Jobs at Humana

Designs and operates mission-critical stateful backend services for real-time decisioning and personalization. Responsibilities include state-machine architecture, transactional state management, idempotent and exactly-once processing, outbox-based event delivery, concurrency control, observability, auditability, and failure recovery. The engineer will use AI-assisted development tools, collaborate across engineering teams, participate in architecture reviews, and mentor other engineers. The role requires hybrid work near specified metropolitan areas with occasional office travel.

Analyzes complex internal and external data using data mining, predictive modeling, forecasting, and optimization to guide business decisions, improve patient experiences, and drive revenue growth. Presents insights to senior leadership and collaborates with analytics, technology, product, finance, and patient experience teams. The role is remote with occasional travel for training or meetings.

Analyzes and forecasts financial, economic, market, and healthcare data, with a focus on Lifetime Value and Net Present Value modeling. Builds and maintains models using SAS, Snowflake, SQL, and Databricks; establishes metrics; ensures data integrity; investigates anomalies; and supports strategic and operational decisions. Partners with actuarial, finance, marketing, sales, and strategy teams while advising executives on complex analytical issues.

Owns day-to-day operations, onboarding, production support, performance, and continuous improvement for Humana’s FHIR APIs and healthcare interoperability products. Coordinates with product, IT, security, architecture, compliance, and external partners to manage incidents, escalations, support models, operational metrics, documentation, and backlog enhancements. The role leads cross-functional initiatives, supports regulatory reporting, improves partner connectivity and onboarding, and mentors product teams.

Build, deploy, and operate production machine learning and decisioning pipelines for Humana’s Decision Intelligence Platform. Responsibilities include MLOps, feature engineering, scoring workflows, monitoring, optimization-aware decisioning, reinforcement learning, simulation, constrained optimization, and large-scale data processing. The role partners with engineering and product teams to deliver reliable, scalable, auditable systems while addressing clinical eligibility, operational constraints, policy failure modes, and regulated-domain requirements.

Leads financial modeling, valuation, forecasting, and SQL-based analytics for Medicare Advantage and Risk Adjustment programs. Owns model development, validation, enhancement, and performance measurement; translates healthcare methodologies and business requirements into scalable analytical solutions. Partners with Finance, Operations, Analytics, and senior leaders to assess financial outcomes, improve forecasting accuracy, communicate assumptions and risks, and influence decisions without formal authority. Requires advanced SQL, Excel, financial modeling, healthcare analytics, stakeholder leadership, and Medicare Risk Adjustment expertise.

Owns the translation of approved business requirements into implementation-ready documentation for Humana’s Next Best Action platform. Coordinates Product Managers and configuration teams, manages action and treatment requirements, reviews completeness, resolves ambiguities, supports backlog and change management, tracks implementation progress, and improves documentation standards. The role is remote with occasional travel and focuses on scalable decisioning configuration practices across business areas and channels.

Leads strategic sourcing, procurement, category management, and outsourcing initiatives from opportunity assessment through negotiation, contracting, and value realization. Develops multi-year sourcing strategies, conducts RFIs/RFPs/RFQs, builds financial business cases, negotiates complex contracts, and manages strategic supplier performance. Partners with executives and cross-functional teams to optimize spend, mitigate risk, improve supplier outcomes, and advance responsible sourcing.

Own regional Medicare Advantage product portfolios across strategy, CMS bid filings, benefit configuration, member materials, provider directory oversight, implementation, and enrollment readiness. Lead cross-functional partners, maintain filing and product accuracy, identify risks and dependencies, develop recommendations, and ensure compliant, timely execution. The role requires strong product judgment, analytical ability, detailed documentation, and influence without formal authority.

Leads a team of Insurance Product Managers supporting Medicare Advantage portfolios. Oversees resource allocation, product validation, testing, filings, implementation, regulatory readiness, quality controls, and delivery across shared-service workflows. Partners with Senior Product Managers, Compliance, Operations, Marketing, Claims, and regional teams to manage risks, improve processes, standardize operations, and ensure accurate, compliant deliverables. Coaches employees, monitors performance metrics, and drives accountability during deadline-driven Medicare Advantage and CMS regulatory cycles.

