Strategy Advancement Advisor - Distribution Strategy
Santa Fe, NM job
**Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does.
The Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.
**Become a part of our caring community and help us put health first**
The Strategy Advisor (Distribution) provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for the Enterprise Growth vertical. The Strategy Advisor's work involves complex assignments performed without direction where the analysis of situations or data requires an in-depth evaluation of variable factors. This work may require leading end-to-end strategy engagements.
As part of the Strategy Advancement team, this role will support MarketPoint's investment rationalization and strategic planning efforts. The role requires comfort with ambiguity and creating new solutions in the "white space" where answers are not clear cut or readily available. A successful candidate will be someone who has worked for several years in large matrixed organization (e.g. a publicly traded corporation or large not profit organization) or has several years' experience with stakeholder management (strategy/operations at a top-tier consulting/professional services firm). They will have a demonstrated ability to synthesize large amounts of information into clear and concise outputs (PPT, Excel). This person must be comfortable working collaboratively with senior leaders and subject matter experts alike and should have a high degree of executive presence leading engagements with these stakeholders. This person also will be effective at multitasking and possess keen program and change management skills to balance an evolving set of priorities and deadlines. Healthcare experience is a plus, but not required, though must have a history of mastering an understanding of their prior industry.
Other examples of the kind of work required from this role include leading the analysis of complex business problems and issues using data from internal and external sources. The candidate should bring expertise or identify subject matter experts in support of multi-functional efforts to identify, interpret, and produce strategic recommendations and plans. The candidate's work will substantially shape the thinking of distribution org. They will exercise independent judgment and decision making on complex issues to determine the best course of action and work under minimal supervision.
**Use your skills to make an impact**
About the team: Humana's distribution organization, MarketPoint, plays a key part in driving Humana's long-term vision to achieve leading growth in Medicare and individual products. The MarketPoint strategy team was created to help transform Humana's customer acquisition approach. The team functions with a mandate to think creatively, discover new opportunities and re-envision operations to drive growth and deliver a first-class experience to our members and agents.
**Responsibilities:**
+ Leads multiple short- and long-term work streams sometimes across engagements, including hypothesis development, working sessions, and report-outs with leaders across the company, and documenting key ideas and actions to drive follow-up actions
+ Partners closely with finance, analytics, and operators to optimize, track, and report out on internal and external compensation strategy and results
+ Develop high-quality analysis and deliverables that clearly frame organizational objectives, issues/challenges, and articulate compelling, insightful findings, conclusions, and recommendations
+ Lead multiple cross functional investment sizing workstreams and provide high-level support for senior leaders to make informed decisions
+ Identify new growth avenues of opportunity through independent analysis and presents actionable findings
+ Lead key portions of presentations at high-visibility meetings
+ Assist MarketPoint leadership in communicating value and impact of MarketPoint initiatives to broader Humana organization
+ Coach junior team members to develop technical and professional skillsets
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree
+ **3+ years** of progressive experience consulting in finance, strategic planning, or related roles.
+ Proven track record in **building compensation models** and **incentive design frameworks** .
+ Advanced proficiency in **financial modeling and Excel**
+ Demonstrated experience **managing large, complex budgets** and guiding senior leadership through **trade-off decisions** .
+ Strong background in **business case development** , including **value sizing** , ROI analysis, and scenario modeling.
+ Ability to influence and partner with senior executives to drive strategic decisions.
+ Exceptional analytical and problem-solving skills with a focus on **data-driven decision-making** .
+ Strong communication skills to present complex financial concepts clearly to non-financial stakeholders.
**Preferred Qualifications**
+ Healthcare industry experience, preferably in the managed care or provider sector
+ Experience in **compensation strategy** within large organizations.
+ Exposure to **enterprise-level budgeting and resource allocation** .
**Additional Information**
**- Position does have the potential for up to 5% travel.**
**- Position will be working Eastern (EST) hours.**
**Virtual Pre-Screen**
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a HireVue interview. In this interview, you will listen to a set of interview questions over your phone or text and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
**Work-At-Home Requirements**
At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$115,200 - $158,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-28-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Easy ApplyActuary, Risk and Compliance
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Lead Actuary, Risk and Compliance is responsible for the overall management and oversight of actuaries and/or support staff where activities are concerned with identifying and managing risks. Identifies and analyzes potential risks and estimates the potential financial consequences, develops and recommends controls and cost-effective approaches to minimize risks. The Lead Actuary, Risk and Compliance works on problems of diverse scope and complexity ranging from moderate to substantial.
The Lead Actuary, Risk and Compliance assesses and communicates information regarding actuarial/business risks across the organization. Provides peer review and counsel on a wide variety of company, industry, and regulatory practices. Activities may include monitoring developments in actuarial techniques, and researching laws and regulations applicable to actuarial science and insurance operations. 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, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.
In this specific role, you will be part of a team tasked with assessment of risk , opportunities, and mitigation strategies to assure the compliant submission of bids to support Humana's pricing and product development of Medicare Advantage and Prescription Drug Plans that positively impact the financial performance of Humana.
+ Supporting Humana's MA-PD and PDP bid filings by ensuring appropriate interpretation and implementation of CMS guidance, and implementation and execution of review standards and controls to minimize compliance risk associated with the bid filing
+ Participate in CMS audits and reviews related to Humana's Medicare bids.
+ Create and maintain process improvements to bid filings to continually improve Humana's ability to file compliant bids.
This position comes with the opportunity of leading a team of 2 direct reports.
