The Manager, Product Ownership leads and coaches a team of Product Owners to define product vision, prioritize backlogs, and ensure business needs are met. They act as a key partner to stakeholders and technology teams to drive strategic initiatives while maintaining Agile standards.
The Care Coach evaluates member needs, coordinates care, and drives interventions to improve health outcomes and quality performance. They conduct proactive telephonic outreach to identify clinical, financial, and social needs while collaborating with multidisciplinary partners to resolve barriers to care.
The Care Coach conducts telephonic outreach to members with chronic conditions to assess needs and develop individualized care plans. They coordinate services and connect members to clinical and community resources to ensure optimal health outcomes while maintaining compliance.
Architect and implement goal-setting and decomposition mechanisms for autonomous agents operating in dynamic environments. Develop evaluation frameworks to ensure agent alignment with human intent, reliability, and operational safety.
The Senior Product Owner manages the product vision and roadmap for DevSecOps initiatives while collaborating with stakeholders to prioritize the product backlog. They act as the voice of the customer, translating business needs into technical requirements and ensuring the delivery of high-quality, innovative solutions.
Administer, configure, and support the Genesys Cloud CX platform while managing telephony integrations and contact center routing solutions. Partner with business stakeholders to deliver scalable, customer-focused solutions and maintain technical documentation for operational procedures.
The Senior Counsel provides legal advice on complex matters, focusing on primary care operations and merger and acquisition activities. They ensure compliance with healthcare regulations, including fraud, waste, and abuse laws, while collaborating with company leadership to mitigate risk.
The manager leads teams of nurses and behavioral health professionals to oversee the assessment and evaluation of member needs. They are responsible for making tactical decisions, managing departmental resources, and coordinating care across various health programs.
The professional will use behavioral health knowledge to coordinate medical services and perform benefit administration determinations. They will communicate with providers and members to facilitate optimal care while interpreting clinical criteria and organizational policies.
Design, develop, and maintain UI and API test automation frameworks while integrating them into CI/CD pipelines. Partner with cross-functional teams to improve release quality and utilize AI-assisted tools to enhance automation productivity.
The Lead Enterprise Architect aligns business strategy with technology execution to improve member experiences and health outcomes. They provide mentorship to architecture teams and drive the adoption of lean enterprise architecture practices within an agile framework.
The Data Engineer will ingest data from various sources using cloud-native platforms and develop software tools that leverage AI and big-data techniques. They will transform data into actionable insights to improve member health outcomes while following organizational strategies.
The Channel Development Lead defines sales product strategies and drives sustained mail order pharmacy utilization through member engagement and retention initiatives. This role collaborates with cross-functional teams to optimize member touchpoints and improve refill rates, auto-refill adoption, and overall prescription growth.
The Senior Coding Educator identifies opportunities to improve provider documentation and creates tailored education plans to enhance coding accuracy and quality of care. They collaborate with internal teams to develop risk adjustment strategies and deliver educational sessions to provider groups.
The Corporate Medical Director performs clinical reviews of grievance and appeal cases to ensure compliance with medical policies and regulatory requirements. They serve as a clinical subject matter expert and provide medical interpretation regarding the appropriateness and quality of healthcare services.
The Medical Director reviews complex Medicare drug appeals by analyzing clinical data against regulatory policies and medical necessity standards. They also engage in peer-to-peer discussions with prescribers and support cross-functional teams to ensure optimal value-based care.
The Director oversees the design and execution of transformation strategies and operating models to improve product delivery and organizational effectiveness. They lead cross-functional teams, manage budgets and workforce planning, and establish governance frameworks to ensure alignment with enterprise goals.
The Subrogation Professional investigates accident, injury, and claim events to determine if Humana has the right to recover payments from responsible parties. This role involves gathering information from various stakeholders, creating and maintaining liens, and negotiating repayment amounts.
The Senior Business Intelligence Engineer develops and maintains data pipelines, reporting datasets, and automated workflows to provide actionable business insights. This role partners with stakeholders to translate complex business needs into scalable solutions using Power Platform and Databricks.
The Technology Solutions Professional supports software quality by creating and executing test cases to validate system functionality and business requirements. They collaborate with cross-functional teams to document, investigate, and resolve defects while ensuring adherence to QA standards.
The Business Intelligence Lead will serve as a strategic partner to the Conversational Channels organization, driving analytics strategy, KPI governance, and roadmap planning. They will also provide technical leadership and mentorship to a team of engineers while delivering actionable insights through executive dashboards and reporting.
The Strategy Advancement Advisor will lead high-impact strategy projects, focusing on Medicare enrollment growth and investment optimization. They will conduct market and financial analysis to provide actionable recommendations to senior leadership.
The Lead Application Architect will define architecture strategies and lead the design of scalable, secure, cloud-native enterprise solutions. They will also mentor engineering teams and establish technical standards across the organization to ensure high-performing digital platforms.
The analyst supports value-based provider relationships by analyzing financial patterns, trends, and contract pricing to ensure accuracy and compliance. They collaborate with internal departments to achieve organizational strategy and improve the provider experience.
The Senior Content Designer will drive content strategy and design across digital products by partnering with cross-functional teams to create human-centered experiences. They will simplify complex healthcare information and use research and analytics to optimize content usability and performance.
