20 open positions available
Analyze and forecast financial and economic data, maintain data integrity, support Medicare Advantage pricing tools, and collaborate with business partners to improve tools. | Bachelor's degree, completion of at least 3 actuarial exams, strong communication skills, and preferably experience with SQL, VBA, and Medicare Advantage. | Become a part of our caring community and help us put health first The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Actuarial Analyst 2, Analytics/Forecasting work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Actuarial Analyst 2, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. This role will support a few tools used within our Individual Medicare Advantage pricing and internal reporting process. This includes: • Helping make and test methodology changes to the tools, primarily in SQL, VBA, and Excel • Answering questions and researching issues from other business partners that utilize our tools • Working with our business partners to help understand how we can improve our tools Use your skills to make an impact Required Qualifications • Bachelor's Degree • Successful completion of at least 3 actuarial exams • Meets requirements for Humana's Actuarial Professional Development Program (APDP) • Strong communication skills • Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications • Strong technical skills, especially SQL and VBA • Individual Medicare Advantage experience 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. $80,900 - $110,300 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: 12-30-2025 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.
Build trust and educate individuals on Medicare Advantage plans through face-to-face and community engagement to drive sales and expand market presence. | Must have or obtain active health insurance license, reside in the local territory, be comfortable with face-to-face sales interactions, and have valid driver's license and insurance; Medicare sales experience and bilingual skills preferred. | Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll help bring Humana's strategy to life: Deliver on the fundamentals, differentiate through exceptional service, and grow by expanding our reach and impact. What You'll Do in This FIELD Based Role: • Deliver: Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental, Vision, and Prescription coverage. • Differentiate: Create meaningful, face-to-face connections through grassroots marketing, community events, and in-home visits-providing a personalized experience that sets Humana apart. • Grow: Drive self-generated sales, meet performance goals, and expand Humana's presence in the market by becoming a valued resource in your community. You'll engage with customers in the FIELD through a mix of in-person, virtual, and phone interactions. Face-to-face visits in prospective members' homes are a key part of this role. Why Join Humana? • People-first culture that supports your personal and professional growth. • Inclusive and diverse environment that values multilingual talent and cultural understanding. • Autonomy and flexibility to manage your schedule and success. • Purpose-driven mission to help people achieve their best health-and transform healthcare along the way. Benefits include: • Medical, Dental, Vision, and a variety ofothersupplemental insurances • Paid Time Off (PTO) and Paid Holidays • 401(k) retirement savings plan with a competitive match • Tuition reimbursement and/or scholarships for qualifying dependent children • And much more! Use your skills to make an impact Required Qualifications • Active Health Insurance License or ability to obtain. • Must reside in the designated local territory to effectively serve the community. • Comfortable with daily face-to-face interactions in prospective members' homes and engaging with the community through service, organizations, volunteer work, or local events. • Valid state driver's license and proof of personal vehicle liability insurance meeting at least 25/25/10 coverage limits (or higher, based on state requirements). Preferred Qualifications • Active Life and Variable Annuity Insurance License. • Prior experience selling Medicare products. • Experience in public speaking or delivering presentations to groups. • Associate's or Bachelor's degree. • Experience using Microsoft Office tools such as Teams, Excel, Word, and PowerPoint. • Bilingual in English and Spanish, with the ability to speak, read, and write fluently in both languages. Additional Information • This position is in scope ofHumana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation andMVR review. • Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. • Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website. Schedule: Meeting with members requires appointments and/or event times that may vary on nights and weekends. Flexibility is essential to your success. Training: The first five weeks of employment and attendance is mandatory. Interview Format: As part of our hiring process for this opportunity, we are 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. If you are selected to move forward in the process, you will receive a text message inviting you to participate in a HireVue prescreen. In this prescreen, you will receive a set of questions via text and given the opportunity to respond to each question. You should anticipate this prescreen taking about 15 minutes. Your responses will be reviewed and if selected to move forward, you will be contacted with additional details involving the next step in the process. Pay Range The range below reflects a good faith estimate of total compensation for full time (40 hours per week) employment at the time of posting. This compensation package includes both base pay and commission with guarantee. The pay range may be higher or lower based on geographic location. Actual earnings will vary based on individual performance, with the base salary and commission structure aligned to company policies and applicable pay transparency requirements. $80,000 - $125,000 per year #medicaresalesrep Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 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.
Lead enterprise platform engineering strategy, oversee architecture and vendor partnerships, manage budgets, and foster organizational culture. | 10+ years in platform engineering or cloud architecture, 8+ years leadership managing large teams and budgets, expertise in cloud platforms and data ecosystems. | Job Description: • Support development and execution of cloud implementation strategy within organization's existing IT infrastructure. • Lead the strategy, delivery, and operational excellence of Humana’s enterprise platform engineering capabilities. • Oversee platform architecture, engineering practices, vendor partnerships, and cross-functional collaboration to ensure platforms are secure, efficient, and aligned with Humana’s long-term strategic goals. • Manage a multi-million-dollar budget, including cloud spend and vendor contracts. • Foster a culture of inclusion, learning, and accountability. Requirements: • 10+ years of progressive experience in platform engineering, software development, or cloud architecture • 8+ years of leadership experience managing large-scale engineering teams and complex programs • Proven experience managing $30M+ portfolios and delivering enterprise-scale technology transformations • Deep technical expertise in cloud platforms (Azure, GCP), data ecosystems (Databricks, Snowflake, Kafka, DBT, Prefect), and full-stack systems • Demonstrated success in driving platform adoption, cost optimization, and engineering maturity. Benefits: • 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.
