Humana

Compensation

Full Description

Note: The job is a remote job and is open to candidates in USA. Humana Inc. is committed to putting health first and is seeking an Associate Director, HEDIS Operations of Non-Standard Supplemental for business operations. This role supports configuration control, data management, and deficiency reporting while overseeing the non-standard supplemental program to ensure success for Medicare Stars and Medicaid LOBs. Responsibilities • Become an expert in HEDIS & Stars specifications, processes, and schedules • Interpretation of the NCQA technical specifications and regulatory audit requirements to partner on data/process updates; and to provide insights, impacts and guidance to the enterprise • Execution and oversight of seasonal program deliverables; including monitoring both current and upcoming weekly deliverables, ensuring satisfaction of program milestones, and providing transparency into potential risks • Governance of stakeholder deliverables, standards, timelines, milestones, escalations, and issue resolution • Provide leadership and management for the NSS season to ensure optimal outcomes from clinical reviews • Development and maintenance of operational workflows, processes, use of technology and systems • Drive development of new and upcoming systems to complement the operational process and increase productivity • Support clinical quality improvement by championing continuous improvements to operational processes and systems/tools development • Partner to drive and oversee comprehensive program to support quality improvements and holistic data capture • Manage multiple data sets from varying systems to inform resource needs, data value, and report metrics • Interpretation and presentation of data to identify trends and opportunities for improved member health and measure compliance • Internal and external partnerships to coordinate, guide, direct and oversee day-to-day HEDIS activities, including: contingency planning and mitigation, communications, metrics, reporting and prioritization • Identify opportunities across HEDIS processes to ensure compliance and audit requirements are satisfied, while also simultaneously maximizing gap closure • Assist with vendor staffing, strategy, and feedback assessment Skills • Bachelor's Degree or equivalent work experience • 6+ years of relevant experience in operations and/or project management • 2 or more years of management/people leader experience • Demonstrated ability to articulate ideas effectively in both written and oral forms • Be agile and adaptable to shifting priorities • Proficient in balancing numerous projects and resource pools simultaneously • Able to learn and leverage multiple systems and data sets • Self-starter who assumes accountability for their team’s success and strives to maximize results for the enterprise • Master's Degree in Business Administration or a related field Benefits • 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 Company Overview • Humana is a health insurance provider for individuals, families, and businesses. It was founded in 1964, and is headquartered in Louisville, Kentucky, USA, with a workforce of 10001+ employees. Its website is http://www.humana.com. Company H1B Sponsorship • Humana has a track record of offering H1B sponsorships, with 202 in 2025, 246 in 2024, 284 in 2023, 274 in 2022, 212 in 2021, 84 in 2020. Please note that this does not guarantee sponsorship for this specific role.