The Growth Strategy Principal will lead high-impact strategy projects and cross-functional teams to drive growth and profitability for Humana's Medicare and Medicaid businesses. This role involves deconstructing complex business challenges, performing rigorous analysis, and facilitating collaboration with executive leadership to implement strategic recommendations.
The Senior Process Improvement Professional leads enterprise-wide procurement digital transformation and AI-driven initiatives to optimize systems and processes. This role acts as a bridge between business stakeholders and technology teams to design, implement, and govern innovative solutions that enhance operational efficiency.
Assess members’ health, safety, strengths, and preferences to develop and update Member Care Plans, and coordinate services with nurses and community providers. Conduct required in-person assessments and visits, maintain regular member contact, arrange non-medical supports, evaluate risks, and document services and authorizations.
Review inpatient hospital claims and medical records to verify coding, reimbursement, and diagnosis-related group assignments, including MS-DRG accuracy. Resolve or respond to provider disputes and internal information requests, while supporting accurate payments and cost reduction through claims analysis and database work.
The role involves administering and governing access within the Genesys Cloud platform, including user provisioning, role management, and compliance auditing. The associate will collaborate with security and operational teams to ensure platform integrity and support ongoing system enhancements.
The Lead Release Train Engineer serves as the primary facilitator and servant leader for a complex Agile Release Train, ensuring effective adoption and execution of SAFe principles. They partner with business and technology stakeholders to drive alignment, remove impediments, and optimize value delivery across the organization.
The Lead CyberSecurity Engineer will design and implement security solutions for web applications, APIs, and cloud-hosted services while leading cross-functional initiatives. They are responsible for optimizing WAF and Bot Management platforms and driving enterprise-wide security improvements through roadmap planning and automation.
The Senior Configuration Management Analyst leads the operational excellence, governance, and continuous improvement of the Configuration Management Database (CMDB). This role partners with cross-functional teams to ensure data accuracy, service modeling, and the integration of AI-enabled insights.
The Community Resource Navigator provides personalized support by connecting members to community resources, care teams, and social services. They conduct outreach, perform needs assessments, and assist in the development and implementation of member-centered care plans.
The Senior Product Engineer will define the roadmap and build accessibility products, including automated testing tools and AI agent skills, to support accessible web and mobile experiences. They will also manage the Digital Accessibility Program, conduct audits, and provide technical guidance to product teams to ensure compliance.
The Medical Director reviews preauthorization requests and clinical scenarios to determine the appropriateness of services based on national guidelines and CMS policies. They also collaborate with internal teams and external physicians to support regional market priorities and care management initiatives.
The role involves managing and publishing website updates within the Adobe Experience Manager (AEM) platform across multiple product groups. You will also perform quality assurance testing and collaborate with cross-functional teams to ensure content accuracy and adherence to service level agreements.
The Senior Enterprise Architect will lead technical planning and modernization efforts to align Humana's environments with technology standards and security compliance. They will collaborate with enterprise teams to design and implement cloud-native solutions while providing thought leadership on best practices and architectural frameworks.
Design, develop, test, deploy, and maintain a new pharmacy eligibility application, modernizing legacy components and improving system scalability, reliability, performance, and backend workflows. Collaborate with agile teams to resolve complex technical issues, strengthen engineering quality, and guide architectural decisions for enterprise-grade healthcare software.
You will design, develop, and deploy accessible user interfaces and microservices while building shared AI coding tools for the platform. You will also collaborate with cross-functional teams to shape product roadmaps and ensure high standards for performance, reliability, and accessibility.
The Lead Product Engineer will set the technical direction for the Digital Health Platform, shipping production code while leading the adoption of AI-driven engineering practices. This role involves mentoring engineers, defining product outcomes, and collaborating with stakeholders to ensure high-quality, accessible, and scalable digital experiences.
You will create ad hoc reports, datasets, and information dashboards by integrating data from multiple sources using system tools and database queries. Additionally, you will maintain report forms and formats while interpreting business requests to determine appropriate courses of action.
Own and configure Workday Talent and Performance solutions, translating business requirements into scalable designs while leading requirements gathering, testing, implementation, and ongoing optimization. Provide advanced production support and troubleshooting, advise stakeholders on Workday capabilities, and support governance, releases, integrations, and cross-functional enterprise initiatives.
The Software Engineer 2 designs, develops, tests, and maintains software applications while collaborating with cross-functional teams in an Agile environment. They contribute to all phases of the software development lifecycle and support cybersecurity and identity access management initiatives.
Design, build, maintain, and optimize scalable data pipelines and ETL/ELT workflows using Azure Databricks, SAS, SSIS, SQL, and big data technologies. Monitor and troubleshoot data processing, improve platform performance and reliability, and collaborate with product, SRE, software engineering, and analytics teams to deliver data solutions aligned with business needs and enterprise architecture.
Perform initial credentialing and recredentialing for practitioners and organizational providers, maintain accurate provider records, and monitor credentialing requirements and turnaround times. Support compliance and audits, resolve discrepancies, improve workflows, and coordinate with internal departments and external credentialing vendors.
Conduct in-person visits with Medicaid members in homes and care facilities, assess their needs and barriers, and develop individualized care plans that support well-being in the least restrictive setting. Coordinate and monitor services, connect members and families with appropriate community and healthcare resources, and collaborate with providers and interdisciplinary teams to support members’ goals.
