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

HQRI is an organization that is responsible for improving health outcomes and advancing the care experience of our members and provider partners through integrated risk adjustment (RA) and quality (Stars) solutions that leverage data and technology to empower members, providers, and Humana. HQRI Health Quality and Stars (HQS) is committed to caring for our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS).The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations.

In this pivotal role, you will provide analytical expertise and strategic insights that drive our Stars program success. Your work will directly support leadership decision-making and the advancement of Stars improvement efforts. This is an exciting opportunity for a seasoned professional to influence outcomes that improve member health, enhance plan quality and drive organizational growth.

Location: Remote but strong preference for Louisville, KY based candidate (combination of in office and work at home)

The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations.

In this pivotal role, you will provide analytical expertise and strategic insights that drive our Stars program success. Your work will directly support leadership decision-making and the advancement of Stars improvement efforts. This is an exciting opportunity for a seasoned professional to influence outcomes that improve member health, enhance plan quality and drive organizational growth.

Key Responsibilities:

Strategic Analysis:

• Analyze the impact of member growth, retention and movement on Star Ratings

• Develop insights that inform business strategies and operational improvements to support Star Rating goals

• Interpret complex data to evaluate program nuances and their implications on performance

Leadership Support:

• Prepare high-quality, data-driven materials for VP and senior leadership discussions

• Participate in strategic conversations, providing actionable insights and recommendations

• Communicate complex analytical findings in a clear and compelling manner to non-technical audiences

Stars Improvement Initiatives:

• Collaborate with cross-functional teams to assess and enhance Stars performance

• Act as a subject matter expert, explaining the intricacies of Stars methodology and metrics

Data Visualization and Reporting:

• Create executive-level dashboards and presentations that showcase key metrics, trends and improvement opportunities

• Ensure data accuracy, consistency and clarity in all reporting and analysis

Use your skills to make an impact

Role Essentials

• Bachelor's degree

• 8 or more years of technical experience in data analysis

• 3 years of experience in Medicare Advantage, Stars programs or healthcare analytics

• Strong understanding of CMS Star Ratings and Medicare Advantage programs

• Exceptional analytical, problem-solving and critical-thinking skills

• 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

• Excellent communication and presentation skills, with the ability to convey complex concepts clearly to senior leadership

Role Desirables

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

• 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

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.

$117,600 - $161,700 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.