**Use your skills to make an impact**
**Required Qualifications**
+ a Bachelor's degree
+ 8 or more years of technical experience
+ 2 or more years of project leadership experience
+ Associate or Fellow in the Society of Actuaries
+ Member of the American Academy of Actuaries
+ Strong communication skills
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Medicare Advantage experience
+ Strong Communication Skills
+ Ability to manage large projects involving actuarial and non-actuarial staff
**Additional Information**
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$129,300 - $177,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-30-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Associate Vice President Corporate Communications, CenterWell
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Associate Vice President of Communications, CenterWell, is a strategic leader responsible for shaping, elevating, and protecting the company's reputation across all stakeholders-employees, patients, providers, partners, and the broader healthcare community. This role oversees CenterWell communications strategy, media relations, issues/crisis management, executive communications, M&A communications, internal communications, and brand storytelling for CenterWell and its three lines of business - Primary Care, Home, and Pharmacy. The AVP will be a hands-on leader who can operate at both the strategic and executive levels, partnering closely with senior executives to drive clear, consistent, and impactful communication.
**Key Responsibilities**
**Strategic Communications Leadership**
+ Develop and lead a team on an integrated communications strategy aligned with company objectives, purpose, and growth priorities.
+ Serve as a trusted advisor to executive leadership on reputation, messaging, and communications risks and opportunities.
+ Lead enterprise-wide narrative development and ensure message cohesion across internal and external channels.
**Media & External Communications**
+ Oversee media relations strategy-including proactive storytelling, reactive media management, and relationship building with healthcare and business press.
+ Craft communications that position the company as a thought leader in aging well, consumer experience, and clinical excellence.
+ Manage external PR agencies and ensure strong, measurable results.
**Issues & Crisis Management**
+ Lead crisis communications planning and rapid-response execution for sensitive healthcare topics (patient issues, operational disruptions, etc.).
+ Develop and maintain crisis playbooks and serve as a core member of the issues-response team.
+ Coach leaders and spokespeople for high-stakes moments and media interactions.
**Executive & Associate Communications**
+ Elevate the voice of the executive team through compelling narratives, speeches, presentations, and internal messaging.
+ Oversee internal communications strategy to foster alignment, culture, and clarity across a geographically distributed workforce.
+ Partner with HR and operations on change management communications.
**Team Leadership & Collaboration**
+ Manage, mentor, and develop a high-performing communications team.
+ Lead cross-functional collaboration with marketing, HR, operations, and legal.
+ Establish communications KPIs, reporting, and metrics to track impact.
**Use your skills to make an impact**
**Requirements**
+ Bachelor's degree in Communications, Public Relations, Journalism, Marketing, or related field.
+ 10+ years of progressive experience in corporate communications, public affairs, PR, or healthcare communications.
+ Proven track record in media relations, internal comms, executive comms, and crisis management.
+ Experience in healthcare (provider, payer, pharma, or healthcare services) strongly preferred.
+ Exceptional writing, storytelling, strategic thinking, and measurement skills.
+ Ability to operate in a fast-paced, high-growth environment with a mix of strategic and hands-on responsibilities.
+ Strong leadership presence and ability to influence senior stakeholders.
**What Success Looks Like**
+ Strengthened brand reputation and increased share of voice in healthcare media.
+ Consistent, clear organizational storytelling that connects strategy to employee engagement and company transformation agenda.
+ Proactive management of emerging issues and confident, steady leadership during crises.
+ Engaged and high-performing communications team
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$203,400 - $279,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-23-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Insurance Strategy Consultant
Santa Fe, NM job
**Become a part of our caring community and help us put health first** Humana, a Fortune 50 Healthcare Company Humana is a publicly traded, Fortune 50 healthcare company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in the 60's, to the largest US hospital corporation in the 80's, to a leading health benefits company beginning in the 90's. Today, Humana is a leader in consumer-focused health solutions and is one of the largest health benefits organizations in the country.
The Healthcare Strategy team supports Humana's Insurance segment. This segment, Humana's largest, comprises the majority of the company's total revenue and earnings. Team members partner with senior leaders of the business unit, and more broadly with leaders throughout the enterprise, as they deliver strategy projects addressing some of the businesses' most important opportunities and challenges. These high-profile strategy projects place the team at the forefront of helping to define the future of Humana's largest businesses.
Humana is seeking a team member, with prior management consulting experience or professional experience leveraging core consulting skills, to support delivering some of the Insurance segment's highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Senior Strategy Advancement Professional, you will deconstruct issues and challenges, perform targeted research and analysis, support core strategy operational work, and craft sound, logical solutions and recommendations. You will also shape implementation considerations, and work with business owners as appropriate to transition analysis into execution. While deep diving into key areas, you will also have a bird's-eye view of the business unit's overall strategy. Your role be instrumental in synthesizing the strategic and operational choices being made across the business unit into coherent plans to drive growth and profitability, while simultaneously improving the lives and health of Humana's members. While doing so, you will have the opportunity to collaborate with fellow team members, subject matter experts, members of Humana's executive Management Team, and corporate, functional, and business unit leaders.
Recent example projects include assessing the performance of strategic initiatives and business areas, evolving key facets of the Medicare Advantage growth strategy, leading the development of the annual Medicare Advantage strategic plan, monitoring segment-wide operational performance, and refreshing the strategy for Humana's sales organization.
