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Job Information

Humana Healthcare Data Analyst in Louisville, Kentucky

Description

The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our financial recovery. The Payment Integrity Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

As a Payment Provider Integrity reporting consultant you will: provide strategic leadership and consultation services for the various areas/departments within Payment Provider Integrity. You will complete analyses and prepare disclosure materials while interacting and building partnerships with Humana's claim cost management, communications, and information technology teams and with external vendors.

  • Create and manage various types of reporting for Payment Provider Integrity activity, including but not limited to savings projections, monthly dashboards, metrics, project assignments, etc.

  • Communicate findings at committee meetings and other touch points as necessary with internal shareholders

  • Manage special projects - monitoring progression at a granular level, reviewing assumptions and tracking changes, etc...

  • High collaboration among the Payment Provider Integrity departments, ensuring all applicable parties are made aware of project progression, issues that may arise, successes, etc... while bringing those to the Corporate Finance table for read out of updates monthly.

  • Act as a liaison between multiple business partners to identify and resolve problems and concerns

Required Qualifications

  • Bachelor's Degree or Higher

  • Previous experience leading projects/people

  • Professional experience using Microsoft Word, Excel (including formulas, pivots, charts, graphs, etc), Access, and PowerPoint

  • Self-sufficient, self-starter

  • Intermediate professional experience using SQL Programs including Microsoft Access

  • Excellent communication skills, both written and verbal

  • Excellent presentation skills

Preferred Qualifications

  • Experience in Financial Recovery

  • Experience using the following systems: CAS, MTV, CIS PRO, and CIS

  • Experience in a fast paced, metric driven operational setting

  • Bilingual in Spanish and English

  • PMP Designation

Additional Information

  • In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. 

Scheduled Weekly Hours

40

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