Humana

Compliance

• Ensure compliance with governmental requirements related to the administration of Specialty products with a focus on Dental and Vision plans
• Analyze business requirements, provide research and regulatory interpretation
• Advise internal business units and external business partners
• Complete risk assessments and develop audit and monitoring work plan
• Make decisions on moderately complex to complex issues regarding technical approach for project components
• Review and analyze documents and data to identify evidence for meeting regulatory requirements
• Coordinate implementation and compliance with corrective action plans

Senior Compliance Professional – Specialty Dental and Vision

• Manage team to deliver and maintain compliant products to meet the needs of the enterprise goals.
• Create a high-performing organization to execute products that meet state and federal regulations and compliance and quality throughout the organization.
• Understand and guide product development through regulatory considerations and processes.
• Works closely with legislative and legal teams.
• Anticipate business impact of required legislation and stays informed of potential legislation based on industry information and trends.
• Ensure products meet all state filing requirements, and appropriate approvals.
• Leads a high performing team
• Collaborate with business partners – Actuarial, Marketing, Operations, Product, Sales, and Underwriting – to ensure success.
• Effectively communicates business risks and provides proactive solutions.

Director, Insurance Product Compliance

Medical Director

• Make determinations on requested services and levels of care
• Conduct computer-based reviews of clinical scenarios
• Communicate decisions to internal associates
• Participate in care management meetings and discussions with external physicians
• Ensure all work adheres to regulatory compliance standards

Medical Director – Claims Management

Operations

• Responsible for the accurate and timely dispensing of prescribed medication to patients
• Ensures adherence to quality assurance standards, accurate tracking techniques and a review process prior to shipping medications to patients
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and guidance where needed
• Follows established guidelines/procedures

Staff Mail Operations Pharmacist

Product Manager

• Leads all phases of the product life cycle for the Medicare and Medicaid claims payment integrity value stream
• Develops products to meet specific customer needs and achieve specific cost and success outcomes
• Monitors efficacy of products and uses customer and business partner feedback to ensure products are meeting customer needs
• Adjusts products over time to continue to achieve desired outcomes
• Provides input into claims adjudication strategy
• Leads a team of Product Managers and Product Owners aligned to the claims payment integrity value stream

Director, Product Management

Systems Engineer

• Leading the strategic direction, design, and implementation of associate technology at Humana, focusing on Mac solutions.
• Oversight of multiple systems and projects, including Mac Onboarding, Network, policy management, compliance, and automation across Mac technologies.
• Accountable for implementing business continuity and overseeing and evaluating Mac security, privacy, network, and new device solutions across different lines of business.
• Partner closely with peers across Architecture, Product Management, Support Services, and Experience & Design to grow Mac devices across Humana's many different areas.

Lead Systems Engineer, Mac Engineering

Technical Product Manager

• Lead end-to-end delivery of a large, multi-year productivity and labor optimization program.
• Establish and maintain integrated program plans, milestones, dependencies, risks, and delivery rhythms across multiple teams and project managers.
• Serve as the central point of coordination to prevent siloed execution and ensure alignment across segments, vendors, and operating models.
• Drive clarity and structure in a dynamic environment where scope, schedule, and budget may continue to evolve.
• Manage program schedule, budget and any changes to scope.
• Deliver executive-level presentations that frame data-based challenges, opportunities, benefits realization, and progress towards the strategic roadmap.
• Facilitate technology implementation supported by a thorough understanding of portfolio, product, program, project and agile delivery models.
• Implement and operate a central project governance model, including escalation paths, decision frameworks, and issue resolution.
• Proactively identify scope, schedule, resource, financial, and change risks; develop mitigation strategies and surface trade-offs early to leadership.
• Ensure consistent application of project management standards, reporting, and controls across all teams.
• Track progress against productivity targets and key milestones, highlighting gaps and recommended corrective actions.
• Coordinate delivery activities tied to vendor strategies, including phased rollouts by segment.
• Partner with Procurement and Operations leaders to align transition plans with rate cards, MSAs, vendor consolidation strategies, and evolving operating models.
• Support complex vendor migrations, SOW conversions, and potential FTE conversions where applicable.
• Act as a trusted partner to executive sponsors and senior leaders, providing clear, concise updates on progress, risks, and decisions required.
• Develop and execute communication strategies that balance urgency with accuracy.
• Lead and influence cross-functional teams without direct authority in a highly matrixed environment.
• Coach and support team-level project managers to ensure strong execution and consistent practices.

