Humana Senior Informaticist - Specialty Drug Pharmacy Analytics in Louisville, Kentucky
The Senior Informaticist coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Senior Informaticist work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Informaticist leverages its advanced knowledge of data, modeling, optimization, and tools. Applies disciplined analytics to predict behavior and optimize programs and products to maximize revenue growth. Utilizes advanced or predictive modeling to develop, test and validate cases that improve the outcomes and quality of the programs we offer. Contributes to more innovative approaches to financial models as it builds knowledge of the business context in which it operates. Understands and analyzes complex data, articulates to various units within the company at the appropriate level, impacts the business from mathematical concepts which have a potentially sizeable dollar impact on the business. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
Humana is seeking a Senior Informaticist in Humana Pharmacy Analytics to support the Specialty Strategy team in short-term and long-term analysis and planning. In this role, you will support the development, implementation, and management of specialty tools to identify opportunities for clinical, benefit maximization, and Humana cost interventions.
Specific role responsibilities will include:
Perform deep-dive analysis into high-dollar disease states to better understand prevalence, total cost of care components, and identify trends and outliers
Develop and maintain savings trackers for the specialty initiatives
Participate in strategy development and review of competitive information
Perform market sizing and trending analysis to show the shifts over time to support future program valuations and execution plans
Evaluate and implement improved management processes, reimbursement strategies, claim edits, reporting, and ongoing opportunity mining to reduce payment issues and increase cost control
Evaluate the impacts of benefit design and utilization management strategies
Bachelor's degree and 5 or more years of data analytics experience OR Master's degree and 3 years of experience
Experience with data mining, predictive modeling techniques and using data to drive business outcomes and decisions
Knowledge of Specialty drugs and/or medical claims
Intermediate to Advanced knowledge of SQL and/or SAS programming
Excellent verbal and written communication
Able to articulate and present findings and insights to senior leadership
Strong attention to detail
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Six Sigma certification
Prior exposure to tableau and/or Power BI tool development
Scheduled Weekly Hours
Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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