The Outbound Telesales Agent will conduct outbound calls to members to promote and schedule virtual appointments with healthcare providers. They are responsible for maintaining detailed records in the CRM system and collaborating with team members to meet scheduling targets.
Manage complex medical cases across the continuum of care, using appropriate care settings and interventions to reduce hospital readmissions, support appropriate resource utilization, and improve coordination. Serve as the beneficiary’s primary contact and coordinate with care management teams, military treatment facility staff, and providers to develop integrated care plans.
Contact members by phone to explain virtual healthcare appointments and persuade them to schedule appointments with providers. Record call outcomes in the CRM, follow up with members and providers, respond to inquiries, and collaborate with the team to meet scheduling targets while following privacy and regulatory requirements.
The Case Manager provides care management services including psychosocial assessments, service plan development, and ongoing monitoring for adults with disabilities and the frail elderly. They also facilitate collaboration with medical professionals and educate members on benefits and community resources.
The Senior Configuration Professional leads Medicaid-related product capabilities, configuration strategy, and backlog management within care and utilization management platforms. This role partners with cross-functional teams to define product vision, prioritize business needs, and ensure system solutions meet clinical, regulatory, and operational outcomes.
The Associate Actuary analyzes financial and market data to develop and maintain forecasting models for Medicare, Medicaid, and other insurance products. They ensure data integrity, troubleshoot anomalies, and collaborate with cross-functional partners to influence departmental strategy.
The Senior Network Performance Professional will collaborate with healthcare providers to improve STARs ratings, quality metrics, and overall performance through strategic initiatives. They will also act as a liaison to resolve provider abrasion and ensure alignment with organizational goals regarding interoperability and value-based care.
The manager will lead a team of quality assurance professionals to ensure compliance with state and Humana requirements for LTSS eligibility and service authorization. They will oversee daily operations, collaborate with external partners like Area Agencies on Aging, and develop policies to maintain high operational standards.
Design and lead the development of core backend services, APIs, and service-to-service integrations to support AI product stacks. Establish security patterns, ensure HIPAA compliance, and drive engineering standards across the team.
The Senior User Interface Design Engineer will own end-to-end design for clinical product verticals, focusing on complex workflows and data-dense interfaces. They will also contribute to design systems, conduct user research, and integrate AI-assisted tools into the design process.
The Utilization Management Registered Nurse interprets and supports the coordination, documentation, and communication of medical services and benefit determinations. They manage post-acute care services to ensure members receive the appropriate level of care in the most suitable setting.
The engineer will design and build high-quality user experiences using TypeScript, React, and Next.js while translating AI capabilities into intuitive clinical interface patterns. They will own features from design handoff through production deployment while ensuring compliance with HIPAA and accessibility standards.
The Director is responsible for defining and executing the enterprise strategy for provider data quality, governance, and directory accuracy. They lead cross-functional initiatives to ensure data integrity while partnering with technology and operations teams to enhance provider and member experiences.
The Principal Automation Engineer defines and scales enterprise-wide test automation strategies, frameworks, and AI-enabled quality engineering capabilities. This role partners with cross-functional teams to drive automation-first practices and ensure reliable, secure technology solutions across the organization.
Design, implement, and maintain secure cloud infrastructure and DevOps platforms across Azure and GCP. Manage enterprise DevOps tools including JFrog, Argo CD, and Kubernetes while ensuring regulatory compliance and software supply chain security.
The role manages the end-to-end Medicaid Utilization Management rates and timeliness evaluation process across various markets. Responsibilities include coordinating reporting schedules, validating data, analyzing performance trends, and preparing materials for governance committees.
The Medical Coding Coordinator reviews and educates providers on disputed claims involving code editing denials and financial recovery. They are responsible for extracting clinical information from medical records and assigning accurate procedural and medical codes.
The Principal, Segment QE Architect defines and scales enterprise-wide test automation strategies, frameworks, and AI-enabled quality engineering capabilities. This role serves as a strategic technical advisor, partnering with cross-functional teams to drive automation-first practices and modernize quality engineering across the organization.
Own and advance the Service Operations product portfolio across incident, major incident, problem, and knowledge management, including ServiceNow enhancements, integrations, and upgrades. Define and prioritize product requirements and backlogs, enable automation and AI capabilities, and measure outcomes such as incident reduction, faster resolution, knowledge effectiveness, and self-service adoption.
The Principal Automation Engineer will lead the strategy, implementation, and support of enterprise quality engineering tools and automation platforms. This role acts as a technical advisor to cross-functional teams to ensure successful tool adoption, integration, and continuous improvement across the organization.
The Lead Technology Leadership Professional provides hands-on technical leadership across multiple Scrum teams to drive software delivery from planning through implementation. This role acts as a key technical advisor, removing obstacles and ensuring alignment with enterprise architecture, security standards, and engineering excellence.
The Quality Assurance Professional reviews LTSS contractor documentation to ensure compliance with state and federal regulations while preventing fraud, waste, and abuse. They also conduct audits, analyze operational metrics, and ensure adherence to organizational and departmental policies.
The Process Improvement Lead coordinates cross-functional operational workstreams and ensures governance activities are consistently applied across the department. This role drives process optimization, maintains project plans, and facilitates operational readiness to support strategic business objectives.
