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Humana Senior Informaticist - Specialty Drug Pharmacy Analytics in Louisville, Kentucky

Description

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.

Responsibilities

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

Required Qualifications

  • 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

Preferred Qualifications

  • Advanced Degree

  • Six Sigma certification

  • Prior exposure to tableau and/or Power BI tool development

Scheduled Weekly Hours

40

About Us

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.

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailboxtasrecruit@humana.com for assistance.

Humana Safety and Security

Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailboxtasrecruit@humana.com to validate the request.

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