Humana

Analyst

• Analyze and audit complaints received by the plan to ensure the integrity of claims, authorization processes, and business operations.
• Utilize established process guidelines and industry knowledge to validate organizational decisions and assess downstream and upstream impacts
• Perform root cause analysis of audit findings and make recommendations for appropriate change management.
• Emphasize continuous improvement by identifying opportunities to reduce redeterminations, complaints, and rework of claims.
• Identify trends and areas of improvement resulting from information obtained through the Resolution team resources and available reporting/data.

Senior Grievances & Appeals Analyst

Business Intelligence Analyst

• Develop data solutions that uncover actionable insights into marketing performance
• Support the creation and maintenance of dashboards and reporting tools that surface trends
• Measure campaign effectiveness and empower marketers to optimize strategies through data-driven decision-making
• Gather and translate marketing stakeholder requirements into actionable data solutions
• Design and develop dashboards and visualizations that empower marketers to make data-driven decisions
• Collaborate with analytics and business teams to ensure reporting meets stakeholder needs

Associate, Marketing Business Intelligence

Operations

• Engage with high-performing and low-performing provider groups to understand clinical workflows and operational drivers that contribute to better chronic condition management. Translate insights into best practices and operational playbooks.
• Drive and synthesize insights across Clinical Analytics, member research, and provider research to inform the strategic roadmap and execution priorities.
• Co-develop and drive the execution of direct-to-member interventions to improve chronic condition management.
• Lead the design and refinement of provider-facing data views (dashboards, insights, performance summaries) to ensure they are actionable, timely, and aligned to provider workflows.
• Co-develop and support the execution of interventions to address key barriers for providers (PCPs and specialists).
• Work with enterprise partners (e.g., care management, clinical programs, analytics) to ensure alignment and remove operational barriers to member and provider adoption.
• Synthesize complex clinical, operational, and analytic information into clear recommendations for executive leadership.
• Engage in an ambiguous problem solving and strategy setting.
• Use data and insights from experts to identify the greatest opportunities in clinical outcomes, quality, cost, and experience for members and providers.
• Lead cross-functional teams to define discrete opportunities that are both impactful and achievable.
• Work directly with cross-functional partners across the enterprise to create the operationalization models, test and learn strategies, performance management strategies, and roadmaps to execute on prioritized opportunities.
• Lead or support implementation of initiatives in partnership with internal or external teams.

Strategy & Operations Lead – Clinical Outcomes

Manager

• Provide comprehensive, holistic approach for Behavioral Health Case Management
• Personal interaction with beneficiaries to address behavioral health needs
• Assess, plan, coordinate, implement, monitor, and evaluate care needs of TRICARE beneficiaries
• Maximize each beneficiary's capacity for self-care and achieve desired clinical outcomes
• Serve as primary point of contact for all activities within the clinical spectrum
• Coordinate and collaborate with Military Treatment Facilities, Care Management programs, and providers

Care Manager, Telephonic Behavioral Health

Actuary

• analyzes and forecasts financial, economic, and other data to provide accurate and timely 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 to forecast the organization's short, medium and long-term financial and competitive position
• ensure data integrity by developing and executing necessary processes and controls around the flow of data
• develop, build, and continuously improve complex reserving models leveraging cloud-based technology and advanced analytics
• leverage tools such as Databricks and Power BI to build, automate, and optimize reporting processes
• conduct in-depth analyses to identify opportunities for improving reserve accuracy, translating your findings into actionable enhancements to the reserve model

Associate Actuary, Analytics and Forecasting

Pharmacist

• advises and collaborates with cross functional leaders
• combines clinical Rx acumen with holistic desired health outcomes
• works across multiple departments to execute strategies
• influences department’s strategy
• makes decisions on complex issues regarding technical approach for project components
• exercises considerable latitude in determining objectives and approaches to assignments

