The Business Intelligence Lead describes the tools, technologies, applications and practices used to collect, integrate, analyze, and present an organization's raw data to create insightful and actionable business information. The current Special Investigations Unit review process has experienced a significant increase in activity and impact, with new provider reviews rising monthly, increasing stop/void checks, and prepay denials. This role will have a significant focus on Fraud and Waste and its substantially expanded fraud detection and payment prevention efforts. Due to our fast growth, this role will lead internal and enterprise improvement projects such as operational improvements, AI integration, automation, platform implementation and Key Performance Indicators/reporting improvements.
Use your skills to make an impact
Required Qualifications
- Undergraduate degree
- Minimum 8 years of experience in data analysis including enhancing relational data sets for reporting and analytics
- Minimum 2 years of project leadership experience
- Experience with Fraud, Waste, and Abuse in either the healthcare or banking industry
- Advanced experience working with big and complex data sets within large organizations
- Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction
- Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs
- Proficiency in understanding Healthcare related data
- Proficiency in verbal/written communication to senior and executive leadership
Work-At-Home Requirements
- At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested
- Satellite, cellular and microwave connection can be used only if approved by leadership
- Associates 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 associates 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
Preferred Qualifications
- Advanced Degree
- Advanced in SQL, SAS and other data systems
- Experience with tools such as Tableau and Qlik for creating data visualizations
- Expertise in data mining, forecasting, simulation, and/or predictive modeling
- Experience creating analytics solutions for various healthcare sectors
Additional Information
- As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
- If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
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.
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.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.
Skills Required
- Undergraduate degree
- At least 8 years of experience in data analysis, including enhancing relational datasets for reporting and analytics
- At least 2 years of project leadership experience
- Experience with healthcare or banking Fraud, Waste, and Abuse
- Advanced experience working with large and complex datasets within large organizations
- Experience analyzing data to solve business problems and create data visualizations that drive strategic direction
- Ability to work with cross-functional teams and translate requirements between business, project management, and technical teams or programs
- Proficiency understanding healthcare-related data
- Strong verbal and written communication skills with senior and executive leadership
- Advanced degree
- Advanced proficiency in SQL, SAS, and other data systems
- Experience with Tableau and Qlik for data visualization
- Expertise in data mining, forecasting, simulation, or predictive modeling
- Experience creating analytics solutions for healthcare sectors
Humana Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Humana and has not been reviewed or approved by Humana.
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Healthcare Strength — Medical, dental, vision, supplemental health, and long-term care insurance are offered alongside on-site/virtual wellness resources and weekly paid well-being time, indicating a whole-person focus.
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Leave & Time Off Breadth — Paid PTO and holidays, volunteer time, and formal leave options such as parental and caregiver time provide broad time-away support. Adoption assistance and lactation rooms extend coverage for key life events.
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Retirement Support — A 401(k) with company match anchors long-term savings. Employer-matched emergency savings programs complement retirement planning.
Humana Insights
What We Do
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
