Humana

Operations

• provides operational leadership for build, maintenance, submission, and updating of formularies and drug lists
• ensures accuracy of formularies and utilization management criteria in the Centralized Formulary System
• collaborates with healthcare professionals, pharmacists, and other business functions to operationalize formularies
• performs formulary analysis and reporting to ensure optimal operational flow
• develops key performance indicators and plans to improve overall process improvements and efficiency
• creates formulary management process and training documentation
• understands department, segment, and organizational strategy and operating objectives
• makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed

Formulary Operations Management Professional 2

Bilingual

• Support Pharmacists and patients and report to a Clinical Programs supervisor
• Accomplish programs developed to improve overall health outcomes
• Assist members by connecting them with financial assistance resources
• Make outbound and take inbound calls to Humana members
• Communicate with Humana members and collect medication history information
• Prepare members for a comprehensive medication review

Bilingual Clinical Pharmacy Technician

DevOps Engineer

• Design, build, and maintain cloud infrastructure on Azure and GCP
• Develop, operate, and optimize CI/CD pipelines using Azure DevOps, Harness, GitHub Actions and GitOps - ArgoCD
• Deploy and manage containerized applications with Kubernetes (AKS, GKE, OpenShift)
• Implement security best practices, administer and integrate tools such as SonarQube, JFrog Artifactory and Jfrog Xray
• Develop automation scripts in PowerShell, Bash, and Python
• Ensure HIPAA and SOC2 compliance throughout DevOps processes
• Provide L3 and on-call support for infrastructure and platform services
• Troubleshoot and resolve complex platform incidents independently
• Monitor system performance, reliability, and scalability to ensure optimal operation
• Participate in Agile Scrum ceremonies (Daily Standup, Sprint Planning, Retrospectives), backlog grooming, and continuous improvement

Senior DevOps Platform Engineer

Full-stack Engineer

• Lead technical architecture and design, and presenting vision
• Apply using data structures and algorithms
• Evaluate problems in both strategic and tactical terms
• Lead and mentor a small team of high-caliber engineers
• Drive positive change with technical vision and solutions
• Promote software-driven engineering and automation
• Deliver business-critical systems and components with high quality
• Lead by example with hands-on platform, backend, and frontend development
• Review pull requests and provide constructive feedback
• Investigate and propose new ideas, frameworks, technologies, or processes
• Advise executives to develop functional strategies on matters of significance
• Exercise independent on complex issues

Lead Full Stack Engineer

Counselor

• Uses behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations
• Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action
• Uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members
• Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed
• Follows established guidelines/procedures

Licensed Behavioral Health UM, RN, SW, Counseling, Psychology

Call Center Representative

• addressing incoming telephone, digital, or written inquiries
• performing varied activities and moderately complex administrative / operational / customer support assignments
• providing resolution or pathway to resolution on each call
• addressing member needs including complex benefits questions
• resolving issues and educating members
• handling 40+ inbound calls daily
• accurately recording details of inquiries, comments or complaints, transactions or interactions
• escalating unresolved and pending member grievances
• working under minimal direction within defined parameters
• following standard policies / practices

Medicare Call Center Representative

• Work with a team of developers with deep experience in frontend technologies, distributed microservices, and full stack systems
• Work across Agile teams to design, develop, test, implement, and support technical solutions in full-stack development tools and technologies
• Work with cloud native stack, build on Azure, AWS, or Google, use technologies like Kubernetes
• Write effective REST APIs and technical documentation
• Write automated test cases to ensure correctness, responsiveness, and efficiency of the software product
• Provide expertise to influence project, initiative, and maintenance technical direction during discovery, planning, and implementation stages
• Maintain modern development standards with best-practice approaches and development processes

Senior Full Stack Software Engineer

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

• 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
• Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months
• 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

General Counsel

• Provide legal support and guidance on counseling including artificial intelligence (AI), litigation, and e-Discovery
• Support legal reviews related to the development and deployment of AI products and systems
• Provide analysis and advice on compliance with AI regulations and standards
• Collaborate across AI product developers, engineers, data scientists, multiple business and legal teams
• Help draft AI guidance, strategies and governance materials
• Support AI litigation, regulator inquiries and requests for information
• Work independently under time pressures and deadlines in a dynamic, demanding environment

Counsel

Medical Director

• Responsible for behavioral health care strategy and/or operations
• Make determinations on requested services and level of care authorization
• Conduct discussions with external physicians for additional clinical information
• Support regional market priorities through collaboration with clinicians and community groups
• Flow to work as needed for coverage during vacations, weekends, and holidays.

Behavioral Health Medical Director

Data Engineer

• Design, build, and maintain data architectures and pipelines supporting Application Health reporting and analytics.
• Ingest and integrate data from multiple internal and external sources using modern cloud‑native technologies.
• Develop analytics, dashboards, and scorecards across architecture, data quality, security, engineering standards, reliability, and technology stack alignment.
• Leverage big data and AI/ML‑enabled solutions to cleanse, transform, and enrich enterprise data.
• Provide technical leadership, set engineering standards, review designs, and mentor team members.
• Partner with Technology Stewardship, Tech Strategy, EIP, CIO Segment Engineering, and application owners to align solutions with enterprise priorities.
• Ensure data solutions comply with governance, security, privacy, and regulatory standards.
• Evaluate emerging technologies to improve scalability, performance, reliability, and cost efficiency.

Lead Data Engineer

Security Engineer

• Provide leadership for engineering and operations teams responsible for enterprise load balancing, traffic management and gateway services, and edge integrations
• Own the strategy, roadmap, and operational performance of Secure Edge platforms enabling resilient, hardened connectivity
• Ensure high availability, performance, and resiliency of services governing enterprise traffic and user access across on-premises and cloud environments
• Drive modernization initiatives, including on-premises standardization, optimization of cloud-delivered global traffic services, and integration of native cloud gateways
• Establish and maintain consistent policies, standards, and architectural patterns across corporate and subsidiary environments
• Oversee operational metrics, service health monitoring, incident response, and continuous improvement efforts
• Manage budgets and resource allocation across associates, contractors, and supporting services
• Develop and mentor senior technical leaders while building and sustaining high-performing engineering teams

Associate Director, Edge Security – Traffic Management

Community Manager

• Act as a liaison between markets, sales, and community partners to ensure seamless coordination and execution.
• Foster a collaborative, mission-driven team culture focused on growth, impact, and accountability.
• Develop and implement local outreach strategies, including events and partnerships, to generate quality leads.
• Identify and cultivate high-potential lead sources, including T65 opportunities.
• Track and measure grassroots marketing, community outreach, and event success.
• Build and maintain strong relationships with community organizations, local businesses, and other stakeholders.
• Plan and execute community events to enhance brand visibility and generate leads.
• Prepare and present regular reports on outreach activities, performance, and outcomes.

Formulary Operations Management Professional 2

Bilingual Clinical Pharmacy Technician

Senior DevOps Platform Engineer

Lead Full Stack Engineer

Licensed Behavioral Health UM, RN, SW, Counseling, Psychology

Medicare Call Center Representative

Senior Full Stack Software Engineer

Case Manager

Case Manager

Counsel

Behavioral Health Medical Director

Lead Data Engineer

Case Manager

Associate Director, Edge Security – Traffic Management

Field Community Executive