Senior Pharmacy Clinical Advisor

Product Manager

• Lead a complex product area within our applied AI portfolio, defining success, prioritizing problems, and identifying the best AI-driven strategies considering wider organizational context.
• Adapt and adjust strategies to reflect learnings and changes.
• Partner directly with business units to deeply understand their operations, capture requirements, map processes, and identify the most significant opportunities for AI-driven improvement.
• Translate business objectives and user needs into clearly scoped AI use cases and drive them from concept through prototyping, development, evaluation, and validation.
• Own the backlog - write epics, features, and stories; prioritize the work.
• Develop detailed program plans, milestones and risk mitigation strategies.
• Lead 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 product vision, develop roadmaps, and drive progress against goals and milestones, while improving team health and up-leveling team effectiveness.
• Gather and analyze user research, business process data, and market analysis to inform product decisions and influence the wider product organization.
• Lead the development of evaluation frameworks to test, benchmark, and compare AI models and platforms against enterprise success requirements.
• Actively identify opportunities and resolve dependencies by creating shared strategies across teams in adjacent product areas.
• Develop reusable product frameworks, playbooks, and best practices that accelerate AI solution delivery across the organization.
• Influence strategy and progress across partner teams, enhancing collaboration and resolving divergent goals.
• Communicate product strategy, progress, and business value with radical clarity to all stakeholders.
• Support the growth of PMs and cross-functional team members by providing mentorship, coaching, and hands-on guidance.

Lead AI Product Manager

Director

• Advance Humana's federal advocacy priorities by implementing strategic engagement plans with Congress and the Administration
• Build trusted relationships with Members of Congress, congressional staff, and important federal partners
• Track and assess legislative and regulatory developments that impact our business and the healthcare industry, and communicate relevant updates
• Partner across the organization to provide insight on public policy trends, risks, and opportunities
• Collaborate with internal leadership and external partners to shape and advance policy agenda
• Develop compelling materials, including policy briefs, talking points, and internal communications
• Represent Humana with trade associations and industry groups to strengthen our voice in the broader healthcare community
• Support federal engagement efforts, including leadership briefings and partner meetings in Washington, DC

Director, Federal Affairs

Compliance

• ensure compliance with governmental requirements
• timely reporting of accurate and complete (quality) data or other filings in response to required external agency mandates
• coordination with Regulatory Compliance for government regulator (or their contracted vendors) communications
• internal coordination with Corporate Affairs and other business partners regarding issues or other concerns/barriers related to timely submission of accurate and complete data
• responsible for State and Federal filings on a weekly, monthly, quarterly, and annual basis
• responding to any State Department of Insurance inquiries

Senior Compliance Professional

Data Engineer

• responsible for leading the modernization, optimization, and stabilization of the Wisconsin Medicaid Market's data platform ecosystem across two independent health plan technology stacks.
• owns the market's Data Warehouse and ODS, drives ETL/data movement strategy (including SSIS modernization), and improves the reliability, observability, and security posture of data pipelines supporting critical Medicaid operations.
• partners closely with the Market BI team as their IT counterpart to improve data access and flow, including establishing and managing Databricks pipeline patterns and platform enablement as the BI environment evolves.
• accountable for modernizing and optimizing the market's data platform to improve reliability, reduce technical debt, strengthen observability/fault tolerance, and increase engineering efficiency in a complex dual-stack environment.
• primary IT partner for data platform enablement — improving data access patterns, strengthening pipeline governance, and helping establish a maintainable approach to Databricks pipelines and workflows as the market matures its analytics capabilities.

Lead Data Engineer – Modernization, Reliability

Full-stack Engineer

• The Senior Full Stack Engineer – Platform & Architecture is responsible for hands-on architecture, design, development, and modernization of applications and platforms that support the Wisconsin Medicaid Market.
• This role operates with a high degree of autonomy and trust, owning solutions end-to-end across the full stack rather than confining itself to a single application or technology area.
• Collaborates with peers, enterprise architecture, and platform partners to define technical direction, align to enterprise standards where appropriate, and reduce system complexity and operational burden.
• Drives technical architecture and design across UI, API, data, and integration layers; present a clear vision and pragmatic patterns that standardize approaches and improve efficiency across technology stacks.

