Medicaid 业务智能负责人
Medicaid Business Intelligence Lead
成为我们关怀社区的一员
业务智能主管负责支持医疗补助计划注册的主分析和注册运营专家。该职位负责领导各州实施准备工作的努力，监管和合同报告支持、注册分析、合规监控以及整个医疗补助市场的分析现代化。业务智能主管利用内部和外部数据源解决复杂的业务问题和运营挑战，为业务领导者提供可操作的见解和战略方向。该职位是支持医疗补助注册运营计划的主要分析负责人，负责各州实施准备、注册分析、合规监控和可扩展解决方案架构。
该职位作为战略个人贡献者和内部顾问，与业务领导者、运营团队、合规组织和技术合作伙伴合作，设计和实施分析解决方案。业务智能主管在影响各州合规性、注册运营、合同报告义务、会员报告、对账流程和运营绩效的复杂问题上拥有独立判断和决策权。
该职位利用现代分析平台，包括 Databricks、Power BI、SQL 和基于云的数据环境，创建可重用和可扩展的解决方案，以支持当前和未来的医疗补助市场扩展。该职位需要影响战略，识别运营效率提升的机会，建立报告标准，并推动现代化工作，以减少实施工作量，同时提高合规性、运营可见性和业务成果。
运用你的技能产生影响
所需资格条件
- 商业、信息系统、数据分析、医疗保健管理、计算机科学或相关领域的学士学位
- 5年以上支持复杂运营流程的医疗保健分析经验
- 5年以上处理大型医疗数据集、数据仓库和分析平台的经验
- 5年以上高级 SQL 开发经验
- 5年以上设计和交付 Power BI 仪表板和报告解决方案的经验
- 有支持医疗补助业务的实际经验
- 在 834 注册交易和会员报告方面有实际专业知识
查看英文原文
Become a part of our caring community
The Business Intelligence Lead serves as the primary analytics and enrollment operations expert supporting Medicaid Enrollment. This role is responsible for leading state implementation readiness efforts, regulatory and contractual reporting support, enrollment analytics, compliance monitoring, and analytics modernization across Medicaid markets.The Business Intelligence Lead solves complex business problems and operational challenges using internal and external data sources to provide actionable insights and strategic direction to business leaders. This role serves as the primary analytics lead supporting Medicaid Enrollment Operations initiatives, with responsibility for state implementation readiness, enrollment analytics, compliance monitoring, and scalable solution architecture.
This associate functions as a strategic individual contributor and internal consultant, partnering with business leaders, operational teams, compliance organizations, and technology partners to design and implement analytics solutions. The Business Intelligence Lead exercises independent judgment and decision-making authority on complex issues affecting state compliance, enrollment operations, contractual reporting obligations, membership reporting, reconciliation processes, and operational performance.
The role leverages modern analytics platforms including Databricks, Power BI, SQL, and cloud-based data environments to create reusable and scalable solutions supporting current and future Medicaid market expansions. This associate is expected to influence strategy, identify opportunities for operational efficiencies, establish reporting standards, and drive modernization efforts that reduce implementation effort while improving compliance, operational visibility, and business outcomes.
Use your skills to make an impact
Required Qualifications
- 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
Preferred Qualifications
- Medicaid managed care experience
- Experience supporting state implementations, market expansions, or operational readiness initiatives
- Experience supporting state reporting, contractual requirements, compliance monitoring, and audit activities
- Advanced Databricks development experience
- Experience building reusable data products and scalable reporting architectures
- Experience with enrollment systems, eligibility processing, membership reconciliation, and operational workflow optimization
- Expertise in healthcare operational reporting, automation, and process modernization
- Lean, Six Sigma, Agile, or process improvement experience
- Master's degree in Analytics, Information Systems, Public Health, Business Administration, or related discipline
Additional Information
This role is not eligible for work visa sponsorship.
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
40Pay 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 yearThis 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: 10-01-2026
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.
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.
Originally posted on Himalayas