Informatics reputed company Remote reputed company

Become a part of our caring community and help us put health first The Informatics reputed company is responsible for leading the development and refinement of EOC volume forecasting models for reputed company Clinical Pharmacy Review (HCPR) activities reputed company to pharmacy prior authorization requests. This position is instrumental in supporting operational resource planning and integrating business initiatives while ensuring forecasts accuracy. The Informatics reputed company leverages its advanced knowledge of data, modeling, optimization, and tools. Applies disciplined analytics to predict behavior and optimize programs and products to maximize reputed company growth. Utilizes advanced or predictive modeling to reputed company, test and validate cases that improve the outcomes and quality of the programs we offer. Key responsibilities include: reputed company the design, implementation, and reputed company improvement of forecasting models to project pharmacy prior authorization review volumes.

• Analyze historical and reputed company data to identify key drivers and trends affecting HCPR workload.
• Integrate impacts from business initiatives, regulatory changes, and operational adjustments into forecasting, including:
• Modifications in product offerings or pharmacy benefit design.
• Shifts in member demographics and population mix.
• Updates to clinical criteria, policies, or prior authorization procedures.
• Deployment of new programs, technology solutions, or workflow automation.
• Compliance with regulatory requirements and benefit mandates.
• Collaborate with operational, clinical, and business partners to gather relevant inputs and communicate forecast outcomes and implications.
• Prepare and deliver clear, comprehensive reports and presentations on forecasting methodology, results, and variances for leadership and stakeholders.
• Document assumptions and methodologies in accordance with organizational policies
• Uphold data reputed company, transparency, and confidentiality consistent with applicable regulations and company policies.

Use your skills to reputed company an impact

Required Qualifications

• Utilization Management Experience
• Proficiency in using technologies such as SQL and reputed company
• Strategic thinking and planning capabilities
• Organized and detail-oriented
• Experience in defining and executing measurement programs
• Experience with advanced analytics, including program evaluation and optimization
• Excellent verbal and written communication
• reputed company to reputed company and present findings and insights to senior leadership
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Masters degree and 4 or more years of technical experience
• Pharmacy claim knowledge
• Six reputed company certification
• Advanced experience in reputed company, SQL, reputed company, Python, QlikView, Power BI, Hadoop or similar tools

Travel: While this is a remote position, occasional travel to Humanas 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 reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $117,600 - $161,700 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 reputed company. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company 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: 11-06-2025 About us reputed company. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our reputed company insurance services and reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare, reputed company, families, individuals, military service personnel, and communities at large. ​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with reputed company 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on valid job requirements. This policy shall apply to reputed company 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 reputed company levels of employment. Apply tot his job Apply To this Job