Data Quality and Integrity Lead - HEDIS

Become a part of our caring community and help us put health first
 

The Lead, Data Quality/Integrity understands end-to-end master data processes and flows and uses that knowledge to design and implement master data management solutions. The Lead, Data Quality/Integrity works on problems of diverse scope and complexity ranging from moderate to substantial.

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

Responsibilities:

• Become an expert in HEDIS guidelines and specifications across all product lines, processes, and internal systems

• Drive internal and external partnerships to coordinate, guide, and oversee the enterprise’s interpretation and implementation of HEDIS regulatory guidelines

• Support clinical quality improvement by defining metrics and reporting needs to highlight gaps or opportunities in clinical data

• Help define requirements for IT enhancements in collaboration with other stakeholders

• Support Stars clinical teams on strategy and initiative implementation

• Partner with areas throughout the enterprise to align with care management initiatives to support HEDIS reporting purposes

• Assist in researching Humana systems and policies to demonstrate compliance with measure specifications

• Ability to decipher regulatory literature, translate that into technical requirements, and effectively communicate requirements, impacts and changes to the enterprise

• Able to complete self-directed data analysis from numerous sources (Oracle, SQL, Excel, etc.) with an understanding of database structure design

• Establish and maintain effective professional relationships with key regulatory partners and maintain library of regulatory guidance received

• Help oversee and facilitate the HQS compliance committee discussions to align clinical and business teams on specification interpretation and strategy

• Champion improvements to existing processes

Use your skills to make an impact
 

Role Essentials

• Bachelor’s Degree or equivalent experience

• 7 years of experience in data research and/or informatics

• Experience with data analysis tools: SQL, Python, R, and/or SAS

• Knowledge of data quality assessment

• 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

• Ability to manage multiple simultaneous time-sensitive deliverables

Role Desirables

• Master's Degree

• Five years HEDIS experience

• HEDIS and/or Medicaid Experience

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

Additional Information

Humana is an organization with careers that change lives—including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you’re ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.

Scheduled Weekly Hours

40

Pay 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.

 

$106,900 - $147,000 per year

 

This 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 06-21-2025

About Us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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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.