Demo

Principal, HEDIS Data Quality/Integrity

Humana
Louisville, KY Full Time
POSTED ON 1/30/2025
AVAILABLE BEFORE 3/30/2025

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

The Principal Data Quality/Integrity Engineer understands end-to-end master data processes and flows and uses that knowledge to design and implement master data management solutions. The Principal Data Quality/Integrity Engineer provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience.

Location: remote but strong preference for in person Louisville, KY

The Principal of Data Quality and Integrity will design, implement, and oversee a structured, disciplined approach to data quality and governance, ensuring that our HEDIS data accurately reflects the health status of our members. This role requires assessing data quality across multiple clinical sources, setting up robust performance metrics, and establishing best practices to ensure data accuracy, consistency, and scalability.

In this influential role, the Principal will collaborate extensively with internal teams, enterprise colleagues, and external partners to address both challenges and opportunities in data quality and integration.

Key responsibilities include:

  • Data Quality and Integrity Assurance: Ensure HEDIS data is captured and interpreted correctly for clinical analysis, overseeing comprehensive quality controls, profiling, and validation processes.

  • Data Governance Oversight: Implement regular data quality assessments (e.g., for data types, ranges, formats, completeness) and ensure compliance with business rules and regulatory requirements.

  • Tool and Process Optimization: Identify and deploy leading-edge tools and best practices to enhance data quality frameworks.

  • Data Normalization and Standardization: Oversee data normalization efforts to maintain alignment with HEDIS auditor and clinical guidelines, supporting consistent data interpretation.

  • Continuous Improvement in Data Exchange: Drive improvements with connectivity partners to enhance data exchange processes and optimize clinical data capture.

  • Supplemental Data Health Assessment: Guide efforts to evaluate and strengthen supplemental data connections to improve provider optimization and clinical insights.

  • Data Infrastructure Advancements: Assess, recommend, and execute on opportunities to refine data infrastructure and processes, such as supplemental datamart and data processing reengineering.

  • Stakeholder Communication and Reporting: Establish effective channels to report quality performance and communicate key insights to stakeholders.

  • Compliance and Risk Management: Proactively identify and escalate potential compliance or risk issues, ensuring timely reporting, management, and resolution.


Use your skills to make an impact

Role Essentials

  • Bachelor’s Degree

  • 8 years of experience in data management, data operations, or data warehousing, with a proven track record in quality control.

  • 3 years of experience leading teams or driving initiatives cross-functionally.

  • Comprehensive understanding of health plan operations and clinical data warehousing, including claims and provider data.

  • Working knowledge of HEDIS standards, processes, and reporting.

  • Strong strategic thinking skills with the ability to translate business needs into measurable results.

  • Proven ability to communicate complex data insights to senior management, business leaders, and external stakeholders.

  • Demonstrated skills in KPI and metrics development and oversight.

  • Strong collaboration skills and ability to influence across business areas to align on shared objectives.

  • Exceptional communication skills (written and verbal) with the ability to convey insights to diverse audiences.

Role Desirables

  • Master’s degree in a relevant field

  • Technical proficiency in the software development lifecycle, agile methodologies, ETL processes, and SQL.

  • Strong knowledge of HEDIS standards and regulatory processes.

  • Expertise with electronic health record (EHR) technology and industry clinical exchanges.

  • Technical proficiency in the software development lifecycle, agile methodologies, ETL processes, and SQL.

Additional Information

Humana is an organization with careers that change lives—including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you’re ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.

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.

$142,300 - $195,700 per year

This 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.


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.


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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

Salary : $142,300 - $195,700

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