Medicaid Business Intelligence Lead
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Job Description
Medicaid BI Lead modernizing enrollment analytics, compliance reporting, and scalable data solutions for Humana’s healthcare business. Supporting state implementations and Medicaid Enrollment Operations.
Responsibilities:
- Lead state implementation readiness efforts for Medicaid markets
- Support regulatory and contractual reporting
- Lead enrollment analytics and compliance monitoring
- Develop analytics modernization initiatives across Medicaid markets
- Solve complex business problems using internal and external data sources
- Provide actionable insights and strategic direction to business leaders
- Serve as the primary analytics lead for Medicaid Enrollment Operations initiatives
- Design and implement analytics solutions with business leaders, operational teams, compliance organizations, and technology partners
- Exercise independent judgment on issues affecting state compliance, enrollment operations, contractual reporting, membership reporting, reconciliation, and operational performance
- Use Databricks, Power BI, SQL, and cloud-based data environments to create reusable and scalable solutions
- Influence strategy and identify operational efficiency opportunities
- Establish reporting standards and drive modernization efforts
- Reduce implementation effort while improving compliance, operational visibility, and business outcomes
Requirements:
- Bachelor's degree in Business, Information Systems, Data Analytics, Healthcare Administration, Computer Science, or related field
- 5+ years of healthcare analytics experience supporting complex operational processes
- 5+ years of experience working with large healthcare datasets, data warehouses, and analytic platforms
- 5+ years of advanced SQL development experience
- 5+ years of experience designing and delivering Power BI dashboards and reporting solutions
- Demonstrated experience supporting Medicaid business
- Demonstrated expertise with 834 enrollment transactions, membership reporting, and related operational controls
- Experience with Databricks, cloud-based analytics platforms, and modern data architecture practices
- Ability to independently lead cross-functional initiatives
- Strong verbal and written communication skills with demonstrated ability to communicate to executive leadership
- Experience driving process improvement and operational efficiency initiatives through data and analytics
- Ability to function as an internal consultant and trusted advisor to business partners
- Passion for improving member experiences through data-driven decision making
- This role is not eligible for work visa sponsorship
- Home-based work requires a minimum internet speed of 25 Mbps download and 10 Mbps upload
- Dedicated workspace required to protect member PHI/HIPAA information
Benefits:
- Bonus incentive plan based on company and/or individual performance
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Paid time off
- Company holidays
- Personal holidays
- Paid parental leave
- Paid caregiver leave
- Short-term disability
- Long-term disability
- Life insurance
- Whole-person wellness support
- Occasional travel to Humana offices for training or meetings
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