The Senior Associate will develop and execute digital marketing strategies across owned channels including website, email, SMS, and social media. They will monitor KPIs, analyze performance data, and partner with cross-functional teams to drive engagement and conversion.
The Field Care Manager performs face-to-face and telephonic assessments to provide integrated behavioral health care coordination for members. They serve as the primary point of contact, leading interdisciplinary care teams to ensure timely service delivery and improved health outcomes.
The Member Services Advisor leads strategies to improve member engagement, retention, and satisfaction while overseeing key market KPIs and performance metrics. They serve as a member advocate, coordinate cross-functional communications, and identify opportunities for automation and process optimization.
The Director will lead quality engineering strategy and execution across a defined portfolio, overseeing teams responsible for test automation, release readiness, and continuous improvement. This role involves partnering with cross-functional stakeholders to embed quality throughout the software development lifecycle and drive the adoption of AI-enabled engineering capabilities.
The Growth Strategy Principal will lead high-impact strategy projects and cross-functional teams to drive growth and profitability for Humana's Medicare and Medicaid businesses. This role involves synthesizing strategic choices into coherent plans, facilitating critical meetings, and collaborating with executive leadership to define the organization's future.
The Compliance Professional is responsible for coordinating, preparing, and submitting Medicaid state reports while ensuring data accuracy and completeness. They will partner with business owners and market leadership to educate stakeholders on reporting processes and identify gaps in data availability.
The Director will lead quality engineering strategy and execution across a defined portfolio, overseeing teams responsible for delivery quality, test automation, and release readiness. This role involves partnering with cross-functional stakeholders to embed quality throughout the software development lifecycle and drive continuous improvement through AI-enabled capabilities.
The Director of Quality Engineering leads the strategy and execution of quality practices across a defined technology portfolio to improve delivery speed and production stability. This role manages teams of engineers and managers while driving automation-first practices and integrating quality signals into CI/CD pipelines.
The Manager, Care Management leads a team of Care Coaches in conducting telephonic outreach to close care gaps and connect members with health and social resources. This role involves setting performance expectations, analyzing data to improve outcomes, and collaborating with enterprise partners to align outreach strategies with Stars priorities.
The Director will lead quality engineering strategy and execution across a defined portfolio, overseeing teams responsible for test automation, release readiness, and continuous improvement. This role involves partnering with cross-functional leaders to embed quality throughout the software development lifecycle and drive modernization efforts.
The Field Care Manager assesses and evaluates member needs to facilitate access to resources and ensure optimal wellness. They develop and monitor care plans while identifying and resolving barriers to effective health outcomes.
The Senior Enterprise Architect aligns business strategy with technology execution to deliver improved member experiences and health outcomes. They provide mentorship to technical teams, lead application modernization, and define enterprise standards to ensure robust, cost-effective technology solutions.
The Cloud Solutions Engineer 2 provides operational support, maintenance, and troubleshooting for Genesys contact center platforms and integrated telecommunications infrastructure. This role also focuses on improving workflows through automation and AI-driven solutions while participating in a 24x7 on-call rotation.
The Director leads the EHR data acquisition portfolio, overseeing strategy, roadmap execution, and product team leadership for clinical data retrieval and interoperability. They are responsible for aligning portfolio investments with enterprise priorities, managing product talent, and driving measurable business value through clinical data access.
The Product Manager is responsible for the strategy, roadmap, and performance of provider-facing workflow products delivered through EHR platforms. They lead the planning, development, and optimization of these capabilities while collaborating with cross-functional teams to drive adoption and business outcomes.
Define and deliver the Provider Direct Connect product vision, strategy, roadmap, and scalable integration capabilities, aligning investments with provider needs, business outcomes, and technical standards. Partner with providers and internal teams to support onboarding and adoption, resolve operational issues, measure product performance, communicate priorities to leadership, and continuously improve provider experiences.
Own strategic relationships with assigned EHR vendors, align vendor roadmaps with enterprise priorities, and monitor performance, commitments, KPIs, and service levels. Coordinate cross-functional initiatives, manage governance and escalations, identify partnership opportunities, and advise leadership on vendor investments and future plans.
Lead recurring and ad hoc financial analysis, reporting, forecasting, and performance insights to improve Medicare Advantage market results. Support regional bid strategy and financial close activities while advising operational leaders and driving cross-functional process improvements.
Engineer and support enterprise identity security solutions across SailPoint ISC, Okta, Active Directory, and Entra ID, including identity lifecycle management, authentication, access governance, and application integrations. Automate and troubleshoot identity processes, support HIPAA-related compliance and audits, and provide technical leadership and mentoring across security and healthcare teams.
The Fraud and Waste Professional 2 conducts comprehensive investigations into suspected Medicaid fraud, waste, and abuse by analyzing billing patterns and provider records. They coordinate with law enforcement and internal partners to assemble evidence, prepare complex audit reports, and support program integrity initiatives.
The Lead Site Reliability Engineer maintains, integrates, and implements software applications while coordinating testing, quality assurance, and system stability. They also advise executives on functional strategies and lead high-severity incident restoration efforts.
The Lead Solution Architect will drive the architecture strategy, design, and governance of the organization's CIAM/XIAM ecosystem using ForgeRock. They will collaborate with cross-functional teams to translate business requirements into scalable, secure, and compliant identity solutions.