Leads enterprise readiness strategies for healthcare implementations, modernization, decommissioning, operational transformation, and service response initiatives. Partners with business, technology, clinical, and operational stakeholders to assess impacts, mitigate risks, establish governance, manage transitions, and drive adoption. Oversees implementation through stabilization and continuous improvement while supporting operational recovery and executive decision-making.

Leads enterprise solution architecture for healthcare technology initiatives, including target-state architectures, reference patterns, governance, integrations, cloud and data platforms, and generative or agentic AI capabilities. Partners with product, engineering, security, compliance, and executive stakeholders to deliver scalable, secure, resilient solutions across healthcare ecosystems. Defines integration strategies, architecture roadmaps, non-functional requirements, and governance processes while guiding multi-team delivery in regulated HIPAA environments.

Analyzes and forecasts financial, economic, market, and utilization data to support strategic and operational decisions. Develops financial projections for Utilization Management programs, establishes metrics, maintains data integrity, troubleshoots anomalies, conducts root cause analysis, and advises executives on complex issues. The role requires actuarial credentials, experience across multiple actuarial functions, strong communication skills, and independent judgment. This is a fully remote position with occasional travel for training or meetings.

Leads enterprise platform modernization and transformation initiatives from planning through delivery. Establishes governance, integrated roadmaps, dependency and risk management, resource planning, organizational readiness, and executive reporting. Partners with senior leaders and cross-functional teams across business, technology, operations, vendors, and external stakeholders. Drives decision-making, change management, adoption, strategic alignment, and value realization while improving delivery methods and organizational effectiveness.

Leads the lifecycle of Humana’s enterprise consent and preference management platform, including backlog ownership, requirements, integrations, delivery coordination, compliance, adoption, and performance optimization. Partners with engineering, marketing, digital, CRM, legal, privacy, compliance, data, and business teams to deliver omnichannel consent capabilities. Tracks KPIs, improves data quality and activation, reduces operational friction, and ensures transparent customer experiences aligned with regulatory requirements.

Leads complex cybersecurity initiatives from planning through operational transition. Coordinates cybersecurity, technology, business, vendor, and executive stakeholders; manages scope, schedules, risks, dependencies, budgets, resources, governance, and reporting. Translates technical concepts into executive communications, drives accountability and issue resolution, supports vendor and procurement activities, and ensures cybersecurity outcomes such as risk reduction, compliance, remediation, resilience, and capability maturity. Mentors junior project managers and adapts delivery methods across Agile, Waterfall, and Hybrid environments.

Leads end-to-end delivery of strategic cybersecurity initiatives across areas such as identity security, security operations, cloud security, application security, and governance. Manages project plans, budgets, risks, dependencies, vendors, reporting, stakeholder communications, and governance activities. Partners with technical and business teams to align execution with cybersecurity strategy and deliver measurable risk reduction, compliance, resilience, and capability outcomes using Agile, Waterfall, or Hybrid methods.

Leads product vision, strategy, roadmaps, and execution for clinical programs. Partners with design, engineering, clinical, operations, analytics, and external organizations to develop scalable healthcare solutions. Prioritizes backlogs, defines requirements and success metrics, conducts research and business-case analysis, manages risk, and drives agile iteration. Mentors junior product managers and leads cross-functional alignment to deliver measurable member, provider, adoption, satisfaction, utilization, and financial outcomes.

Leads development of production-scale machine learning and reinforcement learning systems for Humana’s Next Best Action platform. Designs decision policies, simulations, offline evaluations, and monitoring strategies; builds scalable pipelines using Python, PyTorch, Databricks, PySpark, Ray RLlib, and MLflow. Owns models throughout their lifecycle and provides technical direction on architecture, experimentation, deployment, and constraint-aware decision-making.

Design end-to-end mobile and digital experiences for Humana’s Part D pharmacy benefits products. Create user flows, prototypes, wireframes, and high-fidelity designs while applying research, analytics, accessibility, and inclusive design principles. Partner with product, engineering, research, marketing, and business stakeholders to simplify complex healthcare information, support informed decisions, improve member engagement, and contribute to scalable design systems. Provide design leadership, influence strategy, and mentor less-experienced designers.