Humana

Vice President

• Develops, implements, and monitors a comprehensive framework under the Medicaid Third Party Entity (TPE) Governance Office for management of the TPE portfolio ensuring alignment with organizational strategic priorities
• Designs a business and financial modeling methodology to evaluate a new vendor, including business need, financial value or operating efficiency thesis, service level baseline, future scalability, platform enablement, and implementation agility for appropriate vendor selection and alignment to Medicaid priorities
• Leads process alignment of the TPE Governance office and business owners to ensure operating model strategies enable adoption of best practices and continuous improvement
• Partners with the PMO on implementation of new vendors and scaling pilots
• Conducts a monthly governance meeting to review new business cases, current portfolio operations and financial performance, risks and mitigations in place
• Builds and maintains positive relationships with vendors; designs and implements operating and performance management routines (e.g. monthly/quarterly Joint Operating Committees) to foster collaboration, transparency, accountability and improvement alongside business partners
• Identifies and monitors standardized metrics and risk processes to drive consistency and transparency in performance outcomes across the portfolio
• Cultivate a mindset championing cross-functional collaboration, policy harmonization, and ongoing optimization of processes and outcomes
• Ensure financial discipline and robust change control mechanisms to safeguard investments and strategic alignment, directly impacting performance optimization
• Provides leadership to a team of approximately 20 associates of varying levels, identifies capability gaps and implements targeted initiatives to build, retain, and deploy talent in support of evolving business priorities and operational excellence

AVP, Vendor Performance and Value Management

Technical Product Manager

• Develop and articulate technical product vision, strategy, and roadmap aligned with Specialty business priorities and organizational objectives.
• Build and maintain effective, collaborative relationships with business and IT stakeholders to ensure transparency, mutual understanding, and shared goals.
• Lead the gathering and prioritization of requirements, ensuring stakeholder needs are consistently represented.
• Oversee cross-functional teams through the product lifecycle, from concept through delivery and ongoing optimization.
• Coordinate the transition of in-house solutions to third-party models, ensuring minimal disruption and alignment with strategic outcomes.
• Monitor product performance using defined metrics, solicit feedback, and implement continuous improvements.
• Ensure compliance with all relevant policies, standards, and regulatory requirements.
• Serve as the technical product manager and subject matter expert for the core platform's architecture, configuration, integrations, and ongoing performance.
• Design and validate solution architectures including data models, APIs, workflow configuration, and integration with enterprise platforms.
• Partner with the vendor teams to translate business requirements into scalable technical solutions, participating in design reviews and solution planning.
• Lead complex engineering efforts including data migration design, environment configuration, interface development and platform extensions.
• Establish and enforce engineering best practices including coding standards testing approaches, documentation and use of AI.
• Support project delivery teams by creating technical blueprints, estimating development effort and mitigating technical risks.
• Troubleshoot and resolve escalated technical issues including root-cause analysis and remediation.
• Provide technical mentorship to engineers and cross-functional team members, helping develop internal expertise around the new platform.
• Collaborate with enterprise architecture, security, and tech operations teams to ensure solution compliance with company standards.
• Inform platform roadmap evolution, assessing new features, upgrades and enhancements for existing and future business.
• Support change management efforts by contributing to change readiness process, documentation, and communication.

Technical Product Manager, Specialty Core Platform

General Counsel

• Provide strategic advice on operational and regulatory matters
• Counsel operation teams in connection with patient safety and quality issues and related governmental inquiries
• Work collaboratively across the Legal team and other teams within Humana, including Compliance and Risk Management
• Provide leadership with risk assessments, analysis, and proposed mitigation strategies regarding potential decisions and initiatives

Legal Counsel – Healthcare

Sales

• Developing strategic sales/marketing plans, which will assist in maintaining and increasing membership.
• Conduct, attend, and manage local and sales operations meeting(s) in order to provide sales development, teamwork, market strategies, training, etc.
• Monitor sales results, trends and overall performance to hold sales agents accountable for achieving identified targets.
• Collaborate across MarketPoint sales channels to execute strategy and deliver on growth objectives.
• Partner with Market Operations team to develop growth strategy; including sales & retention strategies, product design and provider partnerships/growth.
• Build strategic relationships with distribution partners and agencies to ensure successful business outcomes.
• Lead a team of 6 Managers and 50 indirect reports.

