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The Senior Technical Product Owner is responsible for defining and delivering on the roadmap for the optimization continuous development monitoring and new source selection of a complex data pipeline that powers our CMS HEDIS (Healthcare Effectiveness Data and Information Set) rules engine. This role bridges product ownership data and software engineering and regulatory healthcare data requirements ensuring that data ingestion transformation and delivery are optimized for quality measurement reporting and compliance with CMS standards.

Location: Strong preference for Kentucky based candidate able to come to the office once a month or more OR full remote nationwide

The Senior Technical Product Owner maximizes value of product created by Agile team. Liaises with stakeholders and the development team ensuring the right product is being built in the right order within budget and by the deadline. Serves as the Agile teams primary contact for information work prioritization and decision-making. Begins to influence departments strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Senior Business Intelligence Engineer will be responsible for:

• Refining stakeholder requests to ensure insights drive value

• Define key measurements that are actionable and positively impact the business / members

• Deliver meaningful analysis that drives the business forward

• Provide input to process improvement

• Provide support to peers on the Business Intelligence team as needed

Key Responsibilities:

Strategically minded business ownership of end-to-end data pipeline

• Identify new data sources maintain connections to valuable sources decommission unneeded sources

• Monitor data volume quality age and timeliness of data fed to an interna CQE through numerous stage gates

• Define and maintain the product vision roadmap and backlog for the HEDIS data processing pipeline.

• Develop and maintain the support and monitoring apps and processes along with reportable metrics for uptime data volume and quality

• Act as the primary liaison between business stakeholders compliance teams data engineers production support and the CMS HEDIS rules engine team.

• Understand regulatory requirements and be able to draft detailed SAFe stories with success criteria to modify data feeds as NCQA rulesets change.

Data & Technical Leadership and influence:

• Work closely with data architects and engineers to design data flows that ingest clean validate and transform clinical and claims data for HEDIS measurement.

• Ensure proper integration with the CMS HEDIS engine supporting efficient and accurate quality metric calculations.

• Validate data mappings and transformations especially where they impact measure logic.

• Stay up to date with evolving CMS NCQA and HEDIS requirements.

• Ensure the data processing pipeline remains compliant with CMS mandates audit standards and data submission deadlines.

• Coordinate updates in response to yearly HEDIS specification changes.

Stakeholder Communication:

• Collaborate with QA compliance and analytics teams to define data quality benchmarks and testing protocols.

• Serve as the subject matter expert for how data supports HEDIS quality measures and reporting.

Agile & Delivery Management:

• Maintain a groomed product backlog; prioritize features bugs and technical debt with input from all stakeholders.

• Lead Agile ceremonies (e.g. sprint planning backlog refinement) in coordination with the Scrum Master or Engineering Lead.

Use your skills to make an impact

Role Essentials

• Bachelors degree in a technical discipline (i.e. Computer Science Engineering or related field)

• 5 years or more of experience in data product development and management or a related technical role

• Strong experience with healthcare data particularly clinical and claims data used in HEDIS measurement

• Familiarity with CMS Stars programs NCQA standards and quality performance metrics.

• Experience working with data platforms ETL tools and APIs

• Knowledge of NCQA CMS and health plan quality measurement programs.

• Familiarity with platforms languages and design principles for cloud data storage and connectivity

• Deep understanding of healthcare interoperability standards (e.g. HL7 FHIR X12).

• Ability to interpret measure specifications and translate them into data requirements.

• Excellent communication skills; ability to engage technical and non-technical stakeholders.

Role Desirables

• Experience with HEDIS rules engines such as Inovalon Cotiviti or proprietary solutions.

• Background in data quality frameworks or clinical informatics

• Experience with cloud platforms such as Snowflake and Databricks.

Additional Information

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 recommended; 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

As part of our hiring process for this opportunity we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number if it is not already on file. When required an email will be sent from with instructions on how to add the information into your official application on Humanas secure website.

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.

$94900 - $130500 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.

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.

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.