Lead, Project Manager – Enterprise Productivity

Manager

• Assess, plan, coordinate, implement, monitor, and evaluate medical / behavioral health services required to meet the complex health needs of TRICARE beneficiaries
• Coordinate, review, and approve medically necessary, appropriate care within the guidelines of the TRICARE program
• Provide telephonic care guidance and support to beneficiaries and their family/caregiver
• Identify gaps in care, eligibility for assistance and/or need for care management program or other referral services

Care Manager, Telephonic Behavioral Health

IT Support

• Align AI initiatives with business objectives and oversee complex architecture projects
• Shape the organizational approach to responsible AI adoption
• Bring business leadership, business operations, project management, IT leadership, IT architecture and engineering together
• Deliver business outcomes and improve member experience and health outcomes
• Create technology strategies leveraging the IT portfolio
• Provide mentorship and guidance to other architects across Humana

Lead Enterprise Architect – Enterprise Architecture Activation

Actuary

• Responsible for setting pricing assumptions, submitting bids, and filing premium rates
• Supports implementation of rates, new plans and benefit changes
• Provides guidance to Product Development on cost impacts
• Develops and maintains pricing tools
• Establishes market level financial metrics
• Analyzes market level results and projections
• Develops recommended pricing actions
• Collaborates with sales and partners for membership growth
• Accountable for actuarial certifications of rate filings

Actuarial Analyst

Full-stack Engineer

• Design, code, and maintain software applications to meet business and platform requirements
• Deliver technical solutions and hands-on development expertise within a team environment
• Contribute to platform administration and apply strong technical knowledge within the Appian domain
• Contribute to code development that accelerates delivery of impactful initiatives in a HIPAA-regulated environment
• Collaborate on the design and development of software solutions using Appian low-code capabilities
• Participate in the configuration and optimization of the Appian platform, addressing technical issues as needed
• Develop and maintain integrations between Appian and other systems using RESTful services, APIs, and enterprise data sources
• Support the delivery of workflow and case management solutions based on Appian for various business initiatives
• Assist in evaluating and implementing Appian platform features and upgrades to enhance reliability and efficiency
• Promote Appian best practices and help ensure alignment with established engineering standards

Senior Software Engineer – Appian Platform

• codes, designs, and enhances software applications based on business and platform requirements.
• provides strategic technical guidance and hands-on engineering expertise to multiple functional teams.
• serves as a hands-on technical authority for an enterprise Appian platform supporting multiple business initiatives.
• standardizes engineering quality, development practices, and platform governance.
• actively designs and develops software solutions across concurrent initiatives.
• Applies advanced expertise in Appian platform configuration, security models, and performance optimization.

Principal Software Engineer – Appian

Designer

• Lead discovery with stakeholders to define user needs, workflows, KPI hierarchy, and success measures
• Create rapid prototypes (wireframes, clickable mockups, workflows) and partner with BI/Data Engineering to deliver production-ready dashboards, calculators, and reporting experiences
• Establish and run an innovation pipeline (intake → triage → prototype → pilot → scale)
• Drive adoption through usability testing, training materials, playbooks, release notes, and stakeholder engagement
• Partner with data governance and engineering to ensure consistent definitions, scalable designs, and alignment to enterprise data strategy
• Advise leaders on functional strategies related to analytics product design and innovation priorities

Design & Innovation Lead – Stars Analytics, Quality

Business Intelligence Analyst

• solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers
• works on problems of diverse scope and complexity ranging from moderate to substantial
• design and develop data models and turn data and insights into actionable plans
• collaborate with teams across the enterprise
• develop data analytics infrastructure strategies, build models to forecast future trends and outcomes, and create various data products
• negotiate with cross functional business units and establish effective data and business analytics infrastructure for big data analysis and machine learning
• oversee the collection, integration, and management of data ensuring data quality, accuracy, and consistency
• drive innovation in BI practices and methodologies and promote a culture of continuous improvement
• maintain and collect structured and unstructured data sets for analysis and reporting
• exercise independent judgment on complex issues and work under minimal supervision

Business Intelligence Lead

Engineer

• design, build, and maintain rapid analytics solutions and reusable reporting assets
• translate business requirements into analytics deliverables by building prototypes and production-ready solutions such as dashboards, scorecards, automated reports, KPI monitoring, and decision tools
• utilize modern analytics platforms and software development best practices (e.g., SQL optimization, data modeling concepts, version control, documentation standards) to cleanse, organize, validate, and transform data into insights and actions
• build/iterate dashboards and reporting solutions (e.g., Tableau/Power BI or equivalent)
• write and optimize SQL for extraction, validation, and transformation; ensure data quality and reconciliation
• automate recurring analytics and reporting using scripting and workflow tools (Python/R/Alteryx/Power Query or equivalent)
• implement documentation, refresh logic, controls, and basic monitoring to support reliability and auditability
• partner with engineering/BI teams to productionize solutions and align to governance and enterprise standards
• communicate results clearly to technical and non-technical audiences; provide recommendations that drive action.