Director, Medicare Sales

Security Engineer

• Oversee all plannable cybersecurity work, with clear traceability to strategic priorities, OKRs, and maturity goals
• Drive strategic alignment across capabilities and shape narratives for senior leadership and portfolio reviews
• Coordinate Agile, project, and operational workstreams to ensure synchronized execution
• Manage cross-team dependencies and proactively identify risks and blockers
• Lead unified reporting efforts including monthly portfolio reviews, OKR progress, delivery health, and risk posture
• Maintain RAID logs and ensure consistent use of execution standards and templates for predictable stakeholder experiences
• Collaborate with Product Managers, Product Owners, RTEs, Project Managers, and SMEs to ensure delivery cohesion
• Provide executive-ready insights and recommendations to inform investment prioritization and risk mitigation
• Mentor peers and contribute to the continuous improvement of delivery processes and standards
• Promote consistent use of execution templates and tools to scale delivery excellence
• Aid in quarterly roadmap refreshes and 12-week planning cycles supporting capability progression
• Ensure adherence to governance standards, reporting cadence, and compliance expectations
• Act as a strategic escalation gatekeeper, validating issues and coaching resolution paths
• Foster cross-functional collaboration and maintain trust with stakeholders across cybersecurity and enterprise teams

Lead, Technology Solutions – Cybersecurity

Full-stack Engineer

• codes software applications based on business requirements
• standardizes the quality assurance procedure for software
• oversees testing and debugging and develops fixes
• researches complaints and makes necessary adjustments and/or recommendations to resolve complex software related issues
• understands department, segment, and organizational strategy and operating objectives
• makes decisions regarding own work methods

CIAM Software Engineer

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

• Provides technical leadership and mentorship to development teams, ensuring alignment with the organization’s vision, mission, and strategic objectives.
• Actively participates in and reviews project plans, solution designs, and other critical artifacts to guide the delivery of complex, custom-developed solutions.
• Participates in project requirements review meetings and conducts thorough analysis of business requirements to ensure accurate understanding and alignment.
• Develops detailed low-level designs and contributes to the overall vision of solution artifacts.
• Engages in daily stand-up meetings with business stakeholders and development teams as part of the agile process, providing regular updates on progress and addressing any issues related to ongoing development activities.
• Collaborates with team members to track and plan agile work supporting core cloud development.
• Collaborates with cross-functional teams—including front-end, back-end, and infrastructure groups—to deliver high-quality solutions.
• Partners with internal architecture and other enterprise teams to ensure a resilient, state-of-the-art cloud environment for a high-profile enterprise application(s).
• Develops and delivers proofs-of-concept (POCs) and sample implementations for widespread adoption within agile teams.
• Works with senior leadership to influence project timelines, deliverables, and strategic direction.
• Utilizes AI tools to accelerate code scaffolding, test automation, migrations, and documentation.

Lead Software Engineer

DevOps Engineer

• Build, optimize, and maintain scalable backend services using .NET (C#) within an Azure 2.0 environment
• Develop and maintain the orchestration logic that integrates with GitHub Actions and Azure DevOps (ADO) pipelines
• Deploy and manage scalable Azure cloud infrastructure utilizing Terraform, and write custom automation scripts using Python
• Play a lead role in our roadmap by helping deprecate legacy SaaS worker functions, optimizing our grading engine, and reducing API bloat
• Work alongside data engineers to support asynchronous 'Run Grade' calculations
• Enforce strict supply chain security using JFrog Artifactory, HashiCorp Vault, and LaunchDarkly for feature toggling
• Lead the implementation of Splunk across our microservices cluster to consolidate logging, improve error handling, and build real-time health dashboards

Senior DevSecOps Engineer

Solutions Engineer

• Designing, developing, and implementing integration solutions using Oracle Integration Cloud (OIC).
• Familiarity with Oracle Artificial Intelligence tools.
• Ability to design and implement Oracle AI tools within ERP for automating business processes.
• Document technical designs, integration flows, and operational procedures.
• Collaborate with stakeholders to define integration requirements.
• Troubleshoot, optimize, and resolve issues related to OIC integrations and related Oracle Cloud services.
• Provide guidance and mentorship to junior engineers and contribute to best practices for integration development.

