DescriptionThe Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Manages HEDIS projects and initiatives according to direction provided by our government contract(s). Analyzes data for specific HEDIS® measures to compare Humana Government Business performance with commercial health plans reporting HEDIS® measures. Evaluate select HEDIS® measures to assess barriers, gaps and opportunities for improvement. Works with senior leaders in development of a comprehensive plan for increasing success in achieving the select HEDIS® measures. Manage all components of the project life cycle: initiation, planning, execution, monitoring, metrics, outcomes measurement, reporting and closing. Works collaboratively and professionally with internal and external customers. Maintains current knowledge of HEDIS requirements and criteria.
- Conduct comprehensive analysis of HEDIS® data to assess barriers, gaps and opportunities for improvement
- Utilize trend analysis, performance thresholds, and national and regional benchmarks to analyze HEDIS® data
- Work closely with the CQM Department and HEDIS team to identify potential health improvement initiatives and strategies to meet target goals and contract requirements
- Develop, manage, monitor, report and update HEDIS® projects
- Collaborate with internal and external customers to maximize opportunities to influence government requirements, coordinate efforts with other departments, and utilize best practices in meeting or exceeding contract expectations.
- Our Department of Defense contract requires U.S. Citizenship
- Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)
- Bachelor’s degree statistics, mathematics, economics, business, accounting or related analytic discipline
- Minimum three years managed care experience in analyzing HEDIS® data
- Prior experience working in system analytics and/or data warehousing environment
- Strong verbal and written communication skills
- Strong data analysis skills
- Advanced computer literacy
- Capable and successful negotiator
- Prior Supervisory experience
- Project Management certification (PMP, CAPM)
- Master’s degree in statistics, mathematics, economics, or related analytic discipline
Scheduled Weekly Hours40