Assist in design, development, testing, debugging, and documentation of software applications with a focus on identity and access management. | Bachelor's degree, 0-3 years experience, familiarity with ForgeRock, and passion for improving consumer experiences. | **Become a part of our caring community and help us put health first** The Software Engineer codes software applications based on business requirements. The Software Engineer work assignments are often straightforward and of moderate complexity. This role is ideal for a recent graduate aspiring to enter IT as a Cybersecurity Identity Software Engineer. Successful candidates in this role will be asked to contribute to external member authentication and identity efforts. This is a great opportunity to learn the foundational basics of Identity and Access Management. Job Description The Software Engineer standardizes the quality assurance procedure for software. Oversees testing and debugging and develops fixes. Research complaints and makes necessary adjustments and/or recommendations to resolve complex software related issues. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. • *Key duties and responsibilities include:** + Assisting in the design, development, and testing of software applications. + Performing software debugging using relevant debugging tools. + Participating in the review of code to ensure quality and functionality. + Documenting coding and design activities necessary for the proper installation, maintenance, and operation of the software. + Contributing to the modification and design of software applications to resolve defects and improve overall performance and reliability. + Assisting in the estimation of time and materials needed to complete project tasks. + Working closely with other developers and the software team lead to gain a comprehensive understanding of the goals and requirements for software applications and systems. + Staying abreast of new technology and programming languages relevant to the field of software development. • *Use your skills to make an impact** • *Required Qualifications** + Bachelor's degree in Computer Science or related field. + Familiarity with and understanding of ForgeRock technology. + 0-3 years of experience in systems analysis and application programming development. + Must be passionate about contributing to an organization focused on continuously improving consumer experiences. • *Preferred Qualifications** + Master's Degree + Hands-on relevant experience with ForgeRock is ideal. • *WAH Requirements:** + WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. + A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + 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. $66,800 - $91,100 per year • *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: 11-20-2025 • *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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website. • *Become a part of our caring community and help us put health first** The Software Engineer codes software applications based on business requirements. The Software Engineer work assignments are often straightforward and of moderate complexity. This role is ideal for a recent graduate aspiring to enter IT as a Cybersecurity Identity Software Engineer. Successful candidates in this role will be asked to contribute to external member authentication and identity efforts. This is a great opportunity to learn the foundational basics of Identity and Access Management. Job Description The Software Engineer standardizes the quality assurance procedure for software. Oversees testing and debugging and develops fixes. Research complaints and makes necessary adjustments and/or recommendations to resolve complex software related issues. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. • *Key duties and responsibilities include:** + Assisting in the design, development, and testing of software applications. + Performing software debugging using relevant debugging tools. + Participating in the review of code to ensure quality and functionality. + Documenting coding and design activities necessary for the proper installation, maintenance, and operation of the software. + Contributing to the modification and design of software applications to resolve defects and improve overall performance and reliability. + Assisting in the estimation of time and materials needed to complete project tasks. + Working closely with other developers and the software team lead to gain a comprehensive understanding of the goals and requirements for software applications and systems. + Staying abreast of new technology and programming languages relevant to the field of software development. • *Use your skills to make an impact** • *Required Qualifications** + Bachelor's degree in Computer Science or related field. + Familiarity with and understanding of ForgeRock technology. + 0-3 years of experience in systems analysis and application programming development. + Must be passionate about contributing to an organization focused on continuously improving consumer experiences. • *Preferred Qualifications** + Master's Degree + Hands-on relevant experience with ForgeRock is ideal. • *WAH Requirements:** + WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. + A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + 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. $66,800 - $91,100 per year • *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: 11-20-2025 • *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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Developing and maintaining cloud-based APIs and IVR solutions, collaborating across teams, and supporting enterprise applications. | At least 8 years of experience in cloud development, with expertise in APIs, cloud platforms, and ideally IVR or contact center technologies. | Become a part of our caring community and help us put health first Humana is seeking a self-driven and collaborative Lead Software Engineer to join our Interactive Voice Response (IVR) team. In this role, you will deliver innovative IVR solutions and develop robust omnichannel APIs for our enterprise platforms. You will have the opportunity to drive the success of a high-impact, customer-facing application within a Fortune 50 company, working closely with multiple teams throughout the software development lifecycle (SDLC).Lead Software Engineer – IVR & Omnichannel APIs Humana is seeking a self-driven and collaborative Lead Software Engineer to join our Interactive Voice Response (IVR) team. In this role, you will deliver innovative IVR solutions and develop robust omnichannel APIs for our enterprise platforms. You will have the opportunity to drive the success of a high-impact, customer-facing application within a Fortune 50 company, working closely with multiple teams throughout the software development lifecycle (SDLC). Key Responsibilities: • Collaborate with team members to track and plan agile work supporting core cloud infrastructure. • Partner with internal architecture and other enterprise teams to ensure a resilient, state-of-the-art cloud environment for a high-profile enterprise application. • Develop and deliver proofs-of-concept (POCs) and sample implementations for widespread adoption within agile teams. • Work with senior leadership to influence project timelines, deliverables, and strategic direction. • Provide Tier 3 support during critical, high-impact incidents to ensure rapid resolution and minimal disruption. Humana is committed to fostering a collaborative and innovative work environment that supports personal and professional growth. Join us to help build solutions that directly impact millions of customers. Use your skills to make an impact Required Qualifications: • At least 8 years of experience in coding and development on cloud-based platforms • Demonstrated experience with IVR systems or similar contact center technologies. • Proven hands-on development expertise with large-scale cloud solutions. • Strong background in designing and implementing API/Web Services. • Excellent analytical, communication, organizational, and problem-solving abilities. • In-depth knowledge of artificial intelligence (AI) implementation, testing, and monitoring processes. Preferred Qualifications: • Bachelor’s degree or higher in computer science or a related field. • Google Cloud (GCP) Contact Center. • Experience with SQL and MongoDB databases. • Previous experience supporting applications at a Fortune 100 company. • Experience in creating MCP Servers 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 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours 40Pay 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.$129,300 - $177,800 per yearThis 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: 12-16-2025 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.
Review medical records and authorize services based on medical necessity, communicate decisions, and maintain compliance and productivity metrics. | MD or DO degree, 5+ years clinical experience post residency, board certification, valid medical license, and strong communication and analytic skills. | Job Description: • The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, level of care, and/or site of service should be authorized. • Reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert decisioning on the requested services. • Regular discussions with external providers by phone to gather additional clinical information and discuss determinations. • Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services. • Maintain accountability for productivity, quality, and compliance metrics. • Communicate determinations clearly both verbally and in writing. • Demonstrate adaptability and willingness to learn evolving workflows, tools, and utilization management practices. Requirements: • MD or DO degree • 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). • Current and ongoing Board Certification in an approved ABMS Medical Specialty • A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required. • No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. • Excellent verbal and written communication skills. • Evidence of analytic and interpretation skills, with prior experience working in a team environment. Benefits: • 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
