BI Engineer - Pharmacy Claims Data solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Engineer 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Role: BI Engineer - Pharmacy Claims Data
Assignment: Pharmacy Analytics
Location: Louisville, KY (no relocation to be offered)
. You will gain a broad understanding of Pharmacy, EDW, Claims Processing, and getting in depth knowledge of the workings of the Pharmacy Analytics Data team. You will also train in all aspects of pharmacy so that you can become a data steward. You will become familiar with a broad range of data subjects, such as Benefits, Enrollment, Networks, customer, coverage, plan, finance and other areas so that you can translate and help others to understand the same.
You will be asked to research and reconcile data output and review others work to make sure it’s correct and appropriate. You will learn who to talk to when you have questions and who to direct people to when you don’t know the answer.
Learn Claims Adjudication and the data flow of Claims data
Learn the inner workings of the different groups we serve.
Learn how to ask the right questions to get people what they need rather than ‘just’ what they’re asking for
Develop design techniques optimized for creating and supporting innovative reporting solutions based on current and future needs in both design and content
Thorough understanding of the diverse data integration techniques and the decision rules on how to apply them
Be a liaison between business and IT so that needs can be communicated between both for productive solutions.
Identify and resolve the data /process discrepancies between various databases and user applications
Maintain the standard operating procedures for backend data assets to meet both internal and external reporting requirements and build reconciliation systems aligning Humana’s internal reporting across the data warehouse (EDW)
Develop complex SQL queries for marting and reporting data.
Serve as a liaison between data teams.
Partner with end users to analyze, design, develop, implement and integrate business systems that will optimize business outcomes
Develop and maintain key relationships with all impacted business areas
Communicating high level summary results to business owners and leadership.
Developing and improving processes and documentation to support best practices.
Standard automation as well as open-ended process innovation
Bachelor’s Degree in Computer Science, MIS, Analytics or 5+ years practical experience.
Must have 3+ years’ experience in RX claims and related information
Experience designing, developing & implementing Business processes and code
Possess a solid understanding of BI data– includes all aspects of data ETL, understanding data models and user Interfaces
Advanced SQL skills
Demonstrable experience in interpreting and generating insights from the data
Experience in gathering and documenting the business requirements
Experience with large scale IT projects
Strong communication, interpersonal and presentation skills
Strong problem-solving and analytical skills
Strong interpersonal and communication skills to manage relationships with customers
Candidates should have the ability to work on multiple projects with occasionally tight deadlines
Candidates should also possess the ability to take initiative, work independently, and exercise appropriate business judgment.
Master’s Degree in Analytics, Business, Computer Information Systems, Mathematics, Statistics or a related field
Thorough understanding of Part D and Commercial pharmacy claims.
Experience with many relational databases such as Oracle, SQLPLUS, DB2, etc.
IT experience and business experience
Experience manipulating large, complex data sets
Experience in multiple programming languages
Prior experience in data mining
Experience/familiarity with Data Lakes
Scheduled Weekly Hours
Equal Opportunity Employer
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