Humana

Events

• Plan and execute 15–20 highly complex events across the U.S. annually
• Collaborate with business partners to achieve event objectives
• Identify appropriate venues, negotiate contracts, and manage all site logistics
• Proactively assess potential risks and implement contingency plans to address issues during events
• Communicate essential information to business partners as needed
• Provide comprehensive post-event reporting, analysis, and actionable insights to business partners and leadership
• Influence and uphold best practices and company guidelines to ensure all meetings align with organizational vision
• Lead projects as required

Senior Event Planning Professional

Product Manager

• Responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog
• Maximizes value of product created by Agile team
• Liaises with stakeholders and the development team ensuring the right product is being built, in the right order, within budget and by the deadline
• Serves as the Agile team's primary contact for information, work prioritization, and decision-making
• Begins to influence department’s strategy
• Makes decisions on moderately complex to complex issues regarding technical approach for project components

Senior Product Owner

Medical Billing and Coding

• Identify opportunities to improve provider documentation and create tailored education plans
• Create and execute the risk adjustment strategy for each provider group
• Analyze data and reporting and provide educational sessions with providers for quality of care
• Collaborate with relationship owners and HQRI to monitor and develop strategies
• Create compliant PowerPoint presentations tailored to group strategy

Senior Medical Coding Educator

Procurement

• Establish and implement software renewal activities across Humana’s enterprise
• Proactively track and execute software renewals to ensure timely end-to-end processing
• Lead and support associates on daily software renewal activities
• Identify and collaborate with key stakeholders to align business objectives, compliance and enhance stakeholder satisfaction
• Participate in strategic planning and process improvement
• Ensure that supplier compliance and performance aligns with organizational objectives, standards, cost-saving initiatives, and agreement terms
• Recommend policies, standards and procedures that are aligned with IT standards and strategy
• Maintain a centralized renewal calendar and monitor renewal statuses through completion and recording
• Review and assign software renewal activities and tasks to associates across the IT Procurement & Supplier Management team
• Review licenses or contracts to ensure that software is covered by the contract and documented
• Analyze software spend and identify cost-saving opportunities to maximize Return on investment
• Negotiate with suppliers to secure favorable terms, pricing, and compliance
• Research and recommend supplier optimization strategies
• Review supplier analysis including capabilities, goals, risk profile, and financial health
• Collaborate cross-functionally to align procurement with organizational strategies
• Conduct research, assemble data, and use reporting tools and dashboards to refine information delivery
• Follow internal procurement policies and external regulatory requirements
• Exercise independent judgment and decision making on complex issues regarding job tasks and related tasks

IT Procurement Lead – Software Renewals

• Lead dedicated Scrum team(s) through all SAFe Agile Ceremonies such as: Daily Stand up, PI Planning, Sprint Planning, Backlog Refinement, Sprint Review, Sprint Retrospective, ART Synch, Scrum of Scrums, PO Synch, System Demo, Solution Demo, etc.
• Lead your dedicated scrum team(s) through quarterly on-site PI Planning.
• Create and refine user stories for the team and maintain a robust backlog ensuring adequate workload for dev team members.
• Prioritize and assign work for development team members based on Humana’s LPM (Lean Portfolio Management) strategy with a top-down value approach.
• Manage technical relationships with external E.H.R. Partners, internal dependent technical partner teams, consuming business owners and own the end-to-end delivery of technical solutions ensuring all parties involved are aligned with the delivery and timelines of the same.
• Manage internal communications with Interoperability Principal Product Managers, Lead Product Managers, IT Directors and AVPs, IT Solution Managers, Tech Leads, Solution Architects, Application Architects, Scrum Masters.
• Remove blockers and drive delivery of the technical solution for product initiatives.
• Lead communications and drive discussions with other Humana teams to achieve product team goals such as Humana’s PIRC (Protected Information Review Council) and Internal Business Leaders and stakeholders for consuming business teams such as Stars, MRA, Clinical and many more.
• Ensure the alignment of delivery timelines meets our strategic goals for Interop Products and our partners’ strategic goals.
• Decompose High Level Architecture and apply that understanding to the work breakdown and strategy for development and consumption.
• Stay apprised and understand Interoperability regulatory and compliance requirements from CMS distilling those into product technical requirements for development teams to deliver.
• Ensure maximum value is delivered to the enterprise through the work of the team(s).
• Function and acquire expertise across multiple Interoperability Product Areas, not just one.
• Develop subject matter expertise and share your acquired knowledge base with others who need to learn.