Lead and coordinate complex Medicare and Duals-related projects ensuring strategic alignment, compliance, and successful delivery through stakeholder collaboration and resource management. | Bachelor's degree or 3+ years project leadership experience, proficiency in project management tools, experience leading multi-workstream initiatives, excellent problem-solving and communication skills, healthcare experience preferred, PMP or Lean Six Sigma certification a plus. | Job Description: • Design, communicate, and implement comprehensive operational plans for Medicare and Duals-related programs and projects. • Lead multiple complex initiatives simultaneously, ensuring alignment with strategic goals and compliance requirements. • Collaborate with stakeholders across cross-functional teams to provide strategic consulting and guidance. • Monitor project progress and performance, proactively identifying and resolving issues to prevent delays and ensure successful delivery. • Develop program and project schedules, budgets, forecasts, and work specifications. • Coordinate internal and external resources, including vendors and contractors, to achieve project milestones. • Facilitate cross-program communication with leaders to manage interdependencies and ensure alignment across initiatives. • Conduct regular status meetings and prepare executive-level reports and presentations on program health, risks, and mitigation strategies. • Set priorities and allocate tasks, providing direction to project staff and cross-functional stakeholders. • Exercise independent judgment and decision-making on complex and variable issues with minimal supervision. • Advise senior leadership on strategic, segment-specific approaches to program management. Requirements: • Bachelor’s degree or 3 or more years of project leadership experience • Proficient in project management tools and methodologies • Proven experience leading multi-workstream initiatives with diverse stakeholder groups in a matrixed organization • Excellent problem-solving and critical-thinking skills; able to manage ambiguity and make sound decisions • PMP certification, Lean Six Sigma or Agile experience a plus • Exceptional communication, collaboration, and stakeholder management abilities • Experience in healthcare Benefits: • 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
Lead and manage multiple complex clinical operations projects ensuring alignment with strategic goals, compliance, and stakeholder collaboration in a healthcare environment. | Bachelor's degree or 3+ years project leadership, proficiency in project management tools, experience leading multi-workstream initiatives, preferably healthcare experience, PMP or Lean Six Sigma a plus. | Become a part of our caring community and help us put health first The Lead Project Manager-Clinical Operations is essential for ensuring the successful execution of complex initiatives. This individual oversees program and project management from initiation to closure, handling multiple concurrent initiatives that encompass operations, compliance, quality, implementations and member experience. This role demands strong leadership skills, independent judgment, and the ability to navigate ambiguity while delivering results in a fast-paced and highly regulated healthcare environment. Key Responsibilities: • Design, communicate, and implement comprehensive operational plans for Medicare and Duals-related programs and projects. • Lead multiple complex initiatives simultaneously, ensuring alignment with strategic goals and compliance requirements. • Collaborate with stakeholders across cross-functional teams to provide strategic consulting and guidance. • Monitor project progress and performance, proactively identifying and resolving issues to prevent delays and ensure successful delivery. • Develop program and project schedules, budgets, forecasts, and work specifications. • Coordinate internal and external resources, including vendors and contractors, to achieve project milestones. • Facilitate cross-program communication with leaders to manage interdependencies and ensure alignment across initiatives. • Conduct regular status meetings and prepare executive-level reports and presentations on program health, risks, and mitigation strategies. • Set priorities and allocate tasks, providing direction to project staff and cross-functional stakeholders. • Exercise independent judgment and decision-making on complex and variable issues with minimal supervision. • Advise senior leadership on strategic, segment-specific approaches to program management. Use your skills to make an impact Required Qualifications • Bachelor’s degree or 3 or more years of project leadership experience • Proficient in project management tools and methodologies • Proven experience leading multi-workstream initiatives with diverse stakeholder groups in a matrixed organization Preferred Qualifications • Excellent problem-solving and critical-thinking skills; able to manage ambiguity and make sound decisions • PMP certification, Lean Six Sigma or Agile experience a plus • Exceptional communication, collaboration, and stakeholder management abilities • Experience in healthcare Additional Information Interview Format As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. Work-At-Home Requirements: • WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. • Satellite and Wireless Internet service is NOT allowed for this role. • 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. $115,200 - $158,400 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: 11-17-2025 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.
Lead architecture design, cloud migration, and performance optimization of contact center platforms, ensuring technical standards and mentoring teams. | Requires extensive experience as a Lead Solutions Architect with Genesys cloud contact center solutions, Conversational AI, SaaS integrations, and leadership in cloud platform governance. | **Become a part of our caring community and help us put health first** The Lead Solutions Architect works with user groups to solve business problems with available technology including hardware, software, databases, and peripherals. The Lead Solutions Architect works on problems of diverse scope and complexity ranging from moderate to substantial. • *Job Description** The Lead Solution Architect is responsible for Architecture design, planning, Cloud migration and performance of several platforms that are used to support Humana’s members. The platforms consist of Nuance IVA, Voice of the Consumer Survey, Guidance Center Video Kiosk, as well as InMoment market research. These platforms are at the core of our strategy to solicit direct feedback from the communities that we serve as well as enable the video channel for guidance centers supporting our senior population. You will be responsible for the architecture of multiple projects and ensure designs are being followed by team and provide technical advice. As we look to migrate and modernize our products to a cloud platform, you will be able to play a role in defining/implementing cloud architecture, mentoring team members on cloud technology and working with our enterprise groups to implement proper standards. The Lead Solution Architect performs technical planning, architecture development and modification of specifications. Develops specifications for new products/services, applications and service offerings. Making architectural decisions that will be followed by Software Engineers. Documenting application development processes, procedures, and standards. Assess the compatibility and integration of products/services proposed as standards in order to ensure an integrated architecture across interdependent applications. Begins to influence department’s strategy. Make 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. • *Use your skills to make an impact** • *Required Responsibilities:** + **Experience as a Lead solutions Architect involving large scale cloud contact center experience solutions implementation on Genesys cloud platform** + **Experience with Conversational AI** + Partner with product managers and product owners to understand business needs and develop architecture solutions and blueprints for the customer experience center platform solutions + Lead and govern technical solutions meeting functional/non-functional requirements and drive technology solution implementations + Establish cloud platform governing and operating model + Provide best practice recommendations and optimization opportunities within the contact center experience platform + Collaborate with internal and external stakeholders for designing and building application architecture and components • *Preferred Skillset:** + **Experience as a Cloud Architect involving large scale cloud contact center experience solutions (SaaS vendor solutions like NICE, Genesys, etc.)