Utilization Management Data Analyst Author by Humana

Profile

Description

Responsibilities

Author, recently launched by Humana, is a service experience designed to meet the whole-health needs of the people we serve. Created to innovate with the speed and agility of a modern start-up and backed by the insights and scale of Humana, Author is pioneering a customer-centered experience designed to foster trusting relationships with members to help them achieve their best health.

Dedicated to simplifying the healthcare experience and helping people navigate their healthcare journey, Author is leveraging digital technologies to eliminate fragmentation and systematic friction for members and providers.

We are seeking individuals who are passionate about solving tough problems as we forge a new path for the healthcare industry. As a member of the Author team, you will have the opportunity to make a difference in the lives and health of the members we serve.

Description

The Health Team Utilization Management (UM) Analyst answers complex business questions and solves operational challenges using datasets from a variety of sources, analyzing these to provide relevant insights to decision-makers. This Analyst focuses on the ideation, creation, and upkeep of operational reporting and related collateral intended to provide Author's UM function with 'the right insights at the right time'. This work aims to improve productivity, inform staffing and investment, enable targeted flagging and review of authorizations, and generally support the team's evolving workflows within the UM function of the business. The outputs of this work are varied - including reports, extracts, aggregated metrics, investigative findings, and data visualizations - and frequently require independent interpretation, determination, and communication of the appropriate courses of action.

This work is delegated as part of a broader insights function within the Health Team, which collaborates alongside other business intelligence, analytics, and technology teams to support the holistic Analytics program at Author.

Responsibilities

The Health Team UM Analyst collects, analyzes, and presents data proving insightful and actionable business information. The UM Analyst has a firm understanding of department and organizational strategy and operating objectives, including their linkages to related areas. With this understanding, the Analyst works with the Health Team Insights Lead and UM leadership on directed projects, while occasionally making decisions regarding analytical methods with limited direction. The Analyst consistently follows established guidelines/procedures, while participating in the creation or review of relevant processes.

Works directly with the UM Team and Health Team Insights Lead, helping them leverage data and technology to address needs specific to the Utilization Management function of the business

Supports the design and delivery of UM-focused reporting to support operational (e.g. authorization-level reporting, performance and efficiency metrics) and strategic (e.g. KPI readouts, manager reports, population dashboards) projects

In partnership with the Health Team Insights Lead, assesses business processes and data flows and identified needs in order to design and build operational reports, address analysis requests, and produce other collateral

Creates documentation capturing the workflows and methods used for producing collateral

Writes queries to pull/summarize/analyze data from various data sets and platforms

Performs various manual-run and/or ad-hoc analyses of data to derive targeted, meaningful, and actionable insights

Participates in Agile team ceremonies and planning efforts for the Health Team

Partners with business stakeholders and analytics/data teams across Author to identify data and technology needs and support their implementation

Required Qualifications

2 years of data analysis experience in a relevant discipline, with exposure to Utilization Management and/or authorization-based strategic and operational reporting

Demonstrable experience analyzing multi-sourced data to solve a wide variety of business problems

Demonstrable experience creating reports, presentations, data visualizations and similar collateral that effectively communicate insights and discoveries to business stakeholders

Strong Excel knowledge, including advanced capabilities (PivotTables/PowerPivot, PowerQuery, VBA, etc.)

Strong SQL knowledge, with experience querying and analyzing data across multiple sources

Familiarity with using BI tools (PowerBI, Looker, Tableau, etc.) for modeling and visualization of data

Comfort with working on many concurrent projects, some with tight turnaround times

Proficiency in verbal and written communication of work, including with senior and executive leadership

Bachelor's Degree

Less than 5 years of technical experience in data analysis

Comprehensive knowledge of Microsoft Office Applications including Word, Excel, Access and PowerPoint

Expertise in assessing complex data sets and performing root cause analysis

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Advanced Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field

1 or more years of experience in SQL, SAS or other data systems

In-depth experience in Microsoft Excel including formulas, pivots, charts, graphs, etc.

Experience with data mining and predictive modeling techniques

Ability to use data to drive business outcomes and decisions

Bachelor's Degree in mathematics, computer science, computer information systems, or a related field

Proficiency in the general business functions of a Medicare Advantage payer, and/or the broader health insurance industry

Proficiency with Agile development methodologies and/or SAFe principles and familiarity with traditional scrum ceremonies and roles

Experience programming in languages such as Python and R, particularly in service of data science or data analysis projects

Experience building ETL solutions for the movement and preparation of data for analysis or reporting

Experience working in a GCP-based data environment (BigQuery, Data Stud

Additional Information

#Author

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com