management
Presents, explains, and communicates to large and small audiences analyses of data sets
Medicaid work
Ensures that Medicaid data is in our proprietary systems and managed appropriately
Reviews proposals and states regulation form for the details of the Medicaid network requirements
Oversees and runs data processing for New Network Management
Presents, explains, and communicates to large and small audiences analyses of data sets
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
Medical Benefits
Dental Benefits
Vision Benefits
Health Savings Accounts
Flex Spending Accounts
Life Insurance
401(k)
PTO including 7 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
And more
Required Qualifications
Bachelor's degree
5 years of experience in a fast paced health care insurance or health care setting
2 years of experience with Excel (pivot tables, vlookups etc)
2 years SQL experience
Excellent communication skills, both oral and written
Excellent presentation skills
Experience implementing and measuring success on complex health-related initiatives and pilots
Process-focused, with ability to leverage and enhance existing processes
Strategic thinker with ability to work independently
Strong relationship building skills and conflict resolution skills
Strong analytical skills
Must be able to thrive and pivot in a fast paced work environment
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Master's Degree
Project management experience
Agile work experience
Proficient with Microsoft Access
Additional Information
For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination OR
Commit to weekly testing, following all CDC protocols, OR
Provide documentation for a medical or religious exemption consideration.
This policy will not supersede state or local laws. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.
Work at Home/Remote Requirements Must ensure designated work area is free from distractions during work hours and virtual meetings Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance is required.
Our Hiring Process
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
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m (satellite and/or wireless internet connections are NOT permitted for Work at Home roles) and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. #ThriveTogether #WorkAtHome
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 **** with instructions to add the information into the application at Humana's secure website.
Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful.
Scheduled Weekly Hours
40
Company info