** + Experience in implementing capabilities including (but not limited to): Omni-channel – “Queuing, routing, and experience”, Softphone, Voice Authentication, Desktop Process Automation and Analytics, Speech Analytics, Call Recording, Workforce Management, AI/ML, Chatbots etc. + Experience integrating contact center applications with other SaaS cloud solution (like Salesforce, ServiceNow, MS Dynamics, etc.). + Technically hands-on experience with setting up pilots and POC for solution evaluations on the SaaS platform + Architecture development experience across Business, Application, Data and Technology domains + Excellent communication and influencing skills + Experience of leading major strategic business and IT transformation programs + Ability to explain complex technical issues in a way that non-technical people may understand + Proven track record of mentoring team in adopting new technologies + Working with vendors to enhance tool capabilities to meet enterprise needs + Using agile methodologies (ex: SAFe), have experience with waterfall as well • *Additional Information** Why Humana? At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few: • Work-Life Balance • Generous PTO package • Health benefits effective day 1 • Annual Incentive Plan • 401K - • Well-being program • Paid Volunteer Time Off • Student Loan Refinancing If you share our passion for helping people, we likely have the right place for you at Humana! • *Work-At-Home Requirements** To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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 + Associates 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 associates 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. \#LI-Remote 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. $142,300 - $195,700 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** 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: 11-27-2025 • *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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website. • *Become a part of our caring community and help us put health first** The Lead Solutions Architect works with user groups to solve business problems with available technology including hardware, software, databases, and peripherals. The Lead Solutions Architect works on problems of diverse scope and complexity ranging from moderate to substantial. • *Job Description** The Lead Solution Architect is responsible for Architecture design, planning, Cloud migration and performance of several platforms that are used to support Humana’s members. The platforms consist of Nuance IVA, Voice of the Consumer Survey, Guidance Center Video Kiosk, as well as InMoment market research. These platforms are at the core of our strategy to solicit direct feedback from the communities that we serve as well as enable the video channel for guidance centers supporting our senior population. You will be responsible for the architecture of multiple projects and ensure designs are being followed by team and provide technical advice. As we look to migrate and modernize our products to a cloud platform, you will be able to play a role in defining/implementing cloud architecture, mentoring team members on cloud technology and working with our enterprise groups to implement proper standards. The Lead Solution Architect performs technical planning, architecture development and modification of specifications. Develops specifications for new products/services, applications and service offerings. Making architectural decisions that will be followed by Software Engineers. Documenting application development processes, procedures, and standards. Assess the compatibility and integration of products/services proposed as standards in order to ensure an integrated architecture across interdependent applications. Begins to influence department’s strategy. Make 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. • *Use your skills to make an impact** • *Required Responsibilities:** + **Experience as a Lead solutions Architect involving large scale cloud contact center experience solutions implementation on Genesys cloud platform** + **Experience with Conversational AI** + Partner with product managers and product owners to understand business needs and develop architecture solutions and blueprints for the customer experience center platform solutions + Lead and govern technical solutions meeting functional/non-functional requirements and drive technology solution implementations + Establish cloud platform governing and operating model + Provide best practice recommendations and optimization opportunities within the contact center experience platform + Collaborate with internal and external stakeholders for designing and building application architecture and components • *Preferred Skillset:** + **Experience as a Cloud Architect involving large scale cloud contact center experience solutions (SaaS vendor solutions like NICE, Genesys, etc.)** + Experience in implementing capabilities including (but not limited to): Omni-channel – “Queuing, routing, and experience”, Softphone, Voice Authentication, Desktop Process Automation and Analytics, Speech Analytics, Call Recording, Workforce Management, AI/ML, Chatbots etc. + Experience integrating contact center applications with other SaaS cloud solution (like Salesforce, ServiceNow, MS Dynamics, etc.). + Technically hands-on experience with setting up pilots and POC for solution evaluations on the SaaS platform + Architecture development experience across Business, Application, Data and Technology domains + Excellent communication and influencing skills + Experience of leading major strategic business and IT transformation programs + Ability to explain complex technical issues in a way that non-technical people may understand + Proven track record of mentoring team in adopting new technologies + Working with vendors to enhance tool capabilities to meet enterprise needs + Using agile methodologies (ex: SAFe), have experience with waterfall as well • *Additional Information** Why Humana? At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few: • Work-Life Balance • Generous PTO package • Health benefits effective day 1 • Annual Incentive Plan • 401K - • Well-being program • Paid Volunteer Time Off • Student Loan Refinancing If you share our passion for helping people, we likely have the right place for you at Humana! • *Work-At-Home Requirements** To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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 + Associates 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 associates 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. \#LI-Remote 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. $142,300 - $195,700 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** 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: 11-27-2025 • *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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Lead development and governance of marketing analytics tools, manage vendor relationships, and drive adoption of analytics platforms to support strategic marketing insights. | Bachelor's degree, 4+ years in marketing analytics or BI, hands-on MMM experience, vendor management skills, strong marketing attribution knowledge, and communication experience. | Become a part of our caring community and help us put health first Become a part of our caring community Join Humana's Integrated Marketing Analytics team as a Senior Associate, Marketing Analytics Capabilities, where you'll lead efforts to enhance and govern the tools and platforms that power our marketing analytics ecosystem. Role Responsibilities As a senior member of the Marketing Analytics Capabilities team, you will lead the development, governance, and adoption of marketing analytics tools that enable deep, strategic insights into campaign performance and business impact. You'll own a portfolio of solutions, drive platform enhancements, and ensure marketers and analytics teams have access to an industry-leading toolset that supports data-driven decision-making. Key responsibilities include: • Lead the implementation and optimization of advanced analytics tools such as Media Mix Modeling (MMM) and other solutions to support strategic marketing performance measurement (e.g. multi-touch attribution). • Establish and manage relationships with third-party partners for solutions including identity resolution, audience segmentation, and data enrichment. • Collaborate with internal data scientists and marketing analytics peers to enable robust methodologies such as multi-touch attribution and predictive modeling. • Drive adoption and governance of marketing analytics platforms, ensuring tools are well-documented, scalable, and aligned with business needs. • Support continuous improvement of the analytics ecosystem by identifying gaps, recommending enhancements, and promoting best practices across teams. • Serve as a subject matter expert on marketing analytics capabilities, providing guidance and training to stakeholders to maximize tool effectiveness and insight generation. Use your skills to make an impact Use your skills to make an impact Required Qualifications • Bachelor's degree in Marketing, Information Systems, or a related field. • 4+ years of experience in marketing analytics, data platforms, or business intelligence roles. • Hands-on experience implementing or managing Media Mix Modeling (MMM) or Commercial Mix Modeling (CMM) solutions. • Experience selecting, onboarding, and managing third-party vendors for marketing analytics solutions such as identity resolution, audience segmentation, and data enrichment, with a strong understanding of capabilities evaluation, integration planning, and ongoing performance oversight. • Strong understanding of marketing attribution methodologies, including multi-touch attribution and predictive modeling. • Minimum of 2 years of experience in communication and stakeholder engagement, with a proven ability to drive cross-functional alignment and successfully implement new processes. Preferred Qualifications • Experience working with identity resolution platforms such as LiveRamp, Neustar, or similar vendors, including integration, data onboarding, and match rate optimization. • Familiarity with the Adobe Experience Cloud ecosystem, including tools like Adobe Analytics, Adobe Audience Manager, and Adobe Campaign. • Experience supporting or implementing marketing data infrastructure within cloud environments (e.g., Snowflake, Azure, AWS). • Exposure to healthcare or insurance environments. • Knowledge of HIPAA and data privacy standards • Experience with cloud platforms and marketing analytics environments. • Exposure to data governance and compliance frameworks. Work at Home Information To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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 • Associates 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 associates 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 Virtual Pre-Screen • As part of our hiring process for this opportunity, we are 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. • If you are selected to move forward in the process, you will receive a text message inviting you to participate in a HireVue prescreen. In this prescreen, you will receive a set of questions via text and given the opportunity to respond to each question. You should anticipate this prescreen taking about 15 minutes. Your responses will be reviewed and if selected to move forward, you will be contacted with additional details involving the next step in the process. • Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website. 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. $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 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: 11-20-2025 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.
