Associate Vice President, Medicaid Data Strategy & Enablement

Associate Vice President, Medicaid Data Strategy & Enablement

Become a part of our caring community and help us put health first. The Associate Vice President (AVP), Medicaid Data Strategy & Enablement, is responsible for leading the strategic development and execution of technology solutions that advance Medicaid business objectives. This executive role acts as a vital liaison between business operations and Information Technology (IT), ensuring that all solutionsincluding IT-developed applications, Business Managed Solutions (BMS), and Robotic Process Automation (RPA)are properly designed, implemented, and governed. The AVP oversees a dedicated Data Visualization and Business Intelligence (BI) Reporting team, transforming Medicaid data into actionable insights to support informed decision-making, regulatory compliance, and operational excellence.

Key Responsibilities :

• Technology Solution Delivery & Partnership :
• Collaborate with IT teams and business stakeholders to identify, prioritize, and deliver technology solutions that directly support Medicaid strategic objectives.
• Oversee the lifecycle management of Business Managed Solutions (BMS) and Robotic Process Automation (RPA) initiatives, ensuring consistency with enterprise architecture, data security, and regulatory compliance.
• Define and implement governance principles for distinguishing between BMS and enterprise IT assets, and ensure appropriate documentation and transition when necessary.
• Enterprise Medicaid Data Strategy :
• Develop, communicate, and execute a comprehensive Medicaid data strategy that aligns with both enterprise-wide and state-specific requirements, including compliance with all relevant regulations.
• Assess the need for Medicaid-specific data domains, and establish processes for the consistent use of verified and trusted data sources in all reporting and analytics for both state and enterprise use cases.
• Data Governance & Stewardship :
• Establish clear Medicaid data ownership and stewardship roles to ensure accountability, particularly during new state program implementations and for management of historical claims data.
• Create and lead a Medicaid Data Governance Council, providing oversight for data quality, access, and usage standards.
• Identify and resolve gaps in data ownership, including those related to files received from external entities and vendors.
• Data Culture & Literacy :
• Champion a culture within Medicaid operations that recognizes data as a strategic asset critical to organizational success.
• Act as a facilitator and translator between business and technical teams, ensuring all cross-domain data needs are clearly understood and addressed.
• Lead programs and training initiatives to improve data literacy and analytical skills across all Medicaid teams.
• AI / ML Readiness & Innovation :
• Expand data governance frameworks to include principles of AI ethics, fairness, transparency, and ongoing model monitoring for Medicaid use cases.
• Develop a clear roadmap for AI / ML applications in Medicaid, including processes for evaluation, implementation, and compliance with evolving state and federal requirements.
• Partner with enterprise AI teams to advocate for and address Medicaid-specific needs and priorities.
• Governance for Business Managed Solutions :
• Ensure all Medicaid teams understand and consistently apply corporate policies regarding BMS, including documentation, security, and compliance protocols.
• Define, communicate, and enforce criteria for determining when a solution qualifies as a BMS versus an enterprise IT asset.
• Strategic Partnership with Medicaid Data Integration Team :
• Collaborate to co-develop the strategic roadmap for the Medicaid Data Integration team, focusing on scalability, interoperability, and future-state architecture.
• Lead prioritization of integration use cases, and oversee the migration of data from legacy systems to enterprise data platforms or the Medicaid data lake, ensuring data integrity and accessibility.
• Data Visualization & Business Intelligence Reporting :
• Direct and mentor the team responsible for Medicaid-focused data visualization and BI reporting, ensuring high standards of accuracy, timeliness, and relevance.
• Oversee the delivery of reports and dashboards that support operational, regulatory, and strategic decision-making for Medicaid programs.
• Drive the adoption of enterprise BI tools and reporting standards, ensuring consistency and alignment with organizational best practices.
• Collaborate with internal and external stakeholders to define and monitor key performance indicators (KPIs) and reporting requirements.
• Promote self-service analytics capabilities, while maintaining robust data governance and integrity controls.

Use your skills to make an impact

Required Qualifications :

Preferred Qualifications :

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. $172,200 - $236,900 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

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.