Humana

Compensation

Full Description

Job Description: • Collaborate with IT teams and business stakeholders to identify, prioritize, and deliver technology solutions that directly support Medicaid strategic objectives. • Oversee the lifecycle management of Business Managed Solutions (BMS) and Robotic Process Automation (RPA) initiatives, ensuring consistency with enterprise architecture, data security, and regulatory compliance. • Define and implement governance principles for distinguishing between BMS and enterprise IT assets, and ensure appropriate documentation and transition when necessary. • Develop, communicate, and execute a comprehensive Medicaid data strategy that aligns with both enterprise-wide and state-specific requirements, including compliance with all relevant regulations. • Assess the need for Medicaid-specific data domains, and establish processes for the consistent use of verified and trusted data sources in all reporting and analytics for both state and enterprise use cases. • Establish clear Medicaid data ownership and stewardship roles to ensure accountability, particularly during new state program implementations and for management of historical claims data. • Create and lead a Medicaid Data Governance Council, providing oversight for data quality, access, and usage standards. • Identify and resolve gaps in data ownership, including those related to files received from external entities and vendors. • Champion a culture within Medicaid operations that recognizes data as a strategic asset critical to organizational success. • Act as a facilitator and translator between business and technical teams, ensuring all cross-domain data needs are clearly understood and addressed. • Lead programs and training initiatives to improve data literacy and analytical skills across all Medicaid teams. • Expand data governance frameworks to include principles of AI ethics, fairness, transparency, and ongoing model monitoring for Medicaid use cases. • Develop a clear roadmap for AI/ML applications in Medicaid, including processes for evaluation, implementation, and compliance with evolving state and federal requirements. • Partner with enterprise AI teams to advocate for and address Medicaid-specific needs and priorities. • Ensure all Medicaid teams understand and consistently apply corporate policies regarding BMS, including documentation, security, and compliance protocols. • Define, communicate, and enforce criteria for determining when a solution qualifies as a BMS versus an enterprise IT asset. • Collaborate to co-develop the strategic roadmap for the Medicaid Data Integration team, focusing on scalability, interoperability, and future-state architecture. • Lead prioritization of integration use cases, and oversee the migration of data from legacy systems to enterprise data platforms or the Medicaid data lake, ensuring data integrity and accessibility. • Direct and mentor the team responsible for Medicaid-focused data visualization and BI reporting, ensuring high standards of accuracy, timeliness, and relevance. • Oversee the delivery of reports and dashboards that support operational, regulatory, and strategic decision-making for Medicaid programs. • Drive the adoption of enterprise BI tools and reporting standards, ensuring consistency and alignment with organizational best practices. • Collaborate with internal and external stakeholders to define and monitor key performance indicators (KPIs) and reporting requirements. • Promote self-service analytics capabilities, while maintaining robust data governance and integrity controls. Requirements: • Bachelor's Degree of Business Administration, Computer Science or a related field • 6 or more years of management experience • Experience leading and establishing data governance and executing on a data strategy • Experience working for a Health Plan organization • Experience overseeing the lifecycle management of Business Managed Solutions (BMS) and Robotic Process Automation (RPA) initiatives within an organization • Experience problem solving and consultation within complex environments • Experience facilitating cross-functional teams' efforts • Must be passionate about contributing to an organization focused on continuously improving consumer experiences • Must be able to work EST hours • Ability to travel to Louisville, KY 15%-20% of the time Benefits: • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Volunteer time off • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Other opportunities