Lead and deliver product roadmap and backlog for data products supporting CMS Stars and HEDIS quality measures, collaborating across technical and business teams to ensure compliance and data quality. | Bachelor's degree, 8+ years in data flow and software application development, 2+ years project leadership, strong healthcare data experience with HEDIS and CMS Stars, and proficiency in cross-functional communication. | **Become a part of our caring community and help us put health first** The Lead, Technical Product Owner requires someone known for creative problem solving. This role solves complex business problems and issues using data and custom software from internal and external sources. The role works on problems of diverse scope and complexity ranging from moderate to substantial. It is responsible for leading, defining and delivering on the roadmap of multiple data and business application products. 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. We are seeking an individual with a growth mindset, who is a highly experienced Technical Product Owner to drive the development of data products specifically related to CMS Stars and HEDIS quality measures. The ideal candidate has deep expertise in Stars/HEDIS data, regulatory requirements, and agile product development, and 3 tier software development and technical support for critical systems. In this role, you will teach and collaborate with business stakeholders, data engineers, and IT teams to translate complex requirements into actionable product features that support quality measurement, reporting, and compliance. • *Key responsibilities:** + **Technology strategy and roadmap of Business and Data Products:** Define and maintain the vision, strategy, and roadmap for data products that enable CMS Stars and HEDIS reporting. Ensure alignment with enterprise goals and departmental priorities. + **Backlog management:** Own, groom, and prioritize the product backlog for one or more agile teams, ensuring it reflects business needs, regulatory changes, and technical dependencies. + **Requirements translation:** Elicit detailed requirements from stakeholders (e.g., business, compliance, and analytics) and translate them into clear user stories with defined acceptance criteria for development teams. + **Cross-functional collaboration:** Act as the primary liaison between business stakeholders and technical teams. Facilitate communication and alignment across data engineering, analytics, compliance, and QA teams. + **Technical guidance:** Work closely with data architects and engineers to design and validate data flows, mappings, and transformations. Provide guidance to ensure technical solutions are feasible and aligned with the product vision. + **Data quality and compliance:** Collaborate with governance teams to establish data quality benchmarks and implement testing protocols. Ensure data products adhere to CMS mandates and NCQA standards. + **Technical debt management:** Advocate for the resolution of technical debt and architectural improvements, balancing short-term feature delivery with long-term product sustainability. + **Stay current:** Monitor evolving CMS, NCQA, and HEDIS requirements and coordinate necessary updates in response to specification changes. + **Travel for this role is quarterly** • *Use your skills to make an impact** • *Role Essentials** + Bachelor's degree + 8 or more years of experience in data flow & analysis and software application building & enhancements + 2 or more years of project leadership experience + 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. + Advanced experience working with big and complex data sets within large organizations + Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction + Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs + Proficiency in understanding Healthcare related data + Proficiency in verbal/written communication to senior and executive leadership • *Role Desirables** + Advanced Degree in a quantitative discipline, such as Mathematics, Economics, + Finance, Statistics, Computer Science, Engineering or related field + Knowledge of NCQA, CMS, and health plan quality measurement programs. + Deep understanding of healthcare interoperability standards (e.g., HL7, FHIR, X12). + Advanced in SQL, SAS and other data systems + Expertise in data mining, forecasting, simulation, and/or predictive modeling + Experience creating analytics solutions for various healthcare sectors • *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 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. 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 you. 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 Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. 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. $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** 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: 11-30-2025 • *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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website. • *Become a part of our caring community and help us put health first** The Lead, Technical Product Owner requires someone known for creative problem solving. This role solves complex business problems and issues using data and custom software from internal and external sources. The role works on problems of diverse scope and complexity ranging from moderate to substantial. It is responsible for leading, defining and delivering on the roadmap of multiple data and business application products. 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. We are seeking an individual with a growth mindset, who is a highly experienced Technical Product Owner to drive the development of data products specifically related to CMS Stars and HEDIS quality measures. The ideal candidate has deep expertise in Stars/HEDIS data, regulatory requirements, and agile product development, and 3 tier software development and technical support for critical systems. In this role, you will teach and collaborate with business stakeholders, data engineers, and IT teams to translate complex requirements into actionable product features that support quality measurement, reporting, and compliance. • *Key responsibilities:** + **Technology strategy and roadmap of Business and Data Products:** Define and maintain the vision, strategy, and roadmap for data products that enable CMS Stars and HEDIS reporting. Ensure alignment with enterprise goals and departmental priorities. + **Backlog management:** Own, groom, and prioritize the product backlog for one or more agile teams, ensuring it reflects business needs, regulatory changes, and technical dependencies. + **Requirements translation:** Elicit detailed requirements from stakeholders (e.g., business, compliance, and analytics) and translate them into clear user stories with defined acceptance criteria for development teams. + **Cross-functional collaboration:** Act as the primary liaison between business stakeholders and technical teams. Facilitate communication and alignment across data engineering, analytics, compliance, and QA teams. + **Technical guidance:** Work closely with data architects and engineers to design and validate data flows, mappings, and transformations. Provide guidance to ensure technical solutions are feasible and aligned with the product vision. + **Data quality and compliance:** Collaborate with governance teams to establish data quality benchmarks and implement testing protocols. Ensure data products adhere to CMS mandates and NCQA standards. + **Technical debt management:** Advocate for the resolution of technical debt and architectural improvements, balancing short-term feature delivery with long-term product sustainability. + **Stay current:** Monitor evolving CMS, NCQA, and HEDIS requirements and coordinate necessary updates in response to specification changes. + **Travel for this role is quarterly** • *Use your skills to make an impact** • *Role Essentials** + Bachelor's degree + 8 or more years of experience in data flow & analysis and software application building & enhancements + 2 or more years of project leadership experience + 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. + Advanced experience working with big and complex data sets within large organizations + Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction + Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs + Proficiency in understanding Healthcare related data + Proficiency in verbal/written communication to senior and executive leadership • *Role Desirables** + Advanced Degree in a quantitative discipline, such as Mathematics, Economics, + Finance, Statistics, Computer Science, Engineering or related field + Knowledge of NCQA, CMS, and health plan quality measurement programs. + Deep understanding of healthcare interoperability standards (e.g., HL7, FHIR, X12). + Advanced in SQL, SAS and other data systems + Expertise in data mining, forecasting, simulation, and/or predictive modeling + Experience creating analytics solutions for various healthcare sectors • *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 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. 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 you. 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 Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. 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. $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** 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: 11-30-2025 • *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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Lead strategic initiatives using data-driven insights to improve clinical outcomes, cost, quality, and member experience in care management programs through cross-functional collaboration and execution planning. | Bachelor's or Master's degree with relevant experience, strong data analytics and communication skills, ability to influence and operate in ambiguity, proficiency in Microsoft Office, and preferably healthcare strategy or consulting experience. | Become a part of our caring community and help us put health first Join Humana as a Senior Strategy Advancement Professional and play a pivotal role in shaping innovative strategies for our high-needs Medicare Advantage and SNP populations. In this impactful position, you'll leverage data-driven insights to tackle complex business challenges, drive improvements in member health outcomes, and enhance both care manager and member experiences. Collaborating with dynamic teams across clinical, quality, operations, and analytics, you'll help lead transformative initiatives that advance clinical quality and deliver meaningful cost savings-making a tangible difference in the lives of our members and the future of care management. The Humana Care Management Strategy Team is focused on improving clinical outcomes and delivering on business priorities for care management programs. Our team employs a rigorous process to set specific business priorities, identify the greatest sources of value, and lead a multi-disciplinary process to identify discrete opportunities for enhanced clinical outcomes, cost control, quality, and member experience. In this context, the Senior Strategy Advancement Professional will: • Drive initiatives to analyze complex problems and issues using data and insights from internal and external sources to identify the greatest opportunities in clinical outcomes, quality, cost, and experience for members in care management programs • Bring expertise or identify subject matter experts in support of multi-functional efforts to identify, interpret, and produce recommendations and plans. • Work closely with associates and leaders from across the enterprise to solicit input, guide data-backed problem solving, and make recommendations to advance care management strategy. • Work with operational owners to translate strategic recommendations into execution plans for implementation. • Drive and support strategic initiatives for developing, integrating, and optimizing care management programs and enterprise value opportunities in collaboration with internal assets, partners, and enterprise-wide initiatives. • Engage in an ambiguous problem solving and strategy setting. • Support cross-functional efforts to define discrete opportunities that are both impactful and achievable. • Work directly with cross-functional partners across the enterprise to create the execution model and roadmap to capture prioritized opportunities. Use your skills to make an impact Required Qualifications • Bachelor's degree with 2+ years of experience in driving and creating strategy or project leadership OR Master's level degree with 1+ years of the same experience. • Experience interpreting and leveraging data and analytics to improve strategy and make recommendations, including data driven story telling. • Experience completing analysis and modeling of data to drive insights and recommendations for strategy advancement. • Experience communicating effectively, both verbally and in writing, and adapting messaging for various audiences, including senior leadership. • Proven skills influencing others and a track record of success operating in ambiguity. • Proven organization, planning and prioritization skills to collaborate with multiple enterprise departments and stakeholders and the ability to execute within deadlines. • Proficient in Microsoft Office, including Power Point and advanced Excel skills, e.g. creating pivot tables, manipulating multi-faceted data, and using complex formulas. Preferred Qualifications • Previous strategy consulting experience with a consulting firm. • Advanced degree in relevant field or MBA. • Exposure or experience with clinical care delivery and interventions and/or care management operations. • Prior experience or exposure to Medicare Stars Program. • Experience leading cross-functional group of stakeholders/teams and initiatives. Additional information • Workstyle: remote, work from home. • Travel: as needed for meetings, up to 20% • Typical work days/hours: Monday - Friday, 8:00 am - 5:00 pm EST WAH Internet 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. HireVue 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. 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. $86,300 - $118,700 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 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: 11-16-2025 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.
