Medicaid Compliance Business Intelligence Lead - Remote US

Become a part of our caring community and help us put health first
 Humana Healthy Horizons is seeking a Medicaid Compliance Business Intelligence Lead who describes the tools, technologies, applications, and practices used to collect, integrate, analyze, and present the Medicaid segment's compliance data to solve complex business problems, issues, and enable Market and National Medicaid Operations (NMO) leaders to make informed decisions based off current and historical compliance information in their Market and others.

The Medicaid Compliance Business Intelligence Lead will support the Medicaid Audit, Policy, and Reporting team (MAPR) through data leadership by utilizing the work performed by MAPR through Enterprise Solution Points (ESP) and other compliance tools/applications.


All work managed by MAPR is currently housed within Enterprise Solution Point (ESP) - Audits, Readiness, P&P Management, BRV, and State Reporting. The Medicaid Compliance Business Intelligence Lead will become an expert on ESP as well as a thought-leader on utilizing data more efficiently within the segment to manage compliance risk needed to support current Medicaid compliance operations as well as projected segment growth.

Roles and responsibilities for this position include:

  • Work closely with the team that owns and manages ESP from an Enterprise perspective.
  • Humana’s voice for Medicaid, to track and ensure Medicaid enhancements are accounted for and prioritized.
  • Create customized reporting/dashboard to visualize and communicate compliance-related insights to market leaders and stakeholders, enabling more informed decision making.
  • Advises executives in the development of functional strategies (often segment specific) on matters of significance.
  • Exercises independent judgment and decision making on complex issues regarding job duties and related tasks and works under minimal supervision.

Use your skills to make an impact

Required Qualifications

  • Bachelor's Degree.
  • 2+ years of project leadership experience.
  • 5+ years of technical experience in data analysis/data visualization.
  • Proficient in Power BI and experience with tools such as Tableau and/or Qlik for creating data visualizations and dashboards.
  • Experience analyzing data to solve a wide variety of business problems; ability to create data visualizations that drive strategic direction.
  • Proficiency in understanding Healthcare related compliance data.
  • Proficiency in verbal/written communication to senior and executive leadership.
  • Must reside in the eastern or central times zones in the contiguous United States.

Work at Home Requirements

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
  • Satellite, cellular and microwave connection can be used only if approved by leadership.
  • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Preferred Qualifications

  • Advanced graduate degree.
  • Advanced in SQL, SAS, and other data systems.
  • Experience with Enterprise Solution Point (ESP).
  • Experience creating analytics solutions for various healthcare sectors.
  • Possess a solid understanding of Humana's operations, technology, communications, and processes and can understand complex connections in those spaces.

Additional Information:

  • Workstyle: Remote
  • Location: Must reside in the eastern or central times zones in the contiguous United States.
  • Core Workdays & Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).
  • Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.....  

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, a third-party vendor.  This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.  If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided.  Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours


Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$104,800 - $144,300 per year


This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.
About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.