Humana

Operations

• monitors and measures relevant performance metrics to assess the performance of IT resources
• optimizes performance through process improvement activities
• devises measures and targets to assess and optimize the performance of IT functions, services, projects and any related improvement initiative
• identifies and analyzes performance measures and metrics
• develops and maintains balanced scorecards and dashboards
• begins to influence department’s strategy
• makes decisions on moderately complex to complex issues regarding technical approach for project components
• establishes policy and optimizes processes by leveraging industry practices to lean processes and reduce waste
• recommends improvements and enhancements to the existing process framework and supporting capabilities

Senior IT Business Performance – Process Improvement Professional

Manager

• Report to the Associate Director of Care Management
• Use clinical nursing skills to support coordination, documentation, and communication of medical services and benefit administration determinations
• Operate within established guidelines and use advanced technical expertise to address moderately complex issues
• Determine methods, resources, schedules, and goals based on assigned goals
• Responsible for leadership and oversight of the physical health Utilization Management staff in daily operations
• Hire, coach, counsel and evaluate performance of direct reports
• Implement and maintain processes compliant with MDHHS and NCQA guidelines
• Work with UM leadership to reduce inefficiencies and provide solutions to improve clinical outcomes
• Collect and analyze data to guide operational metrics and associate performance
• Coordinate and communicate with Providers, Members, or other parties to facilitate care and treatment
• Facilitate cross-departmental collaboration and conduct briefings and area meetings; maintain frequent contact with other managers across departments.

LTSS UM Nurse Manager

Engineer

• perform identity and access management tasks related to end user access, such as access additions, modifications, deletions and disables from various systems
• validate roles and entitlements within the IT systems
• identify role entitlement inconsistencies and provide resolution
• conduct user recertification reviews, as defined by company policies
• 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

Identity and Access Management Engineer

Product Manager

• Responsible for contributing to a product area within our applied AI portfolio, defining success metrics, prioritizing problems, and identifying the best AI-driven strategies aligned with business goals.
• Work directly with business stakeholders to understand their operations, capture requirements, map processes, and identify high-impact opportunities for AI.
• Translate business problems into clearly scoped AI use cases and drive them from concept through prototyping to validation.
• Contribute to rapid prototyping of AI solutions, including GenAI applications, AI agents, conversational AI, and intelligent automation, to demonstrate feasibility and business value.
• Work with a cross-functional team of engineers, designers, and data scientists to define products, develop roadmaps, and drive progress against goals and milestones.
• Gather and analyze user research, business process data, and market analysis to inform product decisions and influence the wider product organization.
• Contribute to evaluation frameworks to test, benchmark, and compare AI models and platforms against enterprise requirements.
• Contribute to reusable product frameworks, playbooks, and best practices that accelerate AI solution delivery across the organization.
• Communicate product strategy, progress, and business value with clarity to all stakeholders.
• Support experimentation, A/B testing, and iterative design approaches to continuously improve AI solutions.

Senior Product Manager, AI

Auditor

• Handle provider disputes in a result-oriented and metrics-driven environment
• Ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality
• Consult and collaborate with coding professionals within and across departments
• Make coding decisions based on standard industry guidelines and best practices
• Manage multiple priorities, collaborate with peers and ensure timely completion of outpatient coding disputes

DME/Outpatient Medical Coding Auditor

• Utilize high-quality, evidence-based behavioral health services through personalized care coordination, crisis intervention, peer support, and strong collaboration with medical and behavioral health providers.
• Provide comprehensive, integrated support to members experiencing behavioral health conditions, including children, adolescents, adults with serious mental illness (SMI) and serious emotional disturbance (SED), Substance Use Disorders (SUD) and justice-involved members.
• Engage members in their own communities, meeting them face-to-face whenever possible to build trust and facilitate meaningful care coordination.
• Coordinate behavioral health and medical services, ensuring appropriate provider engagement and adherence to treatment plans.
• Improve member's health literacy while simultaneously addressing health related social needs to positively impact member's healthcare outcomes and well-being.
• Serve as the driver of the member's interdisciplinary care team (ICT), overseeing care planning, transitions, and service delivery.
• Facilitate ICT meetings, ensuring communication among providers, Service Coordinators, and Care Management Extenders.
• Proactively support transition of care efforts.
• Will work with autonomy but reach out when support is needed.
• Collaborate with internal departments, providers, and community-based organizations to link to appropriate services and create a seamless, culturally competent care experience that respects the members' preferences and needs.
• Follow processes and procedures to ensure compliance with regulatory requirements by the Illinois Department of Human Services (IDHS), Center for Medicare and Medicaid Services (CMS) and the National Committee on Quality Assurance (NCQA).

