Lead Encounter Data Management

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 The Lead Business Intelligence Engineer defines and implements best practices to collect, integrate, analyze, and transform raw data into actionable business intelligence. This position ensures that all encounter submissions exceed compliance standards through advanced data analysis, rigorous quality assurance, and the development of tools to optimize encounter acceptance rates. The Lead Business Intelligence Engineer identifies opportunities to produce applicable insights and enhance submission processes. This role collaborates with partners to design and refine workflows, addresses complex data and process challenges, and leads by example in project execution and technical innovation. The Lead Business Intelligence Engineer also promotes a culture of knowledge sharing and continuous improvement, supporting the team's overall success.

The work hours for this position are Mon-Fri, 8am-5pm EST.

The Lead Business Intelligence Engineer is responsible for accomplishment of strategic goals, operational efficiency, and compliance. You will lead the analysis and resolution of data challenges, critically assessing situations, and applying organizational resources to build resilient and scalable code, dashboards, and data solutions. As a senior member of the Encounter Submission organization, the lead supports compliance, advancing operational efficiency, and ensuring the execution of strategic team goals. The Lead Business Intelligence Engineer also mentors junior team members, fosters a collaborative environment, and upholds data governance standards.

Key Responsibilities:

• Identify, evaluate, and lead strategic intelligence programs that improve and long-term goals
• Lead and manage projects to develop analytic insights and enhance existing business processes.
• Mentor and guide junior Business Intelligence team members, encouraging technical and professional development.
• Translate complex requirements into clear technical specifications.
• Develop a range of technical solutions, including Python scripts, SQL queries, Databricks notebooks, Azure DevOps pipelines, Power BI dashboards, and process automations.
• Support partners by addressing data issues, performing root cause analysis, and proposing, applicable resolutions.
• Present clear and meaningful insights to internal and external partners, adapting communications for varied audiences.
• Advocate and guide continuous improvement in data processes, data quality, and data management practices.
• Promote a culture of innovation, collaboration, and best practices within the BI team.

Use your skills to make an impact
 

This role is instrumental in building a high-performing, collaborative, and innovative Business Intelligence team that delivers strategic value to the organization.

Required Qualifications

• Bachelor's degree in a technical field.

• 6+ years of experience with scalable coding in Python within a collaborative environment, including experience using SQL.
• 6+ years of experience in data analysis with complex datasets.
• 3+ years of experience building applicable dashboards.
• 2+ years of project leadership or technical lead experience.
• Experience working with complex datasets within the healthcare industry.
• Experience managing multiple priorities while maintaining deadlines.
• History of contributing to organizations focused on continuous improvement and innovation.

Preferred Qualifications

• Master's degree in a technical field.
• Experience using machine learning and statistical models to obtain insights from data.
• Prior knowledge of EDI formats, such as X12, 834, 835, 270/271, 276/277, 278, and 999.
• Experience with data governance frameworks and BI (Business Intelligence) best practices.

Work at Home Requirement

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees 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 employees 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.

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.

 

$94,900 - $130,500 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: 03-12-2026
About us
 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.

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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.