**Use your skills to make an impact**
**Key responsibilities include:**
+ Delivering high quality analysis and deliverables that clearly frame objectives, issues/challenges, and articulate compelling, insightful findings, conclusions, and recommendations
+ Managing and delivering analysis and workstreams within high-profile, high-impact strategy projects
+ Developing high quality, insightful, and clear analysis and deliverables for Humana's executive management team and Board of Directors
+ Developing hypotheses to be validated or refined through targeted research and analysis
+ Conducting interviews and working sessions with stakeholders across the company
+ Conducting industry, market, competitor, and financial analysis
+ Working collaboratively with fellow team members and leaders across the company
+ Leading critical processes to prepare leadership for interactions with Humana's executive Management Team and Board of Directors
+ Being a steward of the strategy team's operating model, norms and ways of working
+ Coordinating and overseeing key meetings to ensure key topics and decisions are communicated to leadership in a timely manner
+ Defining and developing opportunities for strategic alignment and consistent reporting across the business segment
+ Partnering with key stakeholders to implement segment-wide tracking tools and databases
+ Designing and monitoring key metrics and the reporting cadence across the organization
+ Working across operational units to execute strategic planning process and quarterly refinement
**Required Qualifications**
+ Bachelor's degree
+ 2+ years of full-time work experience with a leading management consulting firm and/or 3+ years of professional experience in a role that required core consulting skills
+ Demonstrated ability to manage analysis and work streams
+ Excellent verbal and written communication abilities
+ Highly collaborative, flexible, team-oriented working style
+ Strong problem-solving skills and the ability to perform complex qualitative and quantitative analysis
+ Demonstrated ability working within a matrixed environment
**Preferred Qualifications**
+ MBA, MPH, PhD, or graduate degree in a management field
+ Prior healthcare industry experience, preferably in the managed care or provider sector
**Reporting Relationships**
The role reports to a Director within the Strategy team, works collaboratively with leaders and members of rest of the team, and with senior leadership throughout the enterprise.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$86,300 - $118,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-19-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Health Insurance Exchange Liaison
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Health Insurance Exchange Liaison is primarily focused on Humana's obligations, as a Qualified Dental Plan (QDP) issuer, to meet all federal Affordable Care Act (ACA) and state-based requirements to participate in their respective programs on the Federally-facilitated Exchange (FFE) and State Based Exchanges (SBEs). This position is responsible for gathering, reviewing, analyzing, and disseminating relevant participation requirements to internal and external partner teams charged with fulfilling those requirements and overseeing program requirements and deliverables to ensure Humana is compliant with these requirements year-over-year in accordance with federal and state-level timelines. This position will also interface with Humana Dental business leaders, including - but not limited to - actuarial, product strategy, product strategy advancement, and network, about the evolving footprint in accordance with Humana Dental's overall public exchange strategy.
Health Insurance Exchange Liaison will be responsible for:
**_Exchange Liaison_**
+ Establish and maintain effective communication and relationships with numerous Federal and State organizations in support of efforts to participate as a QDP with respect to Exchange operations and integration for Federal and State Based health insurance exchange platforms.
+ Research, review, analyze, and disseminate regulatory information and requirements to all associated internal teams to support Exchange operations and integration with the Federal and State Based health insurance exchange platforms.
+ Serve as the single point of contact for multiple Federal and State Based organizations including, but not limited, to state Departments of Insurance (DOIs) in coordination with corporate affairs and regulatory compliance (when appropriate), exchange regulatory boards, and exchange operation committees.
**_Exchange Facilitator_**
+ Research, review, analyze, and disseminate timelines/deadlines/due dates, exchange requirements, and required documents (i.e., templates) to all associated internal teams in support of efforts to participate in Exchange operations and integration with the Federal and State Based health insurance exchange platforms. This dissemination effort includes - but is not limited to - maintenance of Humana's internal Exchange SharePoint site.
+ Collaborate with product strategy, product strategy advancement, information technology, vendor, and other implementation teams to gather requirements associated with product development, product expansion specific to Exchange operations (i.e., data transmission) and integration efforts for Federal and State Based health insurance exchange platforms.
+ Establish and facilitate regular meetings with all associated internal teams in support of Exchange operations and integration efforts for Federal and State Based health insurance exchange platforms.
+ Partner with Federal and State Regulatory agencies, vendors, and multiple internal teams to analyze requirements to identify and document meaningful executable tasks to establish a workable project plan, calendar, schedule of events, and product guidance for Exchange operations and integration efforts for Federal and State Based health insurance exchange platforms.
+ Operational ownership of all communication to contribute toward strategy execution for Exchange operations and integration efforts for Federal and State Based health insurance exchange platforms, including documenting processes for managing security access, utilizing each SBE's portal/website, etc.
+ Facilitate the gathering of required information and the completion of applications, documents, and points of contact for all Exchange operations and integration efforts for Federal and State Based health insurance exchange platforms in accordance with individual Federal and State regulatory organizations.
+ In coordination with corporate affairs, assist in collecting and disseminating information about future requirements released by Federal and State regulatory organizations concerning Exchange operations and the Federal and State Based health exchange platforms.
**Use your skills to make an impact**
**Required Qualifications**
+ 5 or more years of health industry experience.
+ 3 or more years of ACA/Health Insurance Exchange Qualified Health Plan (QHP) or Qualified Dental Plan (QDP) experience with Federal and/or State Based health insurance exchange platforms
+ Experience working with directly health insurance regulatory entities
+ Experience researching and analyzing Federal and State requirements
+ 2 or more years of project leadership experience
+ Proficient Microsoft 365 (Office) applications, including Word, Excel, Teams, and SharePoint as well as in Adobe Acrobat
+ Hours: 9am to 5 pm EST; will also work PST hours for SBE support (i.e., occasional meetings
**Preferred Qualifications**
+ Experience with Specialty, Dental, and/or Vision products.
+ Experience/familiarity with the Individual QDP health insurance exchange
+ 3 or more years of experience with Federal and State legislation and policy review and communication to diverse teams across a wide range of disciplines
+ 3 or more years of external facing interactions with Federal and State regulatory agencies.