Field Care Manager, Behavioral Health

Actuary

• Analyze and forecast financial, economic, and other data to provide accurate information for strategic and operational decisions
• Establish metrics, provide data analyses, and work directly to support business intelligence
• Evaluate industry, economic, financial, and market trends
• Ensure data integrity by developing and executing necessary processes and controls around data flow
• Collaborate with stakeholders to understand business needs/issues, troubleshoot problems, conduct root cause analysis
• Support the Primary Care business with a focus on IBNR (Incurred but not reported) and claims analytics

Associate Actuary – Primary Care

AI Engineer

• Serves as a senior technical authority responsible for guiding Humana’s enterprise platform strategy and engineering execution
• Leads the design, development, and operation of foundational agentic AI platforms, tools, and services that empower development teams to build, deploy, and operate agent-driven applications efficiently, securely, and reliably
• Influences architectural direction for core infrastructure supporting agentic AI workloads
• Drives innovation in developer experience and automation—including agent orchestration and human-AI collaboration
• Mentors engineering teams, ensuring that platform solutions are robust, scalable, secure, and aligned with Humana’s enterprise agentic AI technology roadmap
• Evaluates, selects, and integrates foundational agentic AI technologies
• Builds and maintains robust CI/CD and agentic AI pipeline automation for automated testing, deployment, and release management
• Develops internal tools, APIs, and services that abstract agentic AI infrastructure complexity

Principal AI Engineer

Data Scientist

• Support initiatives to ensure responsible use of AI across the enterprise, including model risk assessments, fairness evaluations, and compliance with ethical and regulatory standards.
• Champion transparency, accountability, and trust in all AI and data science practices.
• Drive and contribute to R&D efforts to advance innovative, high-impact, and ethically-grounded AI solutions in healthcare.
• Design and implement processes, tools, and frameworks for the evaluation, monitoring, and documentation of AI systems to ensure ongoing compliance with ethical and regulatory standards.
• Stay current with emerging research, regulations, and industry best practices in Responsible AI, translating learnings into actionable recommendations for Humana’s AI ecosystem.
• Partner cross-functionally with legal, compliance, IT, education, and other teams to operationalize Responsible AI principles throughout the organization.
• Support and help evolve Humana’s Responsible AI governance initiatives, policies, and standards.
• Serve as an internal consultant and subject matter expert on Responsible AI topics such as fairness, transparency, privacy, safety, and risk mitigation.
• Facilitate Responsible AI education and awareness initiatives, including the development of training materials and guidance for technical and non-technical stakeholders.

Senior Responsible AI Data Scientist

Director

• Lead the development, implementation, and continuous improvement of capital strategy, planning, and returns management processes
• Collaborate across multiple teams to develop, implement, and refine return on capital metrics aligned with value creation and long-term strategic priorities
• Coordinate cross-functional initiatives, ensuring clear communication, accountability, and timely execution
• Build and maintain analytics and reporting dashboards on internally developed return metrics to provide strategic insight and transparency for finance and business leadership teams
• Develop and implement governance framework for Humana's regulatory capital allocation strategy and decision making
• Prepare Board or investor-ready materials that communicate Humana's capital allocation strategy and performance against it
• Monitor and provide insights on industry and competitive developments focused on regulatory capital optimization and returns
• Provide actionable recommendations to executive leadership based on rigorous financial analysis and market insights
• Communicate strategies clearly and succinctly to both technical and non-technical audiences
• Foster highly productive working relationships that enable close collaboration with Humana's Management Team as well as key corporate, functional, and business unit leaders
• Build and lead a team of 2-3 associates