Senior Cloud Solutions Engineer

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Lead Full Stack Engineer

Capture Manager

• Lead initiatives to develop and execute operating models and strategies to successfully position Humana to capture growth opportunities.
• Work horizontally across the organization, coordinating with Medicaid leadership and population health and clinical subject matter experts.
• Synthesize, assess, and translate state Medicaid and integrated dual eligible program requirements into actionable go-to-market strategy.
• Consult with growth partners to design and optimize population health and clinical operating model blueprints.
• Research and assess prospective Medicaid growth markets.
• Gather key information on market and regulatory landscape.
• Lead cross-functional teams of growth partners and health plan leaders to design high-impact, innovative, and competitive population health and clinical programs.

Medicaid Capture Lead – Clinical and Population

Compliance

• Help with the collection and review of materials to ensure contractual compliance with Medicaid states.
• Work with Regulatory Compliance and state Medicaid markets to meet Readiness and Audit requirements.
• Research compliance issues and recommends changes that assure compliance with contract obligations
• Maintain relationships with government agencies.
• Coordinate site visits for regulators, coordinates implementation and compliance with corrective action plans.
• Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas.
• Make decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
• Follow established guidelines/procedures

Compliance Professional 2

Director

• The Clinical Pharmacist Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders.
• Utilizes broad understanding of managed care and PBM knowledge to develop, and/or implement strategies and programs to mitigate cost trend and improve health outcomes.
• The Clinical Pharmacist Lead works on problems of diverse scope and complexity ranging from moderate to substantial.
• The Pharmacy Director, internally known as a Clinical Pharmacy Lead, plans, directs, and monitors all financial, operational, professional, and clinical activities for the purposes of pharmacy program development for our Medicaid and Fully Integrated Dual Eligible Special Needs Plan (FIDE-SNP) Virginia health plan.
• The individual leverages a broad understanding of managed care and pharmacy benefit management (PBM) to develop and implement strategies and programs that mitigate cost trends and improve health outcomes.
• They ensure the pharmacy department provides optimal pharmaceutical services that meet all legal, accreditation, and certification requirements.
• This position will coordinate day-to-day pharmacy operations directly with the plan Chief Executive Officer and Chief Medical Officer.
• Keeps current with State and Federal regulations regarding the practice of Pharmacy and implements changes as necessary to maintain compliance supporting both the business and public relations strategies.
• Develops corporate communications to be shared with senior leadership.
• Supports trend management by conducting analysis of drug spend, utilization, and/or approval scenarios.
• Advises executives to develop functional strategies (often segment specific) on matters of significance.
• Exercises independent judgment and decision making on complex issues regarding job duties and related tasks.
• Works under minimal supervision, using independent judgment requiring analysis of variable factors and determining the best course of action.
• Facilitates and consults across teams and managing projects working collaboratively and communicating with staff in different positions and all levels of management positions.
• Manages the Virginia health plan relationship with our internal PBM, Humana Pharmacy Solutions ensuring compliance with programmatic requirements, such as claims processing, prior authorization, formulary management and clinical programming.
• Represents Humana at all Pharmacy Medicaid meetings including those with the Virginia Department of Medical Assistance Services (DMAS).
• Develops, executes and manages National Medicaid Pharmacy programs as needed.

Virginia Medicaid Pharmacy Director

Events

• Overseeing the implementation, management, and continuous improvement of the Healthcare Effectiveness Data and Information Set (HEDIS) initiatives
• Develop and implement strategies to improve clinical quality and performance metrics
• Serve as an internal expert on HEDIS Preventive Measures technical specifications
• Lead and be accountable for enterprise HEDIS performance
• Accelerate shared accountability for HEDIS improvement
• Develop and manage a strategic portfolio of improvement initiatives targeting key drivers of HEDIS performance
• Collaborate with cross-functional teams
• Own initiative performance oversight
• Develop strategic recommendations for program evolution and policy advocacy
• Oversee budget, vendor relationships and program delivery
• Lead and develop a team of high-performing direct reports