+ Demonstrated attention to detail and accuracy
+ Proven analytical and problem-solving ability
+ Complex program and project management skillset with the ability to synthesize inputs across multiple disciplines and ensure a quality output
+ Excellent oral and written communication skills. This includes ability to collaborate effectively with associates across all levels of the organization
+ Oversight experience working with multidisciplinary teams of high performing subject matter experts
**Additional Information**
**Work Style** : Remote US (excluding AK & HI)
**Location:** This role is posted remote - nationwide. Regardless of location, it is expected that this person will work East Coast (EST) hours and, when needed, will also work West Coast (PST) hours for SBE support (i.e., occasional meetings).
**Additional Information**
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
**Work at Home Guidance**
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
+ Satellite, cellular and microwave connection can be used only if approved by leadership
+ Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
\#LI-BB1
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$86,300 - $118,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-09-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Medical Director - OneHome
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare/Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts.
The Medical Director provides medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to operationalize this knowledge in their daily work. The Medical Director works in a structured environment with expectations for consistency in thinking, authorship, meeting departmental expectations, and compliance timelines.
**Use your skills to make an impact**
Required Qualifications
+ MD or DO degree
+ Current and ongoing board certification through an approved ABMS or AOABPS Medical Specialty is a requirement. NBPAS certification is not accepted.
+ A current and unrestricted license in at least one jurisdiction and willing to obtain license, as required, for various states in region of assignment
+ 5+ years of direct clinical patient care experience post residency or fellowship
+ No sanctions from Federal or State Governmental organizations
+ The ability to pass credentialing requirements
+ Excellent verbal and written communication skills with analytic and interpretative skills
+ Participate in educational activities by attending required conferences and also create content to lead/teach/present for individual subject matter contribution
Preferred Qualifications
+ Experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age)
+ Internal Medicine, Family Practice, Geriatrics, Physiatry, Emergency Medicine, Critical Care or hospital based clinical specialists
+ Ability to function in a dynamic fast paced environment
+ Commitment to a culture of innovation
+ Passionate about contributing to an organization's focus on consistency in outcomes, consumer experiences, and a highly engaged team culture
+ Knowledge and experience with national guidelines such as NCD/LCD, MCG or InterQual
The Medical Director conducts clinical case reviews of requests received by members of the Medicare population and reports to the Lead Medical Director.
**Other duties:**
+ Identify medical management operational improvements, including those within the medical director area
+ Participate in call rotation which includes weekend coverage
+ Develop collaborative relationships with Team and key partners within the Medicare Line of Business.
+ Support Home Solutions as needed
+ Other activities as assigned by the managing Medical Director
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$223,800 - $313,100 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 02-28-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Senior Accountant - Tax Accounting
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Senior Tax Accountant analyzes and interprets tax laws, regulations, GAAP, and Statutory tax accounting principles, and prepare technical reports on how they impact the organization's operations. The Senior Tax Accountant work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Tax Accountant focuses on Federal and State Income, GAAP and Statutory Tax Accounting, Sales and Use, Property and Premium taxes. Maintains tax information and records, prepares tax returns and other required reports, and pay tax declarations so that compliance obligations are submitted accurately and on time. Prepares correspondence with external tax agencies (for example, auditors). Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree: in accounting/finance
+ 4+ years of relevant tax experience
+ Experience with predicting liabilities for Federal and/or State tax
+ Excellent written and verbal communication skills
+ Strong organization skills - able to manage tax processes, develop work plans, meet deadlines and coordinate with others
+ Experience with computerized tax software and research programs
+ Knowledge of federal and state tax law and current developments
+ Strong Excel proficiency
**Preferred Qualifications**
+ Certified Public Accountant
+ Master's Degree in Business Administration or a related field
+ GAAP ASC 740 tax accounting experience or knowledge
+ Statutory SSAP 101 tax accounting experience or knowledge
+ Good working knowledge of OneSource Tax Provision software
**Additional Informa** **tion**
Preferred location is Louisville office/hybrid but would consider remote depending on skills/quals in Eastern or Central time zones.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$86,300 - $118,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-08-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Nurse Auditor 2
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Nurse Auditor 2 validates and interprets medical documentation to ensure capture of all relevant coding. Applies clinical and coding experience to conduct a clinical validation review of the inpatient medical record to validate billed diagnoses. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
**Use your skills to make an impact**
**WORK STYLE:** Remote/Work at Home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Associates are expected to start each day between 6AM and 9AM in their home time zone.
**Required Qualifications**
+ Active Registered Nurse (RN) license in the state they reside.
+ Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not pediatrics or neonatal). For example: ICU, CCU, PCU, med-surg/adult units or a minimum of 2 years DRG Inpatient auditing. NOTE: Inpatient experience does **not** refer to any other levels of care such as ER, OR, Pre-op, PACU,L&D, mother-baby, behavioral health, SNF, care manager/discharge manager, LTC, rehab, outpatient or office/clinic visits such as wound care, oncology, radiology, interventional radiology, lab, hospice, or home health.
+ In depth knowledge and critical understanding of complex medical diagnoses including, but not limited to, Sepsis (including end-organ failure), Pneumonia, Acidosis, Renal Failure, Encephalopathy, CVA, DKA, MI, etc.
+ Advanced knowledge of MS Office (Word, Excel, etc)
+ Excellent writing, editing, interpersonal, planning, teamwork, and communications skills
+ Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information
+ Ability to work independently and manage workload
+ Customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession
**Preferred Qualifications**
+ Bachelor's Degree in relevant field preferred
+ Inpatient coding certification (AHIMA or AAPC - ex: RHIA, RHIT, CCS, CIS, CIC)
+ Inpatient coding claim experience
+ Prospective payment methodologies, DRG auditing experience
+ Clinical documentation improvement knowledge (CDE, CDEI certification)
**Additional Information**
**Work at Home Requirements**
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
- Satellite, cellular and microwave connection can be used only if approved by leadership
- Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
**Interview Format**
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$78,400 - $107,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Channel Development Lead
Santa Fe, NM job
**Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does.
The Channel Development Lead defines the sales product strategy for single or multiple lines of business targeting specific markets and/or business segments. The Channel Development Lead works on problems of diverse scope and complexity ranging from moderate to substantial.