Director, Capital Strategy – Planning

Outside Sales

• Manage national sales and revenue targets for the External Field Agency channel.
• Develop a multi-year strategy to expand field agency penetration and increase overall channel contribution.
• Recruit, contract, and onboard high-quality field agencies aligned with enterprise growth and quality standards.
• Strengthen existing agency relationships through structured performance management, coaching, and strategic account planning.
• Implement agency segmentation models to prioritize high-performing and high-potential partners.
• Establish production benchmarks, retention standards, and quality KPIs to ensure long-term channel sustainability.
• Drive engagement with top national and regional field agencies, ensuring alignment with enterprise carrier relationships.
• Lead recruitment and activation strategy for independent 1099 agents and brokerage partners.
• Build scalable onboarding, training, and enablement frameworks to accelerate agent ramp time and productivity.
• Design productivity programs, incentives, and engagement models to increase per-agent output and retention.
• Implement disciplined performance tracking to manage agent lifecycle, activation rates, and production consistency.
• Develop initiatives to improve agent retention, quality compliance, and long-term channel viability.
• Own top-line revenue growth across both external field and 1099 brokerage channels.
• Develop sales forecasting models and pipeline visibility across agency and broker segments.
• Optimize channel mix to improve blended revenue performance and contribution margins.
• Partner with Finance and Operations to manage budget allocation and resource deployment in support of growth objectives.
• Identify opportunities to improve CTM, retention, provider engagement, and overall downstream quality metrics through channel management.
• Build and execute national sales strategy in coordination with senior sales leadership.
• Identify new geographic expansion opportunities and underpenetrated markets.
• Develop partnerships with key carrier organizations to maximize alignment and competitive positioning.
• Lead cross-functional initiatives to streamline contracting, onboarding, compensation alignment, and operational processes.
• Evaluate and implement technology and CRM tools to improve visibility into field performance and agent productivity.
• Lead, coach, and develop regional sales managers and channel leaders supporting external distribution.
• Partner closely with Compliance to ensure CMS and regulatory adherence across all distribution channels.
• Collaborate with Marketing and Sales Enablement to build field-ready materials and campaigns.
• Serve as executive point of contact for key agency relationships.
• Participate in national sales meetings, field visits, and industry events to maintain market presence.

Director, External Field Sales

Sales

• Develop and execute a strategy to grow IFG's independent agent channel nationally.
• Lead and coach Regional Sales Executives responsible for recruiting, onboarding, and managing independent agents.
• Drive net new agent growth, activation rates, and production per active agent.
• Establish clear performance expectations and sales targets for the brokerage team.
• Monitor sales results, pipeline activity, and revenue forecasts to ensure goals are met.
• Partner with Carrier Relations, Operations, Marketing, and Compliance to ensure agents are properly contracted, supported, and aligned with regulatory requirements.
• Identify opportunities to improve agent engagement, retention, and overall channel productivity.

Associate Director, Brokerage Sales

Call Center Representative

• Oversee and deliver annual and multi-year revenue targets across all external call center partners
• Define and execute the overarching partner sales strategy, including growth priorities, channel optimization, and market expansion initiatives
• Provide executive oversight of all existing external call center partnerships
• Build and maintain a robust pipeline of new partner relationships
• Negotiate and oversee complex commercial agreements
• Establish performance frameworks, KPIs, and reporting cadences to measure partner effectiveness
• Drive continuous improvement initiatives to enhance sales effectiveness
• Partner closely with internal stakeholders across Sales Operations, Compliance, Marketing, Technology and Training
• Lead, mentor, and develop a high-performing team responsible for partner management, strategy, growth and execution

Director, Call Center – Brokerage

Senior Product Management, AI

Bilingual

• Assess and evaluate members' needs to achieve and maintain optimal wellness
• Guide members with chronic conditions toward and facilitate interaction with resources appropriate for their care and wellbeing
• Resolve barriers that hinder care
• Ensure patient is progressing towards desired outcomes by managing patient care through assessments and evaluations
• May create member care plans
• Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas