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Become a part of our caring community The Lead Data Scientist uses mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions.

The Lead Data Scientist works on problems of diverse scope and complexity ranging from moderate to substantial.

The Lead Data Scientist develops, maintains, and collects structured and unstructured data sets for analysis and reporting.

This individual will create reports, projections, models, and presentations to support business strategy and tactics.

The Lead will advise executives to develop functional strategies (often segment specific) on matters of significance.

• Being a thought partner in shaping the strategy for innovative analytics solutions that provide actionable insights into policy adherence, enabling improved compliance, operational consistency, and decision-making
• Researching, designing, and implementing a policy adherence metric rooted in FRAC and PA denials information using advanced data modeling techniques
• Quick/responsive: first 90 days of billing;
• Comprehensive for professional provider types and facilities and scalable;
• Actionable: leading to network decisions;
• Current: Created and refreshed on a meaningful cadence
• Designing valuation model(s) to measure savings tied to removing outliers who are non-compliant with the policy adherence metric
• Partnering with National BH/Contracting/Medicaid/ND&PPS teams to support use of this metric in operations including compliance with MHPAEA and other HUM policies;
• Shaping the path to measuring ancillary / inpatient psychiatric provider types and/or other opportunity areas in the future
• Managing stakeholders/expectations while working across different teams including data source owners, compliance, policy/governance, business, PTC/National program partners
• Influencing priorities, tradeoffs, roadmap decisions in driving the implementation of a scalable solution
• Use your skills to make an impact

• Master's Degree
• Minimum 8 years of professional experience in data and analytics transforming data sets for actionable insights and reporting
• Minimum 5 years of experience utilizing SQL
• Minimum 4 years of project leadership experience
• Experience in using mathematics, statistics, modeling/Machine Learning modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions
• Successful demonstrated experience in working on problems of diverse scope and complexity ranging from moderate to substantial
• Experience in developing, maintaining, and collecting structured and unstructured data sets for analysis and reporting
• Experience in creating reports, projections, models, and presentations to support business
• Ability to exercise independent judgment and decision making on complex issues regarding job duties and related tasks
• Ability to works under minimal supervision, using independent judgment

• 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
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• 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

• Doctorate degree
• Experience with claims datasets
• Experience with Databricks

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

Scheduled Weekly Hours 40

$156,500 - $215,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance
• many other opportunities

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

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.