**Typical responsibilities include but are not limited to:**
+ develops key performance indicators to drive sales program effectiveness and to ensure cost efficiencies.
+ Provide data driven expertise and management reporting to improve sales performance and increase market share.
+ Develop go to market strategies and identify new business opportunities to increase overall sales portfolio.
+ Identify key areas of improvement through trend and utilization analysis. Collaborate closely with business leaders, marketing and finance to ensure effective, strategic, and competitive sales plans.
+ 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 and works under minimal supervision.
+ Uses independent judgment requiring analysis of variable factors and determining the best course of action.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's Degree or higher
+ 3 or more years of experience with intake and governance to involve managing requests, prioritizing work, and ensuring compliance with organizational standards
+ 2 or more years of project management/leadership experience
+ Comprehensive knowledge of Microsoft Word, Excel, PowerPoint, and Outlook
+ Experience collaborating with key stakeholders on strategic initiatives
+ Experience communicating with strategic level Leaders
+ Ability to manage multiple projects effectively
+ 10% travel may be required as business dictates
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ PMP (Project Management Professional) Certification
+ Experience with Microsoft Planner
+ Strong financial acumen for budgeting, forecasting, and ROI analysis.
+ Excellent stakeholder management, communication, and negotiation skills.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$115,200 - $158,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-18-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Lead Technical Product Manager
Santa Fe, NM job
**Become a part of our caring community and help us put health first** About the Role Humana and CenterWell are developing a cutting-edge Next Best Action (NBA) platform to enable personalized engagement, gamified incentives, and advanced agentic AI decision-making across our organization.
As a Lead Technical Product Manager (PM-T), you will be responsible for shaping the vision, defining the roadmap, and overseeing the delivery of the NBA platform. This includes orchestrating how data, predictive models, and APIs drive real-time decision-making, rewards, and agentic AI experiences across both digital and service touchpoints.
You will collaborate closely with teams in engineering, data science, AI, and various business units to deliver solutions that enhance Star Ratings, accelerate HEDIS gap closure, and improve CAHPS satisfaction.
This position requires a hands-on approach and high level of ownership-ideal for an individual who excels at strategic thinking, precise technical specification, and working with engineering teams to simplify and scale complex systems.
Key Responsibilities
Product Vision & Strategy
+ Define and lead the strategy for the NBA platform, enabling data-driven personalization and intelligent engagement for all brands and channels.
+ Create PRFAQs and technical product narratives to ensure alignment between leadership and engineering on the long-term vision.
+ Translate business objectives (e.g., Stars improvement, gap closure, engagement) into actionable technical roadmaps.
+ Emphasize scalability, observability, and interoperability as essential product outcomes.
Technical Product Ownership
+ Develop and manage comprehensive product requirements, user stories, and technical specifications to guide engineering efforts.
+ Collaborate with architects and engineers to balance scalability, latency, and personalization accuracy.
+ Convert data science models into deployable, measurable product features.
+ Define API contracts, data schemas, and integration patterns that conform to enterprise standards.
+ Ensure seamless integration of NBA decisioning with CDPs, ML scoring models, and omnichannel activation platforms (such as AJO and Salesforce).
+ Lead backlog prioritization, sprint planning, and iterative product development alongside engineering and data science teams.
Data & Intelligence Integration
+ Work with Data Science and ML Engineering to operationalize propensity, recommendation, and optimization models.
+ Define mechanisms by which inputs (Customer 360 data, contextual events, profiles) generate outputs (Next Best Actions, offers, rewards).
+ Own the development of experimentation frameworks, ensuring product decisions are validated through A/B testing and data analysis.
+ Establish success metrics (e.g., engagement uplift, gap closure, reward adoption, member satisfaction) and experimentation frameworks.
+ Oversee instrumentation and analytics strategies to continually enhance NBA logic and outcomes.
Leadership & Stakeholder Management
+ Collaborate with cross-functional teams (Clinical, Marketing, Stars, Compliance) to ensure the NBA engine supports business objectives and meets regulatory requirements.
+ Communicate complex technical concepts to senior executives in a clear, results-oriented manner.
+ Work with compliance and legal teams to ensure NBA logic adheres to CMS, HIPAA, and internal standards.
+ Mentor junior product managers and set high standards for technical product management.
Success in This Role
+ The NBA platform becomes the system of record for real-time personalization across Humana and CenterWell.
+ Business teams can measure clear improvements in engagement, satisfaction, and Stars metrics.
+ Engineering velocity and decisioning quality increase through strong product leadership and technical clarity.
+ The NBA ecosystem evolves into a foundation for future GenAI-powered member experiences. "
**Use your skills to make an impact**
Basic Qualifications
+ Minimum of 8 years' experience in product management or technical program management, including at least 3 years as a Technical Product Manager in data, AI/ML, or personalization platforms.
+ Demonstrated success in defining and launching complex technical products end-to-end.
+ Deep understanding of APIs, microservices, and event-driven architectures (Kafka, Pub/Sub).
+ Hands-on experience collaborating with engineers to design scalable backend systems.
+ Strong analytical skills; adept at querying, interpreting metrics, and running experiments.
+ Excellent written and verbal communication skills, with ability to craft product narratives and influence senior stakeholders.
Preferred Qualifications
+ Experience with NBA/NBO systems, AI decisioning, or real-time recommendation platforms.
+ Familiarity with healthcare data models, privacy regulations, and CMS/HIPAA compliance.
+ Exposure to GenAI and agentic frameworks (e.g., LangChain, OpenAI APIs, MCP).
+ Educational background in computer science, engineering, or related technical field (BS/MS preferred).
