Senior Data Quality Engineer

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

📋 Description

• Comprehend end-to-end data processes and workflows, implementing and executing operations for essential, data-driven processes.

• Formulate and execute a strategy for supplemental and lab data.

• Analyze, identify, and engage significant Provider data connections to acquire data that facilitates HEDIS gap closures.

• Develop relationships with STARs and market teams.

• Create and enhance quality control processes and systems for supplemental and lab data connections.

• Collaborate with market and Provider offices to establish valuable data connections and educate them on data intake processes and protocols.

• Communicate data processing status and areas for improvement to markets and Providers.

• Collaborate with Medicare Risk Adjustment (MRA) and vendors to establish STARs data feeds and optimize the quality of procured data.

• Establish and enhance data quality practices to support the annual HEDIS season and Humana strategy.

• Assist the STARs Clinical Team in sourcing data for pilot programs and Humana acquisitions.

• Submit FTP requests, approve UAT and post-production validation, and collaborate on the development and deployment of data-focused enhancements and functionalities.

• Support annual standard and non-standard supplemental data audits with NCQA and DTS auditors.

⛳️ Requirements

• Bachelor’s Degree.

• At least 5 years of experience in the healthcare sector and/or with lab data.

• Minimum of 3 years in a data-focused role using analytics, reporting, and business intelligence platforms such as SQL and others.

• Proficiency in SQL, PowerBI, and Azure DevOps.

• Outstanding communication skills; including presentation, facilitation, verbal, and written abilities.

• Preferred: Master’s degree.

• Preferred: 5 years of specific experience in clinical/lab data processing or HEDIS, demonstrating data manipulation and analysis skills.

• Preferred: Experience in provider engagement, MRA or Stars.

• Preferred: Familiarity with HEDIS measures.

• Preferred: Knowledge and experience with HCPCS and CPT codes.

• Capability to assign and complete priorities in a dynamic and fast-paced environment.

• Candidates from the Louisville, Kentucky, or Indiana area are highly preferred for occasional in-person meetings.

• Minimum internet speeds of 25 Mbps download and 10 Mbps upload required for Home or Hybrid Home/Office employees.

• Ability to work from a dedicated space free from ongoing interruptions to protect member PHI / HIPAA information.

🏝️ Benefits

• Bonus incentive plan based on company and/or individual performance.

• Medical, dental, and vision coverage.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Internet expense reimbursement for employees working from home in California, Illinois, Montana, or South Dakota.

• Telephone equipment suited to business needs for Home or Hybrid Home/Office employees.