The Principal Data Enterprise Architect defines and executes the enterprise data strategy, leading the transformation from legacy integrations to a modern, domain-driven data product model. This role partners with business and technology leaders to establish data governance, improve data quality, and enable scalable analytics and AI outcomes.
The Lead, Portfolio Management oversees the operational health, financial discipline, and strategic execution of the Enterprise Software Quality Engineering Center of Excellence. This role facilitates portfolio governance, resource planning, vendor management, and cross-functional collaboration to ensure organizational effectiveness.
The Lead, Portfolio Management oversees the operational health, financial discipline, and strategic execution of the Enterprise Software Quality Engineering Center of Excellence. This role manages portfolio operations, vendor governance, resource planning, and executive reporting to ensure alignment with enterprise priorities.
The role involves providing operational and strategic support for application operations and post-production validation teams while driving process automation and innovation. You will oversee daily monitoring activities, develop standard operating procedures, and collaborate with cross-functional teams to ensure system reliability.
Architect and optimize enterprise-scale observability and logging platforms using AI-native tools and automation. Lead cross-functional initiatives to ensure system reliability, scalability, and performance while mentoring junior engineers.
The analyst will deliver proactive cyber threat intelligence and translate it into actionable strategies to reduce organizational risk. They will lead threat prioritization frameworks, produce intelligence assessments, and collaborate with security teams to develop effective countermeasures.
The Director of Risk Adjustment Regulatory Audits is responsible for developing and executing strategies for external regulatory audits to minimize financial risk. This role involves managing cross-functional relationships, implementing technology solutions for audit efficiency, and overseeing team performance and reporting.
The Portfolio Enablement Lead shapes and advances Humana's portfolio operating model, Agile Release Train design, and Ways of Working across multiple portfolios. This role acts as a trusted advisor to executive leadership to translate enterprise strategy into scalable operating models that drive value delivery and business outcomes.
Assess and optimize medication therapy for high-risk patients with chronic conditions, provide patient counseling and education, and coordinate care with physicians and multidisciplinary teams. Document clinical interventions, support quality measures and improvement initiatives, reconcile medications after discharge, and advise and educate healthcare staff.
Manage the Colorado sales territory, building relationships with physician office staff and influencing prescription routing to CenterWell Specialty Pharmacy. Educate clinic staff about specialty medication options and patient benefits, while using geographic and sales analysis to support territory decisions.
Initiate, negotiate, and execute contracts with physicians, hospitals, and other providers, including Medicare, value-based, and incentive arrangements. Analyze contract financial impacts, communicate terms and reimbursement structures, maintain contract documentation, support provider recruitment, and implement strategic initiatives and operational improvements.
Analyze existing business processes and use data, benchmarking, and root cause analysis to develop measurable, sustainable improvements that enhance safety, productivity, and cost efficiency. Recommend new business practices and procedures, assess how information technology can support reengineering, and influence departmental strategy while independently leading complex assignments.
Assess members’ health and safety needs, develop Member Care Plans, conduct regular health assessments, and coordinate care with acute and primary care providers. Educate and support members, document care within required timeframes, conduct monthly phone contacts, and travel for in-person visits.
The Registered Nurse will coordinate care and provide support to Wisconsin Family Care Program members by assessing health needs and developing comprehensive care plans. They will also educate members on disease processes and lifestyle modifications while maintaining accurate documentation within contract timeframes.
The Counsel provides legal advice and support for Medicare Advantage lines of business, ensuring compliance with healthcare regulations. They collaborate with company leaders to drive healthcare strategy and protect the organization against external risks.
The Business Intelligence Engineer solves complex business problems by integrating and analyzing data from various sources to provide actionable insights. They are responsible for describing and utilizing tools and practices to present raw data in a way that supports informed decision-making.
The Lead Product Manager will drive the execution and continuous improvement of enterprise consent and preference management capabilities. This role involves managing the product lifecycle, collaborating with cross-functional teams, and ensuring compliance across all customer touchpoints.
The Senior Care Coordinator evaluates member needs to achieve optimal wellness and guides families toward appropriate care resources. They also provide leadership support by mentoring team members, monitoring field visits, and ensuring compliance with clinical documentation and audit standards.
The Senior Risk Management Professional identifies, analyzes, and minimizes organizational risks while partnering with business owners to ensure compliance within the pharmacy solutions space. They are responsible for designing monitoring programs, overseeing remediation tracking, and developing executive-level dashboards to report on compliance risks and key metrics.
The Lead Enterprise Architect will define and govern a comprehensive enterprise API ecosystem, establishing standards and integration patterns across the organization. This role involves partnering with cross-functional teams to drive API adoption, implement AI-enabled governance, and mentor engineering teams on modern integration practices.
The professional prepares, analyzes, and distributes periodic financial statements and management reports while ensuring compliance with government regulations and organizational policies. They also manage complex financial data sets using advanced Excel and SQL to identify trends and support actionable insights.
The Director will lead the definition, governance, and enterprise adoption of quality engineering standards, methodologies, and AI-enabled practices across the software delivery ecosystem. This role partners with cross-functional teams to mature quality practices, ensure compliance, and drive continuous improvement in engineering outcomes.
