Business Intelligence Engineer 2

Profile

Description

Responsibilities

The Business Intelligence Engineer describes the tools, technologies, applications and practices used to collect, integrate, analyze, and present an organization's raw data in order to create insightful and actionable business information. Understands own work area professional concepts/standards, regulations, strategies and operating standards and makes decisions regarding own work approach/priorities. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

KEY ACCOUNTABILITIES

Researching state regulatory documentation to understand provider reimbursement methodologies.

Monitoring websites and fee schedule/pricing software vendor notices for updates and testing payment systems updates.

Ensure internal support including guidance related to specific edits and answering general questions on the reimbursement methodologies, fee schedules and pricers.

Provide support for provider inquiries and payment disputes related to pricer editing and reimbursement logic, supply evidence of implementation based on updates published by the state.

Required Qualifications

Our Department of Defense Contract requires U.S. citizenship for this position

Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)

Bachelor's Degree

2 years of experience in a managed care environment

Experience with SQL pulling large amounts of data

Comprehensive knowledge of Microsoft Office Applications including Word, Excel, Access and PowerPoint

Expertise in assessing complex data sets and performing root cause analysis

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Experience with TRICARE or military healthcare delivery system

Experience with Tableau

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com