Humana

Data Engineer

• Codes software applications based on business requirements
• Designing, developing, and maintaining scalable data pipelines and solutions across cloud and on-premises environments
• Report to the Director of Data Engineering for CenterWell Tech - Primary Care Organization (PCO) Technology Support team
• Work with a development team and all aspects of developing an application and getting this application to production
• Stay informed about relevant technology trends and developments, including new AI-Assisted coding

Data Engineer – EHR Systems

Full-stack Engineer

• Develop production-grade AI agents and GenAI applications for healthcare
• Emphasis on agent orchestration, RAG, tool use, workflow automation
• Develop secure, scalable AI services using frameworks such as LangChain, LlamaIndex, or Semantic Kernel
• Improve quality through prompt and context optimization
• Partner with product, clinical, data, and compliance teams to deliver measurable value in HIPAA-compliant environments

Senior Applied AI Software Engineer – AI

• architect comprehensive end-to-end AI systems
• define rigorous standards for prompt engineering
• develop performance optimization strategies
• lead deployment of AI systems into production environments
• design scalable data ingestion architectures
• collaborate strategically with platform teams

Lead Applied AI Software Engineer

Designer

• Lead development of new service experiences, including problem framing, user research, analysis and synthesis, concept ideation, prototyping and testing, and implementation planning.
• Create service blueprints, low- and mid-fidelity prototypes, frameworks, concept illustrations, and stories.
• Collaborate with UX/UI designers, product teams, marketing, and operations.
• Demonstrate ability to listen, contribute to, and facilitate conversations across teams.
• Contribute to the continuous development of the design discipline.

Senior Service Designer

• Define and lead service design strategy across enterprise initiatives, connecting member needs to operational capabilities.
• Create service blueprints, journey maps, and ecosystem models that bridge frontstage and backstage experiences, end-to-end.
• Facilitate alignment across teams and business partners to deliver coherent, multi-touchpoint services.
• Mentor designers, evolve service design methods, and contribute to the growth of Humana's design culture.
• Define success metrics and lead post-launch evaluations to ensure services deliver measurable value.
• Collaborate with process and operational teams to ensure services are deliverable, scalable, and grounded in real-world constraints.
• Use compelling narratives and visual frameworks to build empathy, drive decisions, and influence senior stakeholders.

Principal Service Designer

Manager

• assess members health and safety needs to identify their strengths, interests, and preferences to develop a comprehensive Member Care Plan (MCP)
• coordinate with a Field Care Nurse to provide services that address members' health and safety needs, ensuring the team provides support in the least restrictive environment following the MCP
• conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence
• conduct quarterly in-person visits and maintain monthly contact with members by phone
• arrange support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs
• ensure cost-effective service delivery
• evaluate risk factors and provide education to members
• maintain accurate documentation including case notes, service authorizations, and updates to the MCP

Case Manager

Content Marketing Manager

• Define, create and manage content for IVA and IVR experiences
• Create content strategies and collaborate on information architecture, systems of words, content types and voice and tone
• Collaborate with other UX experts on content organization, navigation, site maps and information architecture
• Audit and inventory content to identify gaps in quality, compliance, standards and branding
• Refine conversational content based on user feedback, analytics and testing
• Maintain Humana digital content guidelines, standards, tools and processes

Senior Content Designer – Conversational

Analyst

• Support problem-solving efforts by helping senior leaders define key issues, develop hypotheses and create recommendations
• Identify and incorporate relevant data to inform strategic decisions
• Convert strategy into roadmaps, business cases and projects while prioritizing timelines and ensuring alignment and execution
• Identify the short and long-term impacts of key strategies by assessing qualitative and quantitative data

Corporate Strategy Analyst – Strategy Planning

Medical Director

• Review clinical cases and determine medical necessity of services for Medicare and Medicaid members
• Ensure compliance with review policies, procedures, and regulatory standards
• Apply clinical guidelines, CMS policies, and Medicare/Medicare Advantage/Medicaid requirements
• Identify opportunities for medical management operational improvements
• Participate in call rotations, including weekend coverage and after-hours coverage
• Contribute to an engaged, collaborative team culture that supports organizational excellence
• Deliver exceptional consumer experiences
• Support Home Solutions and other activities as assigned by the OneHome leadership

Director

• Provide strategic and operational leadership for population health management strategy initiatives
• Oversee teams dedicated to population health, including community engagement professionals
• Collaborate with cross-functional teams, provider partners, community-based organizations, and regulatory agencies
• Analyze population health data to identify trends, gaps, and opportunities for interventions
• Develop and execute community engagement strategies in partnership with stakeholders
• Liaise with ODM and other ODM-contracted MCOs on population health activities
• Ensure compliance with ODM requirements and Humana's policies

Director, Population Health Strategy

Customer Success Manager

• Deliver a high level of professionalism, empathy, and compliance with every inbound and outbound customer interaction
• Actively listen to identify customer needs and provide clear guidance on available plans, benefits, resources, and services across multiple carriers, which may include enrolling customers into new plans when appropriate
• Clearly explain plan benefits, coverage details, claims-related questions, and carrier communications in a way that is easy to understand
• Ask thoughtful, compliant questions to uncover broader customer needs, including social or situational factors that may impact healthcare decisions
• Support customer retention and satisfaction by helping customers navigate complex Medicare decisions and resolve issues efficiently
• Partner with sales, service, and carrier teams to resolve issues related to enrollment, disenrollment, eligibility, and plan changes
• Provide feedback and insights to support continuous improvement, test-and-learn efforts, and proactive outreach initiatives

Customer Success Agent

Medical Billing and Coding

• reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery
• extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records
• analyzes, enters and manipulates database
• responds to or clarifies internal requests for medical information
• prioritizes requests and interprets and adapts procedures, processes and techniques

Medical Coder

Vice President

• Serve as the senior clinical executive responsible for shaping and executing the region’s clinical engagement strategy
• Drive quality improvement, cost efficiency, and population health outcomes through strategic provider partnerships, data-informed decision-making, and cross-functional collaboration
• Cultivate and maintain trusted relationships with CMOs and senior executive/clinical leaders at provider and care delivery partner organizations
• Serve as lead clinical executive for provider groups, translating clinical and quality priorities into actionable strategies
• Enhance innovation with hospital systems while fostering collaboration and reducing operational barriers
• Drive population health initiatives to improve the health and well-being of our members
• Collaborate with finance, analytics, and market leadership to identify cost and quality outliers and implement targeted action plans
• Provide clinical input into network development, contract negotiations, and delegation oversight

Regional VP of Health Services

Sales

• Coach, mentor, educate, motivate and train a team of sales individuals.
• Motivate, train and drive a team of Medicare Sales Field Agents who sell individual health plan products and educates beneficiaries on our services in a field setting.
• Actively recruiting new agents for their respective teams as needed.
• Cultivating, maintaining, and building relationships with Humana’s customers, both internal and external business partners, along with the community we serve through telephonic, virtual, and face-to-face interactions with individuals and groups.
• Developing marketing budgets, and looking for branding opportunities.

Senior Manager, Medicare Sales

Operations

• Analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements.
• Researches best business practices within and outside the organization to establish benchmark data.
• Collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on enhanced safety, increased productivity and reduced cost.
• Determines how new information technologies can support re-engineering business processes.
• Manages all aspects of a project, from scoping through execution, so that it is completed on time and within budget.
• Assesses business and operational needs for opportunities to improve efficiency, productivity, effectiveness and accuracy and analyze and measure the effectiveness of existing business processes and develops sustainable, repeatable, and quantifiable process improvements.