+ MBA or equivalent experience in product strategy or enterprise platform management.
Leadership Principles
+ Customer Obsession: Prioritize member outcomes in all decisions.
+ Dive Deep: Gain detailed understanding of technical architecture and data models.
+ Invent and Simplify: Build scalable and intuitive solutions for complex personalization needs.
+ Bias for Action: Deliver incremental value quickly while working towards strategic goals.
+ Earn Trust: Establish credibility across data science, engineering, and business functions.
+ Deliver Results: Ensure all product decisions lead to measurable improvements in engagement, retention, and Star Ratings.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$126,300 - $173,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-21-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Director, General Accounting
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Director, General Accounting performs general accounting activities, including the preparation, maintenance and reconciliation of ledger accounts and financial statements such as balance sheets, profit-and-loss statements and capital expenditure schedules. Conducts or assists in the documentation of accounting projects. The Director, General Accounting requires an in-depth understanding of how organization capabilities interrelate across the function or segment.
The Director, General Accounting prepares, records, analyzes and reports accounting transactions and ensures the integrity of accounting records for completeness, accuracy and compliance with accepted accounting policies and principles. Provides financial support, including forecasting, budgeting and analyzing variations from budget. Analyzes and prepares statutory accounts, financial statements and reports. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.
**Use your skills to make an impact**
**Required Qualifications**
+ Master's Degree
+ 8 or more years of technical experience
+ 5 or more years of management experience
+ Progressive financial and accounting analysis experience
+ Progressive leadership and management experience
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Master's Degree in Business Administration
+ Certified Public Accountant license
+ Prior experience in public accounting and auditing
+ Strong technical accounting skills
+ Prior insurance operations or financial industry experience
+ Knowledge of relational databases such as Access and SQL Server
+ Certified Public Accountant license
**Additional Information**
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$168,000 - $231,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-16-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Financial Planning & Analysis Lead
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Financial Planning & Analysis Lead analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. The Financial Planning & Analysis Lead works on problems of diverse scope and complexity ranging from moderate to substantial.
The Financial Planning & Analysis Lead collects, compiles, verifies, and analyzes financial information and economic indicators so that senior management has accurate and timely information for making strategic and operational decisions on, for example, acquisitions, investments, capital expenditure, divestitures, mergers, or the sale of assets. Analyzes the financial implications of proposed investments or other transactions so that senior managers can evaluate alternatives against the organization's business objectives. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium, and long-term financial and competitive position. Analyzes revenues, expenses, costs, prices, investments, cash flow, profits, labor market trends, inflation, interest rates, and exchange rates. May involve financial modeling, reporting and budgeting as well. 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, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree in finance, accounting or related field
+ 8 or more years of finance and/or accounting experience, or equivalent
+ 2 or more years of project leadership experience
+ Experience advising senior leadership on financial strategies
+ Knowledge of complex accounting and financial transactions for internal and external reporting
+ Prior experience developing methods and criteria for measuring and summarizing data for complex analyses
+ Ability to lead and manage special projects that may necessitate cross-functional partnerships
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
+ Proficient with Microsoft suite of products with expert level Excel and Power Point capabilities
**Preferred Qualifications**
+ Master's Degree in Business Administration or a CPA strongly preferred
+ Prior health insurance industry experience working in Finance/Accounting
+ Prior home health industry experience working in Finance/Accounting
+ Oracle/Anaplan experience?
+ Home Care Home Base or equivalent EMR expertise
+ Familiarity and expertise in PowerBI
**Additional Information**
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
Interview Format
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$104,000 - $143,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-18-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Easy ApplyAssociate Actuary
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**In addition, the Associate Actuary will:**
+ Support long term projects aimed at advancing technical maturity, process efficiency, and forecasting accuracy. We are looking for creativity, curiosity, and a desire to explore and influence uncharted territory.
+ Conduct independent research, collaborate across many teams/departments, and require strong communication skills to be successful in the job.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's Degree
+ Associate of Society of Actuaries (ASA) designation
+ Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP)
+ MAAA
+ Strong communication skills
+ Demonstrated ability to communicate technical information with audiences not in the actuarial space
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
+ 3+ years health industry experience with ASA, or 1+ years health industry experience with FSA
+ 2+ years SQL experience, or equivalent skillset
**Preferred Qualifications**
+ Medicare Advantage background
+ Creative, high degree of self-accountability
+ Experience in Python, PowerApps, and PowerBI
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$106,900 - $147,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-30-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Lead Product Manager - Sales Marketing Technology
Santa Fe, NM job
**Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does.
We are seeking a Lead Product Manager to drive the vision, strategy, and execution of our Sales and Marketing Technology initiatives. This role will be pivotal in aligning product capabilities with business objectives, ensuring seamless integration across platforms, and delivering innovative solutions that empower our sales and marketing teams to achieve growth targets.
The Lead Product Manager Conceives of, develops, delivers, and manages products for customer use. The Lead Product Manager works on problems of diverse scope and complexity ranging from moderate to substantial.
**Key Responsibilities:**
+ Define and own the product roadmap for Sales Technology solutions and their intersection with Humana's Marketing organization.
+ Collaborate with cross-functional teams including Sales, Marketing, Engineering, and Data Analytics to deliver impactful products.
+ Lead discovery sessions to identify pain points and opportunities for process optimization.
+ Manage vendor relationships and evaluate third-party tools for integration.
+ Establish KPIs and measure product performance to ensure continuous improvement.
+ Advocate for best practices in CRM, marketing automation, and sales enablement technologies.
**Use your skills to make an impact**
**Qualifications:**
+ Bachelor's degree in Business, Marketing, Computer Science, or related field; MBA preferred.
+ 7+ years of product management or product ownership experience, with at least 3 years in Sales/Marketing Technology.
