Senior Informaticist at Humana Studio_h
The Senior Informaticist coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Senior Informaticist work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Informaticist leverages their advanced knowledge of data, business acumen, optimization, and tools. The role applies disciplined analytics for measuring, reporting, root cause, and evaluation of data and information to support efforts on improving operations, lowing healthcare cost, and improving care quality. Contributes to innovative approaches in clinical and financial insights as they build knowledge of the business context in which they operate. Understands and analyzes complex data, articulates to various units within the company at the appropriate level, impacts the business from logical concepts which have a potentially sizeable dollar impact on the business. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for program components, and performs work with minimal direction. Exercises considerable latitude in determining objectives and approaches to assignments.
This position will play a pivotal role in the creation of the Humana Military future. You will be a member of a cross-functional team comprised of clinicians, informaticists, data scientists, actuaries, and technologists working to measure and enhance the costs and quality delivered to our population. This role is responsible for delivering cost and quality information and insights to support evolving use cases.
- Summarize and synthesize data, information, and business knowledge from multiple sources, interpret and translate findings into meaningful information and actionable reports for the purpose of improving our financial position and the health and well-being of our members
- Provide thought leadership and project advancement to create population and provider cost and quality measurement solutions
- Participate in requirement gathering, analysis, reporting, and insight development
- Develop and sustain relationships with technical and business SMEs to create shared learning and solution alignment
- Develop new solutions and continually identify ways to improve current deliverables by increasing their value and usability
- Be comfortable and confident within ambiguity while completing ad hoc and special projects
- Our Department of Defense contract requires U.S. Citizenship
- Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)
- Bachelors’ degree in technical, business, or healthcare
- Experience in clinical informatics, managed care, health plan systems, and medical claims
- Expertise with SQL / SSIS
- Knowledge of the Healthcare Effectiveness Data and Information Set Measures (HEDIS)
- Experience with provider cost and quality measurement programs
- Strong understanding of healthcare information standards clinical coding sets such as ICD, CPT/HCPCS, and DRG
- Experience with modeling tools like R, Python, or SAS
- Experience with Optum Symmetry ETG and EBM Connect
- Proficiency with reporting and data visualizations tools (Tableau/Power BI)