The Director of Segment Quality Engineering leads teams responsible for delivery quality, test automation, and release readiness across Humana's technology portfolio. This role partners with cross-functional teams to embed quality throughout the software development lifecycle and drive continuous improvement.
The Clinical Pharmacist will evaluate pharmacotherapy for high-risk patients and collaborate with a multi-disciplinary team to optimize patient care and medication safety. They are responsible for documenting clinical interventions in the EMR and supporting quality measures like CMS Stars and HEDIS.
The RN Care Manager provides case management and health monitoring for members in the Family Care Partnership program through home and community visits. They work within an interdisciplinary team to assess member needs, coordinate care, and ensure health and safety outcomes.
The intern will support and facilitate care for members by partnering with healthcare professionals and project teams. They will work within defined parameters to interpret department policies and complete assigned tasks under minimal direction.
The Lead Actuary analyzes financial and operational data to support value-based provider strategies and relationships. This role oversees internal reporting processes and develops new visualizations to meet evolving business needs.
The Medical Director provides medical interpretation and determinations on acute inpatient rehabilitation authorization requests while ensuring compliance with national clinical guidelines and CMS requirements. They collaborate with internal teams and clinical leadership to facilitate quality outcomes and participate in structured training programs.
The Senior Salesforce Engineer designs, develops, and deploys scalable Salesforce solutions while partnering with stakeholders to solve complex business problems. This role involves active participation in the full software development lifecycle, including troubleshooting, architectural decision-making, and process improvement.
The Medical Coding Auditor reviews medical claims against records to ensure accurate coding and compliance with guidelines like ICD-10 and CPT. They contribute to cost reduction by verifying provider contract payments and maintaining database accuracy.
The intern will support the Medicaid Clinical Services team by managing client interactions, processing claims, and handling administrative tasks. Responsibilities include verifying authorizations, scheduling visits, and assisting members with resource coordination.
Design end-to-end medical benefits experiences, creating user flows, wireframes, prototypes, and polished interfaces informed by research, usability testing, analytics, and member feedback. Collaborate with product, engineering, research, and business partners to improve member outcomes, advocate for accessible and consistent design, and contribute to scalable design systems.
Analyze and forecast financial, economic, market, and Medicare claims data to support strategic and operational decisions, including claims forecasting and modeling. Establish metrics, maintain data integrity through processes and controls, and collaborate with stakeholders to investigate data issues and develop cost-effective resolutions.
You will lead the transformation of the Site Reliability Engineering organization by implementing AIOps strategies and automation to improve operational efficiency. Additionally, you will manage cross-functional projects, mentor small teams, and provide technical support to resolve product-related challenges.
The Field Care Manager assesses and evaluates member needs to develop and monitor personalized care plans that promote optimal wellness. They collaborate with transdisciplinary teams and community services to ensure the delivery of effective behavioral and physical health support.
Lead application portfolio assessments and technology due diligence to support mergers, acquisitions, and strategic partnerships. Develop rationalization strategies and target-state architectures while partnering with cross-functional teams to execute integration plans.
The professional serves as the business owner for dialer campaign performance, leveraging data and operational insights to drive outreach effectiveness. They collaborate with cross-functional teams to identify trends, optimize key metrics, and implement strategies that improve conversion and operational efficiency.
The Informatics Lead analyzes high-value AI opportunities across clinical segments to identify and shape an intelligence layer connecting patient data. They are responsible for designing evaluation schemes for clinical intelligence products and measuring their impact on patient outcomes and operational efficiency.
The Lead Informaticist designs and governs scalable data products and analytical pipelines to support CenterWell Traditional Pharmacy's AI-assisted environment. This role ensures data integrity, defines business logic, and provides technical leadership to integrate disparate healthcare datasets for complex performance evaluation.
The Finance Transformation Lead drives strategic initiatives including process improvement, solution design, and operating model enhancements to improve Finance efficiency. They also support portfolio management activities, including budget tracking, initiative sequencing, and executive reporting to ensure measurable business value.
The Provider Contracting Executive initiates, negotiates, and executes physician and hospital contracts while serving as the primary point of contact for providers. They analyze the financial impact of contract terms and advise executives on functional strategies to meet network needs.
The specialist conducts quality assurance audits of medical records and validates diagnosis codes while traveling to provider offices to retrieve and review documentation. They are responsible for uploading verified records to a centralized repository while ensuring strict adherence to HIPAA and federal regulations.
The Utilization Management Administration Coordinator provides non-clinical support by managing chart reviews, building authorizations, and engaging with providers and members. They are responsible for documenting clinical information, creating determination letters, and collaborating across departments to ensure quality standards.
The Senior Insider Threat Engineer is responsible for configuring, tuning, and optimizing enterprise insider threat technologies like Microsoft Purview and Proofpoint. This role collaborates with cross-functional teams to detect, investigate, and mitigate insider risks while ensuring compliance with regulatory frameworks.
The Lead Security Architect designs secure, enterprise-scale solutions and aligns security architecture with business priorities to mitigate emerging threats. They also lead security assessments, vulnerability analysis, and provide guidance on secure development principles across the organization.
The Senior Application Architect designs and develops IT architecture solutions that align with enterprise standards to solve complex business problems. They are responsible for technical planning, creating architecture specifications, and ensuring the integration of products and services across interdependent applications.