Lead Interoperability Product Owner

Product Marketing

• Lead and support end-to-end product marketing strategy across Humana's diverse product portfolios, including MA, MAPD, D‑SNP, PDP, Med Supp, Group Medicare, and specialty products.
• Translate analytics and insights into actionable strategies, informing product positioning, messaging, and go‑to‑market plans to drive growth, enhance the experiences of our members and improve engagement.
• Partner with cross‑functional teams—including Product, Brand, Sales, Group Segment leadership, and Compliance—to ensure alignment, accuracy, and timely execution.
• Translate analytics, insights, member feedback, and market intelligence into actionable strategies that inform product positioning, messaging, and go‑to‑market plans to drive growth, deepen engagement, and increase lifetime member value.
• Partner with cross-functional teams—including Product, Brand, Sales, Group Segment leadership, Compliance, Operations, Broker Distribution, Lifecycle Marketing, Data & Analytics, and Consumer Insights to ensure strategic alignment, executional excellence, and insight integration.
• Lead campaign planning and creative development for multi‑channel marketing initiatives, overseeing briefs, asset development, and performance measurement.
• Monitor performance and identify optimization opportunities, leveraging testing frameworks, analytics, and market trends to advance growth and improve engagement.
• Collaborate with Customer Lifecycle Marketing to deliver personalized, relevant experiences across key touchpoints that support acquisition, onboarding, activation, engagement, and retention.
• Advance growth and retention objectives across Humana's product portfolio through differentiated messaging, enhanced experiences, and targeted engagement strategies.
• Refine and elevate marketing materials and communications by applying competitive intelligence, member insights, and regulatory updates to clearly differentiate Humana's offerings, strengthen value propositions, ensure compliance, and increase market relevance.
• Support the development and management of marketing roadmaps, content creation, and stakeholder communications to ensure effective planning and cohesive execution.
• Ensure all marketing deliverables are clear, compliant, and aligned with CMS and internal standards, supporting member acquisition, retention, and overall experience.
• Contribute to ongoing process improvements and best‑practice development to improve operational efficiency and scalability within the marketing organization.

Senior Associate, Product Marketing Strategy

Account Executive

• Achieve or exceed personal sales production expectations established by management.
• Develop and maintain multiple benefits brokerage relationships within assigned territory.
• Tracks all activities in company’s CRM system and keep current by updating account information regularly.
• Develop a clear understanding of our business and our diverse Group products.
• Must gain a thorough understanding of our business relationships within the brokerage community and the clients we serve.
• Collaborate with Ancillary Sales Executive and Ancillary Client Executive to expand broker/client relationship in assigned markets.
• Implement and support new sales initiatives developed by Humana to increase sales of existing products and/or develop sales of new products.
• Work closely with the market team to support, mentor and motivate the team to create a strong culture and drive positive results.
• Coordinate with other team members and departments to optimize the sales effort.
• Builds Brand across the market in conjunction with outside organizations and key constituents.
• Identify other strategic relationships in the market and develop those circles of influence to drive business to Humana, Inc.
• Occasionally be required to set-up new cases and participate in enrollment

Small Group Sales Representative

Medical Director

• Uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, or requested site of service should be authorized, with all work occurring within a context of regulatory compliance and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources
• Learns Medicaid requirements and understands how to operationalize this knowledge in their daily work in their assigned cluster
• Work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management, with clinical scenarios arising from outpatient or inpatient environments
• Conducts discussions with external physicians by phone to gather additional clinical information or discuss determinations through the peer-to-peer process, and in some instances, these may require conflict resolution skills
• May speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes and a focus on collaborative business relationships, value-based care, population health, or disease or care management
• Supports Humana values including working collaboratively on a team throughout all activities
• Flows to work as needed within cluster as needed for vacations, weekends and holidays coverage

Behavioral Health Medical Director

Business Intelligence Developer

• Convert processes requiring manual steps (many in Excel) to a more effective tech stack.
• Optimize Pricing Model SQL code where there are known performance issues.
• Triage data/code/user error issues and resolve quickly and effectively.
• Design, demo, develop and test new more efficient processes, typically that are short term/high impact projects.
• Effectively communicate technical concepts to a broad range of audiences including customers, business partners and IT.
• Work closely with the business team, customers and IT to collaborate on technical solutions.
• Coordinate with other developers (both business and IT) to ensure dependencies are documented and testing is sufficient for monthly releases.

