Humana Senior Informaticist - Provider Data Analytics (Remote) in Billings, Montana
The mission of the Physician Performance Insights team is to empower Humana members to make informed healthcare decisions. Our key goal is to ensure transparency and help our members obtain high quality, affordable healthcare while keeping our provider networks efficient and optimal. We achieve this through advanced analytics that enables objective evaluation of physician performance related to our two key metrics: Efficiency of Care (cost) & Effectiveness of Care (quality).
Humana is seeking a Senior Informaticist on the Physician Performance Insights team that leverages their advanced knowledge of data, statistical analysis, problem solving, business analytics, modeling, optimization, and related tools. Utilizes strategic thinking capabilities and is curious about results extracted from the data in order to investigate drivers and propose recommendations. Leads and will be highly engaged in various strategic projects and initiatives, partnering and collaborating with multiple areas across the organization.
Develops or has a deep understanding of physician networks, physician performance and rating metrics (claims, measures, conditions, specialties, etc.), product offerings, and analytics-based approaches, which produce meaningful results
Designs new ways and/or improves current methods to evaluate physician performance measurements and supports conversations/alignment with other areas around physician performance analytics
Pulls and analyzes data using statistical models, techniques, formulas, and calculations
Researches and extracts insights from complex data and reports out on both quantitative and qualitative findings
Executes on existing data related and technical processes to support core functions, which requires significant SQL coding skills and problem solving ability
Creates, reviews, researches, and/or executes complex queries, all while understanding the business context and expected results
Utilizes project management skills (Agile methodology) where applicable
Supports building/modifying (or directly builds/modifies) new reports, models, and dashboards
Applies disciplined approaches to optimize programs to maximize revenue growth
Identifies opportunities to implement process improvements across various functions (Six Sigma and Lean principles)
Effectively communicates to diverse audiences and manages key relationships
Enjoys working in a highly collaborative team environment (whether remote or in office)
Bachelor's Degree and 5+ years of data analytics experience OR Master's degree and 3+ years of data analytics experience
Experience with data mining, statistical approaches, predictive modeling techniques and using data to drive business outcomes and decisions
Experience with statistical models, methods, techniques, and formulas
3+ years of experience in the healthcare sector
Excellent verbal and written communication
Able to articulate and present findings to internal and external stakeholders
Strong attention to detail
Must be passionate about contributing to an organization focused on continuously improving consumer and provider experiences
Experience with claims data and cost efficiency of care
Preferred technologies such as SAS, SQL, Python, Power BI, QlikView, Tableau, Hadoop or similar tools
Expert in data mining, forecasting, simulation, and/or predictive modeling
Six Sigma or Lean certification
Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Scheduled Weekly Hours
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.