Perform expert clinical reviews of inpatient medical records to assess medical necessity based on national guidelines and regulatory standards. Communicate effectively with external providers to discuss clinical information and utilization management determinations.
The Field Care Manager assesses the behavioral, physical, and psychosocial needs of enrollees to develop and implement individualized, person-centered care plans. They collaborate with an interdisciplinary team and community resources to resolve barriers to care and ensure high-quality, cost-effective health outcomes.
The Lead Enterprise Salesforce Architect drives digital transformation by designing scalable solutions and guiding architecture efforts across multi-functional workstreams. They manage client relationships, lead technical teams, and ensure the successful delivery of complex data and marketing technology projects.
The Care Coach assesses the health and social needs of Medicaid members to develop and implement individualized care plans. They coordinate services, monitor progress, and facilitate transitions across various care settings while collaborating with interdisciplinary teams.
The Senior Data Manager oversees configuration control, data management, and deficiency reporting while implementing government and industry policies. They are responsible for managing the full data lifecycle, including acquiring, validating, and protecting data to ensure accessibility and reliability.
The Manager of Care Management leads a team of healthcare professionals to ensure effective care coordination and compliance with state performance metrics. They are responsible for identifying members for case management, monitoring clinical trends, and managing staff performance through mentoring and evaluation.
The AVP will lead the IT procurement and supplier management organization to convert technology spend into business value, innovation, and resilience. They will serve as a strategic commercial partner to the Technology Leadership Team, overseeing category strategies and complex supplier negotiations.
The Lead AI Engineer will design and deliver agentic AI capabilities while actively writing production code and leading a small team of engineers. They are responsible for architecting multi-step AI workflows and integrating LLMs into user-facing platform experiences.
The Associate Director will lead high-priority analytic and causal inference strategy work to improve healthcare outcomes and close care gaps. They are responsible for translating business priorities into rigorous measurement strategies and managing a team to deliver actionable insights for enterprise decision-making.
The Field Care Manager assesses and evaluates member needs to develop and monitor individualized person-centered care plans within LTSS and HCBS programs. They serve as a primary point of contact for the interdisciplinary care team, coordinating resources and advocating for members to ensure optimal health and independence.
The Field Care Manager Nurse assesses member needs and facilitates access to resources to maintain optimal wellness. They manage physical, environmental, and psycho-social health issues while monitoring patient progress toward desired outcomes.
The Field Care Manager assesses and evaluates member needs to develop care plans that promote health, safety, and independence within LTSS and HCBS programs. They identify and resolve barriers to care while coordinating services across interdisciplinary teams and community resources.
The Senior Product Manager will lead cross-functional initiatives to enhance clinical care management and enterprise technology solutions. They will act as a liaison between business and technology teams to define priorities, manage project milestones, and drive continuous improvement.
The specialist will create personalized care plans and coordinate long-term services for members to improve health outcomes and independence. They will conduct field visits to assess member needs, advocate for care, and facilitate interactions between providers and interdisciplinary teams.
The Regional VP provides medical leadership and clinical strategy for Indiana Medicaid lines of business, overseeing operations, quality, and utilization management. This role also drives business development, stakeholder engagement, and the implementation of innovative clinical solutions to ensure cost-effective care delivery.
The Transition Coordinator evaluates member needs and facilitates access to appropriate resources to ensure continuity of care during transitions between health programs and settings. They conduct in-person and telephonic meetings with members, families, and healthcare professionals to develop and implement specific care plans.
The RN Care Manager will assess member health needs to develop comprehensive care plans and provide ongoing education on disease processes and lifestyle modifications. They will also coordinate with primary care providers and perform record reviews to ensure compliance and quality of care.
Design, develop, and maintain scalable omnichannel APIs while enhancing security, resiliency, and performance across enterprise platforms. Collaborate with cross-functional teams to deliver AI-assisted engineering solutions and provide Tier 3 support for critical production incidents.
The Compliance Coordinator reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations. They also collect and analyze data to assess operational metrics and make independent decisions regarding work methods.
The Care Coordinator will conduct comprehensive health risk assessments and proactively outreach to newly enrolled Medicaid members to identify and address healthcare needs. They will coordinate services, monitor care plans, and facilitate access to community resources to ensure members receive optimal care in the least restrictive settings.
The Clinical Pharmacist will manage pharmacotherapy for high-risk patients with chronic conditions and collaborate with a multi-disciplinary team to optimize patient care. Responsibilities include conducting medication reconciliation, providing patient education, and supporting quality measures like CMS Stars and HEDIS.
The Data and Reporting Professional generates ad hoc reports and datasets using system tools, database queries, and scripts. They integrate data from multiple sources to maintain information dashboards and report formats while supporting organizational strategy.
The manager leads teams of nurses and behavioral health professionals to oversee the assessment and evaluation of members' behavioral health needs. They are responsible for making tactical decisions, resolving barriers to care, and ensuring alignment with organizational strategy.
Assess members’ healthcare and support needs through in-person and telephone evaluations, develop and monitor personalized care plans, and coordinate services and community resources. Visit members in homes and care facilities, address barriers and gaps in care, support grievances and appeals, and collaborate with providers, payer sources, and interdisciplinary teams.
The Care Coordinator assesses member needs, develops personalized care plans, and coordinates services to ensure optimal health outcomes. This role involves frequent travel to visit Medicaid members in their homes and care facilities to resolve barriers and monitor progress.