Lead procurement sourcing and category management strategies, manage supply portfolio, ensure compliance, oversee vendor relations, and mentor a team. | Bachelor's degree, 8+ years in process improvement or procurement, 2+ years project leadership, audit experience, with preferred Medicaid, PMP, or MBA credentials. | **Become a part of our caring community and help us put health first** The Associate Director, Procurement generates and implements efficient sourcing and category management strategies. Manages the company's supply portfolio ensuring transparency of spending. The Associate Director, Procurement requires a solid understanding of how organization capabilities interrelate across department(s). The Associate Director, Procurement complies with federal and state regulatory guidelines. Reconciles purchases with invoices from vendors, validates pricing and contract compliance. Monitors performance through oversight documentation through vendor negotiations and promotional opportunities. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates. Responsibilities + Understands and explains procurement and supplier oversight processes to Medicaid markets and business areas contacts + Improve and document processes around third-party identification for new market and reprocurement RFPs. + Design, improve, and document processes for third party reporting including notification, collection, analyze, storage, and distribution. + Team representative and presenter for various Medicaid committee meetings (ex; operations, quality, etc.). + Partner with Medicaid markets to improve processes for communication of activity around third party projects, contracts, and SLA performance. + Manage some complex and multi-market relationships + Participate and supports audit requests. + Lead and mentor a team of associates. • *Use your skills to make an impact** • *Required Qualifications** + Bachelor's Degree + 8 or more years of process improvement, relationship / supplier management, or procurement experience + 2 or more years of project leadership experience (formal or informal) + Experience with internal and external audits + Must be passionate about contributing to an organization focused on continuously improving consumer experiences • *Preferred Qualifications** + Medicaid experience + PMP + MBA • *Additional Information** Interview Format 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. WAH Internet Statement 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. $126,300 - $173,700 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** 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: 11-12-2025 • *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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website. • *Become a part of our caring community and help us put health first** The Associate Director, Procurement generates and implements efficient sourcing and category management strategies. Manages the company's supply portfolio ensuring transparency of spending. The Associate Director, Procurement requires a solid understanding of how organization capabilities interrelate across department(s). The Associate Director, Procurement complies with federal and state regulatory guidelines. Reconciles purchases with invoices from vendors, validates pricing and contract compliance. Monitors performance through oversight documentation through vendor negotiations and promotional opportunities. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates. Responsibilities + Understands and explains procurement and supplier oversight processes to Medicaid markets and business areas contacts + Improve and document processes around third-party identification for new market and reprocurement RFPs. + Design, improve, and document processes for third party reporting including notification, collection, analyze, storage, and distribution. + Team representative and presenter for various Medicaid committee meetings (ex; operations, quality, etc.). + Partner with Medicaid markets to improve processes for communication of activity around third party projects, contracts, and SLA performance. + Manage some complex and multi-market relationships + Participate and supports audit requests. + Lead and mentor a team of associates. • *Use your skills to make an impact** • *Required Qualifications** + Bachelor's Degree + 8 or more years of process improvement, relationship / supplier management, or procurement experience + 2 or more years of project leadership experience (formal or informal) + Experience with internal and external audits + Must be passionate about contributing to an organization focused on continuously improving consumer experiences • *Preferred Qualifications** + Medicaid experience + PMP + MBA • *Additional Information** Interview Format 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. WAH Internet Statement 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. $126,300 - $173,700 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** 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: 11-12-2025 • *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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Lead and manage the Medicaid clinical operations intake process using Agile tools, prioritize requests, facilitate governance, and ensure alignment with business priorities. | Bachelor's degree or 2+ years relevant experience, 2+ years in product management or process improvement preferably in Medicaid/healthcare, experience with Jira and portfolio management tools, and stakeholder engagement in regulated environments. | Become a part of our caring community and help us put health first The Medicaid Clinical Operations Intake Product Manager applies professional concepts, industry knowledge, and organizational policies to independently make recommendations about priorities and process changes, as well as champions Agile methodologies and tools for workflow adoption. Work is performed under general direction and often guided by precedent and professional standards with some interpretation. The Medicaid Clinical Operations Intake Product Manager 2 - leads all phases of the product and intake lifecycle – from request submission through evaluation, prioritization, and transition to delivery – by designing, managing, and continuously improving the intake process to meet organizational goals. This role partners across product, operations and technology teams to: • Develop and manage the Clinical operations intake process using Agile product tools and provides information relevant to decision criteria that is used to balance business value, compliance risk, ROI and technical feasibility. • Capture and validate requests from cross-functional teams, ensuring submissions meet Medicaid-specific documentation guidelines. • Facilitate governance reviews and decision-making forums to evaluate requests against capacity and strategic alignment. • Translate approved requests into actionable work items for product delivery teams to consume. • Monitor process performance metrics (cycle time, volume, backlog, market satisfaction) and identify opportunities for improvement. • Ensure the intake process maintains alignment with Medicaid business priorities and enterprise portfolio standards. • Drive communication and visibility of intake status and decision outcomes across stakeholders. Use your skills to make an impact REQUIRED QUALIFICATIONS • Bachelor’s degree or 2+ years of relevant work experience • 2+ years of experience in product management, operations, or process improvement – Preferably in Medicaid or healthcare delivery. • Experience with product intake or portfolio management tools (Jira, SmartSheet, Sharepoint), process governance, and stakeholder engagement in regulated environments Additional Information • Schedule: Monday through Friday, 8:00 AM – 5:00 PM with flexibility to work overtime as needed. • Work Location: US, Nationwide • Work Style: Remote Work-at-Home (WAH) Internet Statement 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. $78,400 - $107,800 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: 11-17-2025 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.
