Humana Claims Cost Management Business Consultant in Louisville, Kentucky

Role: Claims Cost Management Business Consultant Assignment: Humana Government Business Location: Forum 3, Louisville, KY

Business Consultant responsibilities include conducting full lifecycle analysis to include requirements, activities and design. Business Consultant will develop analysis practices and enhance reporting capabilities. They will also monitor performance and quality control plans to identify improvements. Business Consultant in this role will support and advise internal customers to enable data driven decision-making. The Business Consultant is responsible for trend identification using various mathematical and statistical calculations to determine how the data sampled might best be applied to the business need and quality improvement.

KEY ACCOUNTABILITIES 50 % 1. Review and analyze data either through statistical analysis, data mining, and other proven analysis techniques. Verify analysis findings and provide results and recommendation to management. Develop and implement innovative predictive modeling databases to optimize statistical /mathematical efficiency and quality. 25 % 2. Collect, organize, and disseminate large amounts of information with attention to detail and accuracy. 25 % 3. Develop queries, generate reports and develop high level management presentations.

Role Essentials

  • Our Department of Defense contract requires U.S. Citizenship for this role

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

  • Bachelor’s Degree in Mathematics, Statistics, Business, or Public Health (may substitute equivalent education and/or experience)

  • Three years’ experience in healthcare data analysis

  • Three years’ TRICARE or Medicare insurance claims experience

  • Understanding of medical claim billing and coding requirements

  • Strong knowledge of and experience with database reporting packages

  • Proficiency in Microsoft Access, Excel and Word

  • Ability to write routine reports, correspondence and training documents

  • High degree of self-awareness and emotional intelligence

Role Desirables

  • Ability to read and interpret documents such as contracts and procedural manuals

  • Ability to speak effectively before groups of customers And employees of organization

  • Experience and proficiency in Tableau or related statistical databases

Title: Claims Cost Management Business Consultant

Location: KY-Louisville

Requisition ID: 188882

Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.