Jobs at Humana

Analyzes financial, economic, and market data to support forecasting and strategic decisions. Builds and enhances actuarial and Net Present Valuation models in Databricks for Medicare Supplement, Dental and Vision, and Medicaid. Develops metrics, reporting, data-quality controls, and analytical models; investigates anomalies and performs root-cause analysis. Collaborates with stakeholders to resolve model issues, improve accuracy and performance, and influence forecasting strategy.

Develops and standardizes DevOps practices for AI/ML implementations, including CI/CD pipelines, infrastructure provisioning, platform configuration, security improvements, and automated software delivery. Partners with application engineers to onboard use cases, implement cloud and automation solutions, streamline releases, reduce risk, and improve developer productivity and software quality. Works independently on moderately complex to complex technical decisions.

Configure, tune, and operate Microsoft Purview and Proofpoint ITM to detect and investigate insider threats. Triage alerts, reduce false positives, support eDiscovery, correlate telemetry with SIEM/EDR, automate policy deployment with KQL/PowerShell/Graph API, track KPIs, and ensure controls meet HIPAA/HITRUST/PCI-DSS/SOC2 requirements while partnering with Security Operations, HR, Legal, and compliance stakeholders.

Leads enterprise technology operations, fulfillment, lifecycle management, shared services, Agile delivery enablement, and AI-driven automation. Develops strategies to modernize associate onboarding, deployment, recovery, refresh, and offboarding while improving efficiency, compliance, service quality, and productivity. Oversees governance, operational metrics, transformation initiatives, portfolio planning, and geographically distributed teams. Builds partnerships across technology and business functions, manages organizational change, and develops talent to support scalable digital workplace capabilities.

Supports health plan provider network data administration, including demographics, reimbursement rates, contracts, audits, credentialing systems, and provider service issue resolution. Coordinates data updates, maintains contract management and credentialing records, and assists with audits and reporting. Requires strong organization, communication, analytical skills, Excel proficiency, and the ability to manage multiple priorities. The role is remote with occasional travel for training or meetings.

Manages provider contract data, demographics, and relationships for assigned provider groups within a health plan. Performs roster audits, resolves provider data loading issues, provides customer service liaison support, and manages assigned projects. Works independently using critical thinking, established procedures, strong organization, and time management. The role requires healthcare provider or payer experience, data analytics skills, Excel proficiency, and the ability to meet deadlines in a remote environment.

Manages provider data for health plans, including demographics, rates, contracts, credentialing, audits, and provider relations. Oversees provider service-failure intake processes and interprets administrative procedures with limited guidance. Requires healthcare industry experience, Excel proficiency, multitasking, and deadline management. Preferred experience includes provider credentialing, claims, and contract review or interpretation.

Leads cross-portfolio transformation initiatives for Humana’s supplemental benefits portfolio. Translates regulatory and operational requirements into business requirements, implementation plans, governance routines, vendor frameworks, KPIs, and operating playbooks. Coordinates benefit teams, enterprise partners, and vendors; manages risks, milestones, readiness, remediation, and continuous improvement. The role strengthens vendor performance governance, standardizes reporting and implementation processes, and converts lessons learned into scalable operational capabilities.

Leads enterprise technology solutions and multiple software engineering teams through strategy, architecture, modernization, delivery, and production operations. Establishes engineering roadmaps, manages budgets and vendors, drives DevSecOps and continuous improvement, oversees reliability and performance, and partners with executives, product, security, infrastructure, data, and business stakeholders. Builds engineering talent and accountability while aligning technology investments with business outcomes.

The Accounting Lead manages general accounting activities, including ledger reconciliation, financial statements, statutory reporting, budgeting, forecasting, and variance analysis. The role ensures accounting accuracy and compliance, supports process improvement and automation, advises executives on financial strategies, and exercises independent judgment on complex issues. This fully remote individual contributor position requires extensive accounting or inventory management experience, project leadership, and progressive management experience.

Develop and support Salesforce Health Cloud and Sales Cloud solutions using Apex, Flows, OmniStudio, and Lightning Components. Build integrations, workflows, automations, tests, and deployments; troubleshoot defects and support production applications. Collaborate with product owners, analysts, and cross-functional teams in an Agile environment. Maintain technical documentation and contribute to CI/CD, code reviews, root cause analysis, and continuous improvement.

Leads IFG sales compliance strategy, governance, monitoring, auditing, risk assessments, investigations, corrective actions, and regulatory adherence. Oversees agent and agency compliance teams while partnering with executives, legal, operations, carriers, and regulatory agencies. The role develops policies and controls, evaluates sales practices, analyzes compliance metrics, and drives improvements aligned with CMS, Medicare Advantage, Medicaid, HIPAA, insurance, and carrier requirements.

Leads large, complex, cross-functional programs across multiple workstreams and business areas. Responsibilities include program planning, governance, risk and dependency management, executive communication, stakeholder alignment, resource planning, operational readiness, portfolio prioritization, and PMO standards. The role mentors project managers, drives continuous improvement, and ensures initiatives deliver measurable organizational value. This is a remote position with occasional travel to Humana offices.

Conducts clinical audits to validate medical record documentation, diagnosis coding, billing accuracy, and reimbursement compliance. Reviews complex inpatient cases, identifies high-risk CMS-HCC members, refers cases for follow-up care, analyzes audit root causes, and recommends process improvements. Works independently in a remote environment while protecting HIPAA information.

Reviews prior authorization requests, evaluates medical necessity and level of care using clinical judgment, approves services or escalates cases, educates providers on utilization management processes, and maintains clinical information in medical management systems. The role requires an active Louisiana RN license, independent work, and weekend-capable scheduling. It is remote with occasional travel for training or meetings.

Leads encounter data management processes for Medicaid and Medicare submissions, reconciliation, compliance, claims-error data integrity, and acceptance-rate improvement. Develops tools and long-term process enhancements while resolving complex technical and operational issues. Provides product, agile, project, and people leadership across specialized teams. This is a remote role with occasional travel to Humana offices for training or meetings.

Reviews prior authorization requests, evaluates medical necessity and level of care, approves services or escalates cases for further review, and applies utilization management guidelines. Educates providers on medical management processes, maintains clinical information in medical management systems, and independently makes decisions under established procedures. The role requires an Indiana RN license, utilization or case management experience, and occasional travel for training or meetings despite being remote.

The Senior Content Designer owns content design and strategy across digital product experiences. Responsibilities include creating and optimizing UI content, simplifying regulated healthcare information, conducting research and content audits, improving information architecture and findability, and partnering with product, design, research, engineering, legal, and compliance teams. The role also contributes to content systems, standards, accessibility, testing, and measurable experience improvements.

Provides person-centered social service case management for frail elders and adults with intellectual, developmental, or physical disabilities. Conducts assessments and member visits, coordinates care plans with nurses, supports community integration, housing, employment, and social needs, promotes wellness, documents services, and maintains regular member contact. This field-based role requires travel throughout Jefferson County, Wisconsin, valid driving credentials, and collaboration with members and care teams.

Leads IT procurement and strategic sourcing for healthcare technology categories. Develops category strategies, manages competitive sourcing, negotiates complex software, SaaS, cloud, data, and technology-services agreements, and oversees strategic supplier performance throughout the contract lifecycle. Advises senior stakeholders, analyzes costs and risks, supports contracting and implementation, drives savings and supplier consolidation, and promotes consistent procurement practices.