Manage claims processing related to disasters and cyber events, perform code mapping, conduct feasibility assessments, and provide specialized Medicaid claims support. | At least 2 years of claims processing experience with CAS and Mentor, proficiency in CRM and Microsoft Office, strong research and root cause analysis skills, and effective communication with stakeholders. | Job Description: • Manage all initial claims processing impacts resulting from Natural Disaster Declarations and Cyber Events • Mapping all CPT, HCPCS, and Revenue codes to the correct service category in CAS • Conduct feasibility assessments for proposed new benefits • Provides specialized claims processing support for Medicaid programs • Conduct in-depth research on claims, compliance, and legislative requirements Requirements: • Minimum 2 years of claims processing experience utilizing CAS • Minimum 2 years of experience following claims processing and/or edit documents in Mentor • Experience taking a processed claim and determining what edits/processes the claim hit • Experience utilizing CRM • Proficiency with Microsoft Office Word and Excel including the ability to create pivot tables • Demonstrated experience in root cause analysis and investigation • Strong research skills, with a proven ability to learn quickly and identify improvement opportunities • Ability to switch tasks and adapt priorities as needed • Experience collaborating and communicating effectively with a wide range of stakeholders Benefits: • 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
Develop and execute actuarial talent management programs, maintain metrics dashboards, support exam and continuing education initiatives, and collaborate with leadership and committees to enhance talent strategies. | Bachelor's degree, 8+ years technical experience, 2+ years project leadership, actuarial or talent management experience with data analytics and dashboard skills, and preferred actuarial credentials (ASA/FSA). | Become a part of our caring community and help us put health first The Talent Management Lead develops, implements, and evaluates employee development plans and programs to support organizational needs in a combination of disciplines such as management development, talent management, succession planning, technical or nontechnical training, or e-learning. The Talent Management Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Talent Management Lead monitors employee development and training programs, assesses needs and results, develops new programs, and modifies existing programs. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. Job Title: Actuarial Talent Management Lead Job Family: Talent Management Level: Lead Summary: The Actuarial Talent Management Lead is responsible for helping to lead, execute and enhancing Humana’s actuarial talent programs within the business. A central responsibility is the development, maintenance, and ongoing improvement of the actuarial community metrics scorecard, providing key data-driven insights for executive leadership and program decision-making. This position partners with the Chief Insurance Actuary, HR, and actuarial leadership to support skills advancement, learning, exam progression, and professional standards across the actuarial community. The role supports core programs and provides technical expertise to committees and talent initiatives. Key Responsibilities: • In coordination with the Chief Insurance Actuary, the Actuarial Talent Management Principal, and HR, coordinate and execute the strategy for core actuarial talent priorities. • Exams • Summer Interns • Continuing Education • Rotations • Actuarial Professionalism and Standards • Build, maintain, and enhance the actuarial community metrics dashboard, integrating data from systems such as Workday, SharePoint, and internal sources; provide periodic reporting and analytics to leadership and committees. • Support execution of actuarial rotation and internship programs, including logistics, recruiting coordination with Talent Acquisition, onboarding, and event planning. • Partner with HR and Skills Committee to update the actuarial skills framework; support annual skills assessments and technical reporting. • Collaborate with Exam Committee to administer APDP policy, monitor exam progress, and support exam-related communications. • Track continuing education and compliance in partnership with Learning Committee and volunteers; ensure accurate records and technical reporting. • Maintain and update actuarial talent data in Workday, email lists, and SharePoint; ensure data integrity and support talent program operations. • Serve as technical support for enrichment teams (Innovation, Skills, Exam, Standards & Qualifications, Continuing Education, DEI, Growth, Networking, Insights, Mentoring) through meeting documentation, dashboard analytics, and process improvement. • Participate as a member of the Actuarial Steering Committee, providing technical analysis and program updates as required. • Support process improvement for promotion reviews, actuarial job track alignment, and benchmarking against industry standards through dashboard insights and data analysis. Qualifications: • Associate of the Society of Actuaries (ASA) or FSA preferred • 4+ years of actuarial or talent management experience, with demonstrated technical excellence in data analytics and dashboard/reporting tools. • Experience in program coordination or technical support for talent programs, continuing education, or exam tracking. • Advanced skills in Microsoft Excel and Power BI (or equivalent dashboard tools), with working knowledge of Workday and SharePoint. • Deep knowledge in actuarial talent management • Strong analytical and technical communication skills. • Ability to manage multiple priorities, maintain data accuracy, and collaborate across teams. Use your skills to make an impact Required Qualifications • Bachelor's Degree • 8 or more years of technical experience • 2 or more years of project leadership experience • Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications: • Associate of the Society of Actuaries (ASA) or FSA preferred • 4+ years of actuarial or talent management experience, with demonstrated technical excellence in data analytics and dashboard/reporting tools. • Experience in program coordination or technical support for talent programs, continuing education, or exam tracking. • Advanced skills in Microsoft Excel and Power BI (or equivalent dashboard tools), with working knowledge of Workday and SharePoint. • Deep knowledge in actuarial talent management • Strong analytical and technical communication skills. • Ability to manage multiple priorities, maintain data accuracy, and collaborate across teams. 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. $104,000 - $143,000 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: 12-30-2025 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.
