Senior HEDIS and Medicaid Data Manager job




The Senior Data Manager supports all aspects of configuration control, data management, and deficiency reporting. The Senior Data Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.


Humana’s Health Quality and Stars organization is seeking a Senior HEDIS Data Manager to deliver quality and value in a fast-paced, dynamic environment to support our Medicaid program through engaging in the transformation of clinical data to inform operational and strategic decision making, collaboration with partners across the enterprise and support of the HEDIS program and related activities. This will require building and maintaining strong relationships with corporate and market teams, including IT, Quality Operations and Compliance, and vended partners.


+ Become an expert in HEDIS and Medicaid specifications, processes, and schedules

+ Partner to develop comprehensive Medicaid program to support state measure needs, development, and reporting

+ Drive internal and external partnerships to coordinate, guide, and oversee implementation of clinical measures, as well as all related regulatory activities and reporting

+ Interpretation and presentation of complicated and large data sets to identify trends, data scenarios, and opportunities for improved member health and measure compliance

+ Ability to decipher regulatory literature and effectively communicate impacts and changes

+ Apply critical thinking skills to develop queries, isolate impacts of regulatory changes, and identify patterns in clinical data using Excel, SQL, SAS, etc.

+ Analyze data to solve a wide variety of business problems and creation of data visualizations that drive strategic vison

+ Partnership with IT and HEDIS NCQA-certified vendor on tool and reporting enhancements

+ Establish and maintain effective professional relationships with key upstream and downstream partners

+ Ensure data quality, timeliness and accuracy

+ Champion improvements to existing processes

**Required Qualifications**

+ Bachelor’s Degree or equivalent experience

+ Proficiency in compiling, analyzing, and interpreting data trends and working with large data sets

+ Data analysis and data interpretation experience

+ Superb communication skills (written and verbal) to effectively communicate across teams, levels and functions

+ Self-starter – comfortable working independently to accomplish components of a larger program

+ Strong organizational and time management skills

+ Demonstrated excellence in problem solving/critical thinking with exceptional attention to detail

+ Ability to manage multiple simultaneous time-sensitive deliverables

+ Travel – up to 10%

**Preferred Qualifications**

+ Master’s Degree

+ Project management experience

+ HEDIS and/or Medicaid Experience

+ Advanced proficiency in Excel, SQL, SAS, or other data systems

**Additional Information**

This position is located at the Humana Tower in Louisville, Kentucky as well as working remote.

**Scheduled Weekly Hours**



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