Business Intelligence Lead - Encounter Submissions

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 The Business Intelligence Lead solves complex business problems and issues using data from internal and external sources and leveraging knowledge to provide insight to decision-makers. The Business Intelligence Lead works on problems of diverse scope and complexity within the encounter submissions team that impacts teams across IT teams and operational teams across Humana’s many business segments.

The Business Intelligence Lead Encounter Submissions is able to 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.  Advises 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.   Strong strategic, critical thinking, and conceptual abilities; ability to lead strategic planning discussions, and turn those into plans and tactics that are executable, measurable, and meet business goals.  Excellent planning and organizational skills with demonstrated ability to meet deadlines while implementing projects. Demonstrated ability to communicate with and influence others and interact with all levels of the organization.  Will own tracking and trending of Medicare submission metrics along with end to end analysis of Medicare submissions.  Monitoring and tracking all new opportunities to ensure all HCCs are identified, stored and reported on.  Will also be responsible for pulling and trending submissions data to ensure HCCs are closed.  Will have 5 direct reports for data collection and analysis.

Use your skills to make an impact
 

Required Qualifications

• Bachelor's Degree and 5 or more years of technical experience in data analysis
• 2 or more years of project leadership experience
• Advanced experience working with big and complex data sets within large organizations
• Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction
• Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs
• Proficiency in understanding Healthcare related data
• Proficiency in verbal/written communication to senior and executive leadership
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Advanced Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field
• Master's degree and 4 years of experience
• Advanced in SQL, SAS and other data systems
• Experience with tools such as Tableau and Qlik for creating data visualizations
• Expertise in data mining, forecasting, simulation, and/or predictive modeling
• Experience creating analytics solutions for various healthcare sectors

Additional Information

Work at Home Requirements To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. 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.

 

$117,600 - $161,700 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 07-14-2026
About us
 About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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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.