+ Experience with sales platforms (ie.Salesforce, Highspot and Sproutloud).
+ Proven track record of delivering enterprise-level solutions in CRM, marketing automation, and analytics platforms.
+ Strong leadership and stakeholder management skills.
+ Excellent communication and analytical abilities.
**Preferred Skills:**
+ Familiarity with data-driven marketing and personalization strategies.
+ Agile methodology experience.
**Why Join Us?**
+ Opportunity to lead strategic initiatives impacting revenue growth.
+ Collaborative and innovative work environment.
+ Competitive compensation and benefits package.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$126,300 - $173,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-30-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
SNF Utilization Management RN - Compact Rqd
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Utilization Management Nurse 2 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. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
**Use your skills to make an impact**
**Use your skills to make an impact**
**Required Qualifications**
+ ** Licensed Registered Nurse (RN)** in the (appropriate state) with no disciplinary action.
+ **MUST have Compact License**
+ Greater than one year of clinical experience in a RN role in acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc.
+ Comprehensive knowledge of Microsoft Word, Outlook and Excel
+ Ability to work independently under general instructions and with a team
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Education: BSN or Bachelor's degree in a related field
+ Three or more years of clinical experience in an acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc.
+ Experience as an MDS Coordinator or discharge planner in an acute care setting
+ Previous experience in utilization management/utilization review for a health plan or acute care setting
+ Compact license PLUS a single state RN Licensure in any of the following non-compact states: California, Hawaii, Nevada, Oregon
+ Health Plan experience
+ Previous Medicare/Medicaid Experience a plus
+ Call center or triage experience
+ Bilingual is a plus
**Additional Information**
+ Scheduled Weekly Hours: 40
+ Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Work-At-Home Requirements**
+ Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role).
+ A minimum standard speed for optimal performance is 25mbs download x 10mbs upload is required.
+ Check your internet speed at *****************
+ A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
**About us**
About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.
About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Strategy Advancement Advisor
Santa Fe, NM job
**Become a part of our caring community and help us put health first** Humana is a publicly traded, Fortune 100 health benefits company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in the 60's, to the largest US hospital corporation in the 80's, to a leading health benefits company beginning in the 90's. Today, Humana is a leader in consumer-focused health solutions and is one of the largest health benefits organizations in the country.
Consumer Segment Team
Identifying and delivering new avenues of growth is a critical company priority. The Consumer Segment team is an entrepreneurial, multi-functional team within Humana's Medicare and Medicaid business unit. The team is focused on driving industry leading membership growth, retention and health outcomes by identifying new consumer insights, developing growth strategies, and activating them across the enterprise to serve the unique needs of prioritized segments.
Humana is seeking an experienced team member with meaningful strategy consulting or healthcare strategy experience to join this team. As Strategy Advancement Advisor, you will support development and implementation of consumer segment strategies that drive growth and retention while optimizing member experience and outcomes. You'll collaborate with teammates and cross-functional partners to frame up business questions, conduct analyses, and recommend solutions. You will help answer key strategic business questions that arise during the annual product/sales cycle across multiple domains, including product design, plan footprint, marketing and sales performance, membership analytics, customer/provider satisfaction and more. You will proactively identify new consumer insights and create business cases to support new pilots and initiatives to address critical unmet consumer needs.
**Key Responsibilities Include** :
+ Managing analysis and/or work streams within high-profile, high-impact strategy projects
+ Conducting industry, market, competitor, and financial analysis and deliverables that clearly frame objectives, issues/challenges, and articulate compelling, insightful findings, conclusions, and recommendations
+ Conducting interviews, working sessions, and report-outs with associates and leaders across the company
+ Own development and presentation of key deliverables for leadership and cross-functional partners
+ Innovate new pilots and member experiences to drive growth and improved retention
+ Support business case development for key initiatives
**Use your skills to make an impact**
**Required Qualifications**
+ 7+ years of full-time relevant strategic work experience, ideally post-MBA
+ Strategy management consulting experience
+ Experience leading broad initiatives with cross-functional collaboration
+ Strong problem-solving skills and the ability to perform complex qualitative and quantitative analysis
+ Experience leveraging consumer insights to design and implement new products/services/solutions
+ Proficiency in verbal/written communication to senior and executive leadership
+ Proficient in delivering engaging and informative presentations to diverse audiences
**Preferred Qualifications**
+ MBA, MPH, PhD, or graduate degree in a management field
+ Prior healthcare industry experience, preferably in the managed care or provider sector
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$115,200 - $158,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-18-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Senior Manager, MarketPoint Sales - Raleigh Durham, NC.
Santa Fe, NM job
**Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does.
Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact your own income potential? If so, we are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate beneficiaries on our services in a field setting. Our teams also sell Life, Annuity, Indemnity, Dental, Vision, Prescription plans, and more.
Humana has an inclusive and diverse culture welcoming candidates with multilingual skill sets to service our consumers.
**This role is** **field** **based, and you will be out and about in the field in the Raleigh** **Durham, NC.** **area working with your team and meeting members face to face. You must reside in Raleigh** **Durham, NC.** **area or be willing to relocate to the area.**
In this **field** position, you will; coach, mentor, educate, motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a solid understanding of the market they serve, how to resolve operational problems and provide creative solutions to increase sales while following CMS guidelines. This role also involves cultivating, maintaining, and building relationships with Humana's customers, both internal and external business partners, along with the community we serve through telephonic, virtual, and face-to-face interactions with individuals and groups. Other responsibilities include developing marketing budgets, and looking for branding opportunities.