Manage print production and procurement processes including vendor selection, budget management, production planning, and stakeholder coordination to ensure timely and cost-effective delivery of printed materials. | Bachelor's degree or equivalent, 5+ years relevant experience, print and project management skills, CMS guidelines knowledge, strong financial acumen, Microsoft proficiency, excellent communication, and ability to lead teams and present to senior leaders. | Become a part of our caring community and help us put health first The Senior Print Project Manager will report to the Associate Director of Enterprise Print Management and will be involved in the production and procurement of printed materials. This position involves evaluating and selecting print vendors, ensuring that materials are delivered on time, and managing budgets to achieve cost-effective solutions. Other areas of focus include production planning, inventory control, and distribution. Effective communication and relationship-building skills are key, as the role involves coordinating with various stakeholders. Key Responsibilities • Create integrated processes among business owners, operations, purchasing, logistics, and outside print vendors to ensure seamless workflow and collaboration • Focus resources on continuous improvement of printed material movement through production, establishing and monitoring key performance metrics and benchmarks for supply chain planning and forecasting • Promote organizational alignment by understanding and communicating customer needs and requirements to internal teams and external partners • Demonstrate a strong understanding of departmental, segment, and organizational strategy and operating objectives, including their connections to related areas • Contribute to the execution and management of Requests for Proposal (RFP), including analytics and process oversight • Participate in data gathering, interpretation, and assist with budget planning and forecasting to support departmental objectives • Adhere to established guidelines and procedures to ensure compliance and operational consistency Use your skills to make an impact Required Qualifications • Bachelor’s Degree or equivalent experience in Business, Operations Management, or a related field • Minimum five years of relevant professional experience • Understanding of Centers for Medicare & Medicaid Services (CMS) guidelines • Print and project management experience, with developing and executing project plans • Ability to assimilate, analyze, draw conclusions, and make recommendations from multi-faceted and often ambiguous data • Strong financial and business acumen required • Proficiency in Microsoft products (i.e., Word, Excel, PowerPoint, etc.) • Excellent written and verbal communication skills • Ability to motivate project team members and stakeholders to meet established deadlines • Motivated initiative-taker with the ability to work with minimal oversight • Solid public speaking and negotiation skills required • Experience with working on high visibility projects and skilled and competent in presenting data/analysis to Senior Leaders • Ability to be flexible and willing to learn new skills quickly as the need arises • Effectiveness in working collaboratively with cross-functional teams Preferred Qualifications • Intermediate to advanced proficiency of Microsoft Excel including modeling and development of macros • Experience in working for a large-scale health and wellbeing organization • Experience in working with logistics partners such as UPS, FedEx, and USPS • Understanding mail and logistic best practices • Excellent analytical skills: ability to research and make efficient use of resources to achieve effective business results • Ability to manage multiple tasks or projects simultaneously in a timely and professional manner; ability to transfer lessons learned into new processes; flexibility in job focus 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. $78,400 - $107,800 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.
Review medical records for Coordination of Care studies, analyze data, and implement corrective actions following established guidelines. | Bachelor's degree, clinical background, office or hospital experience, strong communication and analytical skills, and residency near Michigan or bordering states. | Job Description: • Complete medical records reviews for Coordination of Care studies • Analyze data and implement corrective actions as needed • Review medical records for supplemental data and enter data in supplemental database • Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas • Make decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed • Follow established guidelines/procedures • Additional responsibilities based on business need Requirements: • Must reside in MI or within 40 miles of the border in Indiana or Ohio • Bachelor's degree • Clinical background • Strong oral / written communication and presentation skills • Strong analytical skills, able to manipulate and interpret data • Office practice / hospital experience • Organizational and prioritization skills • Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint Benefits: • 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 • many other opportunities
Manage and improve quality assessment programs, ensure compliance, coordinate with stakeholders, and track quality measures for a health plan. | Bachelor's degree or 5+ years in healthcare quality improvement, 2+ years management experience, knowledge of healthcare quality measures, and strong communication skills. | Job Description: • Ensure the Quality Assessment and Performance Improvement (QAPI) program for Humana Healthy Horizons in Michigan operates effectively • Drive quality improvement efforts of Humana’s Quality Operations • Support the implementation and monitoring of program documents such as the Quality Improvement Plan, work plan, QAPI committee and evaluation, as well as other quality operations, improvement, and compliance functions • Audit processes as needed for compliance • Complete and submit state, federal, or other reports as required • Collaborate and maintain frequent contact with other managers across departments and health plan • Conduct briefings and area meetings • Determine the plan’s compliance with requirements for NCQA accreditation • Track HEDIS measures along with the assistance of the Quality Data Analyst to ensure the plan meets the goals set for quality measure withholds • Coordinate with relevant internal/external stakeholders, providers, the Michigan Department of Health and Human Services (MDHHS), and other entities to maintain quality operations and improve health outcomes. Requirements: • Bachelor's Degree or 5+ years related work experience in healthcare quality improvement • 2 or more years of management/leadership experience • Understanding of healthcare quality measures STARS, HEDIS, etc. • Prior experience in a fast-paced insurance or health care setting • Comprehensive knowledge of Microsoft Office suite • Excellent communication skills, both oral and written. Benefits: • 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
Lead development and maintenance of marketing BI dashboards and reports, ensure data quality, collaborate with teams to deliver actionable marketing insights, and mentor peers. | Bachelor's degree, 4+ years BI reporting experience, marketing analytics expertise, stakeholder communication skills, and preferably SQL, DAX, and healthcare data knowledge. | Become a part of our caring community and help us put health first Become a part of our caring community Join Humana's BI Marketing Reporting team as a Senior BI Associate, where you'll lead the development of business intelligence solutions that uncover actionable insights into marketing performance. You'll own reporting processes, champion data quality and governance, and collaborate across teams to ensure scalable data pipelines and trusted analytics that drive strategic marketing decisions. Role Responsibilities As a senior member of the BI team, you will lead the translation of marketing stakeholder requirements into scalable, actionable data solutions. You will own the development and lifecycle of dashboards and visualizations, serve as a subject matter expert on the data and its business context, and mentor peers through cross-training and knowledge sharing to elevate team capabilities and stakeholder confidence. Key responsibilities include: • Build and maintain dashboards and reports that provide visibility into key performance indicators • Own reporting solutions end-to-end by delivering key insights through dashboards and serving as the go-to expert on the data and its business context • Partner with Data Engineering and IT teams to establish, monitor, and maintain robust data pipelines that support reliable and scalable reporting solutions. • Lead data validation, cleansing, and preparation efforts, setting standards for data quality and reliability while guiding peers in best practices to ensure consistent, trustworthy insights. • Design and maintain advanced BI dashboards and reporting solutions. • Collaborate with stakeholders to define reporting requirements and KPIs. • Document methodologies and contribute to governance efforts. • Support continuous improvement initiatives focused on BI capabilities. Use your skills to make an impact Use your skills to make an impact Required Qualifications • Bachelor's degree in Information Systems, Data Analytics, or a related field. • 4+ years of experience with BI tools and reporting development. • Demonstrated experience leading end-to-end BI solution development, including requirements gathering, dashboard design, and stakeholder engagement. • Deep understanding of marketing analytics concepts, KPIs, and performance measurement frameworks. • Proven ability to tailor visualizations to stakeholder needs, ensuring clarity, usability, and alignment with business goals. • Ability to mentor and support junior team members, fostering a collaborative and growth-oriented team environment. • Minimum of 2 years of experience in communication and stakeholder engagement, with a proven ability to drive cross-functional alignment and successfully implement new processes. Preferred Qualifications • Experience with marketing performance reporting. • Familiarity with DAX, SQL, data modeling, and ETL processes. • Exposure to healthcare or insurance environments. • Knowledge of HIPAA and data privacy standards • Familiarity with Databricks, Snowflake Work at Home Information To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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 • Associates 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 associates 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 Virtual Pre-Screen • As part of our hiring process for this opportunity, we are 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. • If you are selected to move forward in the process, you will receive a text message inviting you to participate in a HireVue prescreen. In this prescreen, you will receive a set of questions via text and given the opportunity to respond to each question. You should anticipate this prescreen taking about 15 minutes. Your responses will be reviewed and if selected to move forward, you will be contacted with additional details involving the next step in the process. • Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website. 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. $89,000 - $121,400 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.
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