The Field Care Manager assesses member needs and coordinates care plans to ensure optimal wellness through home and community-based visits. They serve as the primary point of contact for the Interdisciplinary Care Team to facilitate access to medical, social, and educational services.
The Transition Coordinator evaluates member needs to establish care plans and facilitates transitions between care settings and programs. They collaborate with healthcare professionals and families to ensure continuity of care and prevent unnecessary custodial placements.
The Senior Portfolio Enablement Lead shapes and enables portfolio operations, Agile Release Train design, and ways of working across the organization. This role acts as a trusted advisor to senior executives to translate transformation strategy into scalable execution and improved value delivery.
The Value-Based Programs Lead will design and operationalize specialty Medicaid value-based payment models to improve provider performance and total cost of care. This role involves analyzing financial and utilization data while collaborating with cross-functional teams to scale innovative payment strategies.
The pharmacist performs medical necessity and comprehensive medication reviews for pre-authorization requests. They also analyze medication care plans and intervene with providers to ensure cost-effective, high-quality patient outcomes.
The Senior Product Owner conveys the product vision and roadmap to an Agile delivery team by defining user stories and prioritizing the product backlog. They serve as the primary contact for information and decision-making while ensuring the product is built within budget and by the deadline.
The Case Manager will assess member health and safety needs to develop comprehensive care plans and coordinate support services. They will conduct regular face-to-face and phone assessments to ensure members receive appropriate, cost-effective care in the least restrictive environment.
The Senior RX Clinical Programs Pharmacist oversees medication therapy, comprehensive medication reviews, and prescription drug optimization for patients. They drive health awareness through patient education and targeted quarterly campaigns while influencing departmental strategy.
The representative will support pharmacists and patients by managing medication therapy programs and conducting comprehensive medication reviews. They will also handle inbound and outbound calls to confirm patient medication adherence and provide health education.
The Lead Cloud Architect will provide strategic leadership and engineering oversight for enterprise NoSQL database platforms across cloud environments. This role involves designing, implementing, and modernizing database solutions while ensuring they are secure, scalable, and aligned with enterprise standards.
The RN Care Manager assesses member health and safety needs to develop comprehensive care plans and coordinates with acute and primary care providers. They also provide ongoing education to members and maintain accurate documentation in compliance with contract requirements.
The professional will conduct annual quality reviews, perform medical record abstractions for Coordination of Care studies, and analyze data to implement corrective actions. They will also support organizational strategy by managing project goals and facilitating care for members.
The IT integration leader provides strategic guidance for M&A, divestitures, and joint ventures, managing end-to-end IT integration plans and due diligence. This role involves partnering with corporate development and senior leadership to ensure technology alignment, risk mitigation, and synergy realization.
The RN Field Care Manager assesses member needs, develops care plans, and coordinates services to ensure optimal health outcomes in home and community settings. They serve as the primary contact for the Interdisciplinary Care Team and conduct comprehensive clinical assessments to ensure regulatory compliance.
The Medical Director provides clinical determinations and medical interpretations to ensure healthcare services align with national guidelines, CMS requirements, and Humana policies. They collaborate with cross-functional teams to support departmental objectives, quality outcomes, and appropriate utilization management.
Conduct home and facility visits to assess Medicaid members' needs and develop personalized care plans. Coordinate services and monitor patient progress to ensure optimal well-being and access to community resources.
The Senior Stars Improvement, Clinical Professional is responsible for the development, implementation, and management oversight of the company's Medicare/Medicaid Stars Program. This role involves monitoring provider performance in key performance indicators related to preventive care and chronic conditions.
The Quality Assurance, Clinical Professional 2 develops and implements programs to maintain quality standards and conducts quality audits to improve care management services. This role collaborates with various partners on quality, process, and performance improvement initiatives.
The Director of Investment Governance & Portfolio Management will oversee the IT organization’s investment governance processes, ensuring alignment with strategic objectives. This includes managing the intake, prioritization, and execution of investment initiatives while collaborating with cross-functional stakeholders.
The Associate Director of Care Management will lead teams responsible for care management, overseeing the assessment and evaluation of members' needs. They will guide the development and implementation of care management programs while ensuring effective communication with stakeholders.
The Sales Support Professional 1 provides timely and effective sales administrative support to assist with the acquisition or retention of customers. This role involves supporting the Sales team throughout the sales cycle and collaborating with internal stakeholders.
The Pharmacy Contracting Professional 2 ensures all published materials support the contracting process and may perform analysis regarding pharmacy claims and purchasing data. They draft communications for stakeholder review and coordinate with various departments to publish communications.
The Informatics Lead is responsible for leading the development and refinement of EOC volume forecasting models for Humana Clinical Pharmacy Review activities. This position supports operational resource planning and integrates business initiatives while ensuring forecast accuracy.
The Senior Pharmacy Contracting Professional conducts all aspects of pharmaceutical contracting and pricing, including development, implementation, and maintenance. They oversee relationships with Humana pharmacy partners and support pharmacies throughout the contracting process.
The Senior Quality Assurance, Clinical Professional consults and collaborates with clinicians to ensure high accountability of compliance and quality. They conduct case audits, assist with audit preparation, and support quality improvement projects.
