Associate Director, DSNP Encounter Submissions

The Associate Director, Business Intelligence solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Associate Director, Business Intelligence requires a solid understanding of how organization capabilities interrelate across department(s).

The Associate Director, DSNP Encounter Data management will identify and analyze inventory and will ensure encounter submissions meet or exceed all compliance standards via analysis of data, and develop tools to enhance the encounter acceptance rates. This role will work on strategic initiatives and will need to solve problems of diverse scope and complexity ranging from moderate to substantial. This role will utilize various tools, technologies, applications, and data resources. The role will lead a team of up to approx. 7-9 direct associates.

Key Responsibilities include:

• Lead and develop a team focused on strategic understanding encounter workflow, execute inventory management of encounters submissions & deliver key performance indicators.
• Implement new DSNP states for encounter submissions including policy and procedures and key performance indicators.
• Champion increased operational efficiency by driving process improvements.
• Build strong relationships and influence across all levels of the organization, from frontline to executive leadership.

Required Qualifications

• 3+ years of technical experience in CAS, 835/837, encounters submissions, or data analysis and intelligence.
• 3+ years of experience in leading, operational setting, and developing high-performing teams.
• Proven ability to create and present story-driven analytics presentations.
• Knowledge of process improvement and development of metrics.
• Creative and proactive in managing large initiatives.
• Experienced in leading change and inspiring organizational performance during transformation.
• Excellent oral and written communication skills, with executive presence.
• Collaborative mindset and relationship-building skills with diverse stakeholders.

Preferred Qualifications

• Bachelor's degree
• Advanced degree or MBA
• Proficient in advanced analytics, Python, and other statistical software.
• Experienced working in an SQL environment with comprehensive knowledge of SSMS.
• Experience with Cloud Technologies (Azure Synapse Analytics), Databricks, and Power Platform (Power BI, Power Automate, Power Apps).
• Comprehensive knowledge of EDI formats: X12, 834, 835, 837, 270/271, 276/277, 278

Additional Information

Work-At-Home Requirements

• WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

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.

$129,300 - $177,800 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.Application Deadline:

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.