Senior Data Quality/Integrity Engineer

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

Humana’s Health Quality and Stars organization is seeking a Senior Data Quality/Integrity Engineer to deliver quality and value in a fast-paced, dynamic environment. The successful candidate will be self-directed, highly-engaged, and will demonstrate expertise and business intelligence in supporting execution of the HEDIS program and related activities, all within tightly regulated requirements and timelines. This will require building and maintaining strong relationships with corporate and market teams, including IT, Quality Operations and Compliance, and Risk Adjustment, as well as vended partners.

The Senior Data Quality/Integrity Engineer is accountable for engaging in and supporting all aspects of the HEDIS program and regulatory operations, including: vendor oversight, process development, system and technical configurations, and management of efforts to maximize HEDIS results.  The Senior Data Quality/Integrity Engineer champions a collaborative environment where the team and connected partners align on appropriate strategies for each successful season, ensuring all regulatory submissions of data collection and reporting are accurate, complete and timely. This position requires demonstration of a high level of business acumen as well as cultivating and maturing partnerships within the enterprise. Through individual and team contributions, the Senior Data Quality/Integrity Engineer is responsible for the following:

• Become an expert in HEDIS & Stars specifications, processes, and schedules
• Interpretation of the NCQA technical specifications and regulatory audit requirements to partner on data/process updates; and to provide insights, impacts and guidance to the enterprise
• Development and maintenance of operational workflows, processes, use of technology and systems
• Support clinical quality improvement by championing continuous improvements to operational processes and  systems/tools development
• Partner to drive and oversee comprehensive program to support quality improvements and holistic data capture
• Manage multiple data sets from varying systems to inform resource needs, data value, and report metrics
• Interpretation and presentation of complicated and large data sets to identify trends, data scenarios, and opportunities for improved member health and measure compliance
• Internal and external partnerships to coordinate, guide, direct and oversee day-to-day HEDIS activities, including: contingency planning and mitigation, communications, metrics, reporting and prioritization
• Development, tracking and presentation of metrics to ensure data quality, timeliness, and accuracy
• Identify opportunities across HEDIS processes to ensure compliance and audit requirements are satisfied, while also simultaneously maximizing gap closure

Professional Maturity

• Passion for contributing to a cross-functional team focused on continuously improving member experiences and clinical outcomes though data analysis and interpretation
• Establish and maintain effective professional relationships with key upstream and downstream partners

Operational Execution

• Ensure data quality, timeliness and accuracy
• Leverage existing talent and expertise within department to drive efficiency and effectiveness
• Champion improvements to existing processes

Use your skills to make an impact
 

Required Qualifications

• 3+  years experience in healthcare, insurance or related industry
• Bachelor’s Degree or equivalent experience
• Successful experience managing complex projects beginning-to-end
• Proficiency in compiling, analyzing, and interpreting data trends
• Strong analytical skills and experience with large, complicated datasets
• Strong consultative and collaborative skills working with a variety of teams and internal/external partners to influence and align on business objectives
• Self-starter – comfortable working independently to accomplish components of a larger program
• Strong organizational and time management skills
• Self-motivated, proactive, with demonstrated professional maturity and emotional resilience
• Comfortable working in fast-paced environment with an ability to manage multiple simultaneous time-sensitive deliverables
• Demonstrated excellence in problem solving/critical thinking with exceptional attention to detail
• Demonstrated ability to articulate ideas effectively in both written and oral forms to effectively communicate across teams, levels and functions
• Proficiency in Microsoft Office applications, including Word, Excel, PowerPoint and Visio

Preferred Qualifications

• 3+ years of technical experience in data reporting
• Stars or HEDIS Experience
• Process proficiency with ability to develop new end-to-end processes and effectively optimize existing work processes to predict, address and resolve efficiency and accuracy constraints

Additional Information

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.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana’s secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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.$89,000 - $121,400 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 10-07-2025

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.