Business Intelligence Engineer – Entry Level

Compliance

• Participate in performance and quality improvement projects by implementing member and provider targeted interventions to improve health outcomes and member and provider experiences.
• Contribute to multidisciplinary committees, both external and internal, required by NCQA and the State Contract.
• Medical record audits to evaluate provider compliance with clinical practice guidelines, best practices, and regulations in collaboration with internal and external stakeholders.
• Provider outreach to close care gaps.
• Completing and updating reports (including State Reports and Kentucky Medicaid Quality Improvement Committee reports).

Quality Compliance Professional

• Lead and manage all disaster recovery compliance efforts, including data management, governance, and regulatory reporting.
• Oversee internal and external audit response activities, ensuring readiness for Medicare/Medicaid and other regulatory audits.
• Manage IT controls and coordinate RFP responses for disaster recovery requirements.
• Conduct annual DR audits of SaaS providers, ensuring vendors meet recovery and resiliency objectives and reporting on any gaps.
• Drive vendor due diligence for new and renewing contracts, ensuring appropriate recovery-focused language is included and enforced.
• Partner with Business Continuity leaders to mature business capability mapping and strengthen process-to-application mapping and dependency analysis.
• Administer, manage, and develop the ServiceNow Disaster Recovery module, ensuring its functionality aligns with program goals.
• Oversee program training initiatives and documentation management to ensure all stakeholders are educated and compliance standards are maintained.
• Provide DR compliance reporting and insights to senior leadership.
• Support inclusion in vendor testing to verify recovery objectives and enhance audit responses using robust compliance data.
• Maintain awareness of changing regulatory requirements and industry best practices.
• Partner and align on all merger & acquisition activities for smooth onboarding and transition to Humana's DR program.

Associate Director, IT Disaster Recovery – GRC

Insurance

• partners closely with business, technology, and product stakeholders across the Insurance value chain to ensure the IT portfolio and demand pipeline are aligned to enterprise priorities
• organizes and prioritizes programs and projects in alignment with IT Strategy, Enterprise Architecture guidelines, Delivery roadmaps, and segment‑level strategic plans
• balancing discretionary and non‑discretionary spend (e.g., regulatory, compliance, security, member experience, operational efficiency)
• evaluating funding against annual portfolio budgets
• managing intake/throughput capacity
• adjusting schedules
• ensuring the right financial and organizational support is allocated to priority work
• begins to influence departmental strategy and drives technology portfolio decisions by evaluating business value, platform impacts, customer experience outcomes, and risk
• exercises considerable latitude in determining objectives, methodologies, and approaches to assignments.

Senior IT Portfolio Management Professional – Insurance Tech Segment

Consultant

• Work with SouthEast Region providers to define and advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies
• Recommend execution strategies and monitor performance toward these goals
• Actively monitor and analyze provider performance data to identify areas for improvement
• Be an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experience
• Collaborate to develop tailored action plans and communicate applicable insights to improve performance
• Implement strategies to enhance outcomes and provide ongoing support and guidance to providers
• Be a liaison for providers to access Humana resources, educating and encouraging providers on the use of self-serve tools
• Educate provider groups on reward programs and target metrics, collaborating to achieve established goals
• Monitor and reports on the effectiveness of reward programs, making recommendations for enhancements
• Resolve provider abrasion issues, ensuring a positive and collaborative relationship between Humana and its providers
• Collaborate with teams to drive initiatives that support provider performance improvement

Senior Network Performance Consultant

Manager

• Lead teams of nurses, care coordinators and behavioral health professionals responsible for care management
• Supervise, direct and evaluate a diverse group of health care professionals
• Identify members for specific case management and/or disease management activities
• Monitor case management activities, post-discharge calls, discharge planning and pre-assessment of elective admissions
• Develop system-view recommendations, reports trends and implement appropriate actions to control trends
• Develop audit plans and tools for teams to ensure compliance with state contracts on performance metrics
• Onboard new associates including all pre-employment human resource tasks, ordering software, hardware, supplies and support technologies
• Monitor performance of staff including service performance and adherence to established utilization and care coordination benchmarks
• Conduct care team oversight visits, meeting with members and/or their families, community partners and other care teams

Manager, Care Management

Full-stack Engineer

• Perform software engineering activities in all layers of the stack
• Lead technical architecture and design and present vision
• Possess the ability to evaluate problems in both strategic and tactical terms
• Lead a small team of high-caliber engineers by mentoring and coaching
• Deliver business-critical systems and components with high quality and on time
• Review pull requests and provide constructive feedback
• Investigate and propose new ideas, frameworks technologies, or processes