Medicaid Business Intelligence Lead

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee state implementation readiness activities for Medicaid markets

• Assist in regulatory and contractual reporting processes

• Lead analytics related to enrollment and monitor compliance

• Initiate analytics modernization projects throughout Medicaid markets

• Address complex business challenges by utilizing both internal and external data

• Deliver actionable insights and strategic guidance to business leaders

• Act as the primary analytics authority for Medicaid Enrollment Operations initiatives

• Collaborate with business leaders, operational teams, compliance organizations, and technology partners to design and implement analytics solutions

• Make independent judgments on matters impacting state compliance, enrollment operations, contractual reporting, membership reporting, reconciliation, and operational performance

• Utilize Databricks, Power BI, SQL, and cloud-based data environments to develop reusable and scalable solutions

• Shape strategy and recognize opportunities for operational efficiency

• Set reporting standards and lead modernization initiatives

• Decrease implementation efforts while enhancing compliance, operational visibility, and business results

⛳️ Requirements

• Bachelor's degree in Business, Information Systems, Data Analytics, Healthcare Administration, Computer Science, or a related field

• Over 5 years of experience in healthcare analytics supporting intricate operational processes

• More than 5 years of experience working with extensive healthcare datasets, data warehouses, and analytic platforms

• At least 5 years of advanced SQL development experience

• Over 5 years of experience in designing and delivering Power BI dashboards and reporting solutions

• Proven experience in supporting Medicaid business operations

• Established expertise with 834 enrollment transactions, membership reporting, and associated operational controls

• Familiarity with Databricks, cloud-based analytics platforms, and contemporary data architecture practices

• Capability to independently lead cross-functional projects

• Excellent verbal and written communication skills with a proven ability to engage with executive leadership

• Experience in advancing process improvement and operational efficiency initiatives through data and analytics

• Ability to act as an internal consultant and trusted advisor to business stakeholders

• Commitment to enhancing member experiences through data-driven decision-making

• This position does not qualify for work visa sponsorship

• Remote work requires a minimum internet speed of 25 Mbps download and 10 Mbps upload

• A dedicated workspace is necessary to safeguard member PHI/HIPAA information

🏝️ Benefits

• Bonus incentive program based on company and/or individual performance

• Comprehensive medical benefits

• Dental coverage

• Vision insurance

• 401(k) retirement savings plan

• Paid time off

• Company holidays

• Personal holidays

• Paid parental leave

• Paid caregiver leave

• Short-term disability coverage

• Long-term disability coverage

• Life insurance

• Holistic wellness support

• Occasional travel to Humana offices for training or meetings