Senior Software Engineer – Full Stack

Marketing

• Lead the end-to-end marketing strategy for CenterWell Senior Primary Care, aligning with enterprise growth, brand, and member experience goals
• Serve as a senior strategic partner to business unit leadership, bringing insights, perspective, and direction to key decisions
• Build, develop, and coach a high-performing team that supports multiple leaders across the business
• Create and evolve messaging frameworks, value propositions, and proof points that resonate with prospects and patients
• Lead the design and implementation of market research and consumer insights to inform strategies and identify whitespace opportunities
• Define KPIs, track performance, and optimize plans to maximize NPV, reduce customer acquisition cost, and deliver business growth
• Manage intake of marketing initiatives and overall marketing budget
• Identify and evaluate new opportunities to expand patient acquisition, engagement and retention

Associate Vice President of Marketing

• Own end‑to‑end financial oversight for the TechStrat Run Infrastructure portfolio
• Ensure portfolio funding is aligned to strategic priorities and enterprise direction
• Partner with Portfolio Managers and Designated Responsible Individuals (DRIs) to evaluate initiative funding needs and develop realistic forecasts
• Deliver financial analytics, including Actuals vs. Forecast reporting, variance analysis, and trend insights
• Proactively monitor spend and recommend forecast adjustments or funding reallocations as priorities and consumption change
• Maintain accurate, executive‑ready, interactive Power BI portfolio reporting
• Govern CAPEX and OPEX planning, including depreciation and operating cost impacts
• Partner with IT Finance and Portfolio Leads to support sound financial decision‑making
• Improve cost transparency and optimize TechStrat Run Infrastructure spend
• Ensure accurate monthly and quarterly financial reporting
• Track and report on Run Infrastructure‑funded strategic initiatives
• Provide clear portfolio performance updates to leadership and Steering Committees
• Lead and develop the TechStrat Portfolio Management function
• Create a culture of engagement, accountability through effective leadership, coaching, and feedback
• Support senior leaders with portfolio insights that enable informed prioritization and trade‑off decisions
• Govern TechStrat associate position approvals, ensuring alignment to department budgets, workforce plans, and leadership direction
• Provide portfolio‑level reporting on filled, in‑process, and open roles, including savings and capacity targets
• Partner with Hiring Managers and HR to support efficient and compliant hiring processes
• Provide oversight of infrastructure funding and chargeback processes for provisioned virtual infrastructure
• Ensure processes exist for accurate charge allocation, infrastructure replenishment funding, and financial reporting
• Deliver monthly and annual summaries of collected and spent funds to Infrastructure teams and Steering Committees
• Support TechStrat OKR and strategy reviews in alignment with enterprise IT processes

Director, Portfolio Management

• Assess and coordinate care to support members
• Use a holistic, member-centered approach
• Perform telephonic and face-to-face assessments
• Provide clinical interventions through individualized care plans
• Collaborate with providers and community resources
• Facilitate coordination across settings

Field Care Manager, RN

Vice President

• Define and execute the enterprise strategy for Humana’s OTC line of business, positioning it as a component of Medicare Advantage and consumer digital experience
• Establish the operating model for OTC benefits, including digital platforms, vendor partnerships, fulfillment models, and integration with internal systems and channels
• Drive innovation across OTC benefit delivery, including personalization, omni‑channel access, automation, and data‑driven experiences
• Partner with Medicare, Pharmacy, Clinical, Technology, Marketing, and Consumer Experience leaders to integrate OTC engagement into the end‑to‑end member journey
• Own business performance, including growth strategy, financial modeling, budgeting, and performance measurement
• Use data and insights to shape assortment and experience strategies that influence member behaviors, increase appropriate benefit utilization, and support outcomes such as adherence, prevention, and condition management
• Lead merchandising and lifecycle strategies across digital and physical fulfillment channels, including personalization, product placement, promotions, and recommendations tied to member needs and business goals
• Establish KPIs focused on benefit utilization, member experience, quality, equity, and operational efficiency
• Ensure compliance with CMS and regulatory requirements governing OTC benefits, working closely with Legal, Compliance, Audit, and Risk teams
• Build and scale the organization, capability, and governance required to support a sustainable OTC digital business
• Serve as an executive thought leader and influencer on consumer benefits, digital engagement, and Medicare innovation