Humana HEDIS Program Consultant in Louisville, Kentucky

Role: HEDIS Program Consultant
Assignment: Quality Systems Integration
Location: Louisville, KY

At Humana, we want to inspire people to live life fully by awakening them to the right choices for themselves and each other. As the healthcare industry changes and evolves, we’re changing too. We’re growing and re-shaping to become an organization that is committed to helping people achieve lifelong well-being. Humana is an organization where change is constant, and we always have our consumers in mind. We’re known as an innovator in our industry, with a history of being out front of where healthcare needs to go. We need people with a passion for helping others and making change happen. We don’t want to be like everyone else in the industry—we want to be better. And we’re looking for talent that wants to grow, be challenged and inspired to help make that happen.

Role Description Be a part of our Clinical Space - Provide guidance to facilitate interaction or services that connect people with lifelong well-being.

Humana is seeking a HEDIS Program Consultant who will collect and analyze multi-faceted data which support the preparation, execution, and submission of Federal- and State-Level regulatory requirements for clinical quality measures. You will help Humana drive customer quality through the management & execution of HEDIS reporting seasons. This role will:

  • Serve as an expert in HEDIS measurement, analytics, and reporting

  • Provide consultative support to internal and external partners to facilitate understanding and provide guidance around HEDIS submission

  • Provide interpretation and communication of HEDIS and state technical specifications as it pertains to CMS, STARS, Medicaid, Medicare

  • Access and analyze data from internal and external systems to satisfy internal business and external regulatory requirements

  • Meeting and developing on regulatory reviews and quality improvement opportunities with internal partners

  • Coordinate the development and management of necessary vendor solutions to support HEDIS requirements

  • Design, develop, and deliver operational reports, dashboards, and ad hoc requests

  • Identify opportunities to improve and enhance current reports, increasing value and usability

    Role Essentials

  • Bachelor’s Degree or equivalent work experience

  • Strong analytical and creative problem-solving skills

  • Experience identifying and communicating data driven insights to internal and external business partners

  • Excellent PC skills with basic function and strong navigation skills to in Excel

  • High attention to detail

  • Strong verbal and written communication skills

  • Ability to meet and manage time sensitive tasks

  • Ability to work independently under general instructions, self-directed and motivated Role Desirables

  • HEDIS experience

  • Experience providing consultative guidance to audiences on a variety of levels

  • Knowledge of quality Improvement and/or process Improvement

Title: HEDIS Program Consultant

Location: KY-Louisville

Requisition ID: 177510