**Use your skills to make an impact**
**Required Qualifications**
+ **Must reside in the** **Raleigh** **Durham, NC.** **area or be willing to relocate**
+ **Active Health & Life Insurance Licenses**
+ 2 or more years of sales leadership experience
+ 6 or more years of experience working in the insurance industry
+ Must be able to travel up to 50% of the time
+ Ability to lead a team of sales associates and train them in successful sales techniques, educational presentation skills, utilizing technology tools as well as building relationships with communities and medical providers
+ Strong aptitude for technology with proficiency in MS Office products, various CRM platforms, and various iPhone app capabilities
+ Must be a strong leader, strong producer
+ Strong organizational, interpersonal, communication and presentation skills
+ Ability to adapt and overcome when necessary
+ Community Engagement/Grassroots experience in marketing Medicare plans in the community
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
+ This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits
**Preferred Qualifications**
+ Bachelor's Degree
+ Prior experience working in Medicare and the health solutions industry
+ Engaged with the community through service, organizations, activities and volunteerism
+ Project management background or certification a plus
+ Bilingual with the ability to speak, read and write without limitations or assistance
**Humana Perks:**
Full time associates enjoy:
+ Base salary with a competitive commission structure
+ Medical, Dental, Vision and a variety of other supplemental insurances
+ Paid time off (PTO) & Paid Holidays
+ 401(k) retirement savings plan
+ Tuition reimbursement and/or scholarships for qualifying dependent children.
+ And much more!
**Social Security Task:**
Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website.
**Virtual Pre-Screen:**
As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a HireVue interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes.
\#MedicareSalesManager \#MedicareSalesReps
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$77,000 - $105,100 per year
This job is eligible for a commission incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-18-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Easy ApplyActuarial Principal - Financial Planning and Analysis
Santa Fe, NM job
**Become a part of our caring community and help us put health first** Join Humana's Financial Planning & Analysis team, part of the CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial strategy and analysis, with connections to enterprise-wide and total Insurance perspectives. The Actuarial Analytics/Forecasting Principal role offers flexibility in responsibilities, significant exposure to senior leadership, and strong potential for upward mobility.
We seek candidates who are willing to think creatively, challenge assumptions, voice opinions on key drivers and ranges, and contribute to a culture of continuous improvement and healthy debate.
The Actuarial Analytics/Forecasting Principal analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium, and long-term financial and competitive position. The Actuarial Analytics/Forecasting Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience.
The Actuarial Analytics/Forecasting Principal ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost-effective resolutions for data anomalies. Works with senior executives to develop and drive segment or enterprise-wide functional strategies. Advises one or more areas, programs, or functions and provides recommendations to senior executives on matters of significance, and as an advanced subject matter expert competent to work at very high levels in multiple knowledge and functional areas across the enterprise.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree, in some instances a Master's or Doctorate's degree
+ 10 or more years of technical experience
+ 2-5 years of project/people leadership
+ FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations
+ MAAA
+ Strong communication skills
+ Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Medicare Advantage pricing and forecasting experience
+ Experience working with aggregate financials across insurance products or enterprise-level financial planning
+ Demonstrated ability to challenge existing assumptions and propose creative solutions
**Additional Information**
Humana is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, or veteran status.
For more information on Humana careers, please visit Humana Careers (******************************* .
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$156,600 - $215,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-30-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Actuary, ESRD Forecasting and Analytics
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Actuary, Analytics/Forecasting works on problems of diverse scope and complexity ranging from moderate to substantial.
The Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. 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, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
This role will be a subject matter expert on the End Stage Renal Disease (ESRD) population for Humana's individual Medicare Advantage plans. This includes:
+ Owning and improving our ESRD claims forecast process
+ Reviewing input assumptions and outputs of the ESRD forecast for reasonability and accuracy
+ Summarizing and explaining ESRD forecast results for business partners
+ Reviewing and analyzing emerging experience on ESRD members to understand drivers of change and any potential headwinds or tailwinds
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's Degree
+ FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations.
+ MAAA
+ Strong communication and organizational skills
+ Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending)
**Preferred Qualifications**
+ Strong technical skills, especially SQL, VBA, and Databricks/Python
+ Individual Medicare Advantage experience
+ Knowledgeable on ESRD population
**Additional Information**
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$129,300 - $177,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-30-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Medical Director-Payment Integrity
Santa Fe, NM job
**Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized at the Inpatient level. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid, and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work.
The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work and communication of decisions to internal associates. The clinical scenarios predominantly arise from inpatient or post-acute care environments. A remote possibility exists of doing peer-to-peer discussions with an external provider. Some roles include an overview of coding practices and clinical documentation, dispute/grievance and appeals processes, and outpatient services and equipment, within their scope.
Medical Directors support Humana values, and Humana's mission, throughout all activities.
**Use your skills to make an impact**
**Responsibilities**
The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Lead Medical Director. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines.
Supports the assigned work with respect to market-wide objectives and community relations as directed.
**Required Qualifications**
+ MD or DO degree
+ 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age).
+ Current and ongoing Board Certification an approved ABMS Medical Specialty
+ A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required.
+ No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.
+ Excellent verbal and written communication skills.
+ Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation.
**Preferred Qualifications**
+ Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.
+ Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance.
+ Experience with national guidelines such as MCG or InterQual
+ Internal Medicine, Hospitalist, Family Practice, Geriatrics, Emergency Medicine clinical specialists
+ Advanced degree such as an MBA, MHA, MPH
+ Exposure to Public Health, Population Health, analytics, and use of business metrics.
+ The curiosity to learn, the flexibility to adapt and the courage to innovate
**Additional Information**
Typically reports to a Lead Medical Director. The Medical Director conducts post-service, inpatient care reviews for accurate billing of clinically valid diagnoses and care received. May also engage in disputes and grievance and appeals reviews. May participate on project teams or organizational committees.
\#physiciancareers
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$223,800 - $313,100 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 02-28-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************