SVS Vision Remote jobs

**Become a part of our caring community and help us put health first** Humana is evolving its marketing organization to better acquire and engage members through data-driven, technology-enabled, and personalized communications and the creative and content produced by the in-house agency team known as the Hive, is a vital part of this transformation. The **Senior Content** **Strategy** _(internally known as a Senior Professional, Creative Development)_ role will drive enterprise creative, marketing excellence, and enhance business value for Humana Inc. This position requires the experience and vision to inspire and develop marketing and creative strategies based on business objectives while building trusted relationships with our marketing partners. **Key Role Functions** + Build strong, cross-functional partnerships with the internal agency team, marketing partners, and external agencies + Drive creative strategy in support of Customer Lifecycle Marketing (CLM) + Oversee customer-centric campaign strategies and conceptual milestones. Leverage performance marketing expertise to deliver breakthrough creative that drives results. + Lead by example. Demonstrate and enable collaboration, constructive critique, and agile workflows + Understand the business, industry and competition, leveraging that knowledge to help generate new ideas to strategically grow business and marketing strategy + Ensure work is on-strategy and appropriate for the brand and the business + Consistently collaborate with team members throughout the work process to foster, facilitate and consistently deliver great work that is on strategy, on time, and on budget **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + 5+ years of Marketing with a mastery of advertising fundamentals, including: branding, planning, positioning, strategy + 2+ years of advertising or internal agency experience + Ability to identify solutions that will generate measurable results + Independent self-starter and extremely detail-oriented + Able to present to Senior Leadership and influence decision makers + Ability to work well in a fast-paced team environment with an agile approach and iterative design process **Preferred Qualifications** + Master's Degree + Performance marketing **Additional Information** **This role is a 100% remote role anywhere in the US and will primarily operate on Eastern Standard Time business hours.** 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 Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: + Health benefits effective day 1 + Paid time off, holidays, volunteer time and jury duty pay + Recognition pay + 401(k) retirement savings plan with employer match + Tuition assistance + Scholarships for eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Our Hiring Process** As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you. If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. 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. 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. Application Deadline: 12-10-2025 **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 ***************************************************************************

The Senior TRICARE Community Liaison (TCL) is a customer-facing Humana Military associate who is knowledgeable, professional, and courteous. This role interacts in person and by other means, such as by telephone, e-mail, and chat with TRICARE beneficiaries, Medical Treatment Facility (MTF) and other Government staff, including senior military leaders, and civilian healthcare providers and facilities. The primary focus of the Senior TCL is to develop and sustain strong, collaborative relationships with all TRICARE customers in the East Region - Government, beneficiaries, and providers. The Senior TCL must be cognizant of the military way of life during all interactions, including the impact of stress, trauma, and loss on active, reserve component and retired service members and their families that result from military operations. Assigned to specific Health System Areas comprised of Prime Service Areas (PSAs) and Non-Prime Service Areas (NPSAs) in a geography that may span over 43,000 square miles, the team's area of responsibility can include an average of more than 100,000 beneficiaries, 50,000-70,000 network and non-network providers, numerous National Guard/Reserve units, and three to four MTFs. Through clear and concise communication, the Senior TCL is responsible for ensuring MTF, beneficiary, and provider understanding of the TRICARE health plan and how to navigate the Military Health System. The Senior TCL also supports the Health System Leader in local TRICARE network operations, including participating in network development and optimization strategies which focus on a medically ready force and a ready medical force. The Senior TCL is self-directed and uses independent, critical decision-making in managing time, setting priorities, addressing general inquiries, and resolving both straightforward inquires and complicated problems and concerns raised by beneficiaries, providers, and Government customers. The Senior TCL may be designated as an embedded associate at an MTF and may be requested to provide back-up coverage in the absence of the Health System Leader. This position will require work during uncommon duty hours and travel to conduct outreach activities. **KEY ACCOUNTABILITIES** + Provide accurate explanation of TRICARE health plan policies and procedures during on-site and electronic beneficiary, provider, and Government outreach activities, ensuring compliance with all customer support performance standards for the dual purposes of maximizing TRICARE customer satisfaction and the incentives paid by the Government, and of sustaining Humana Military's competitive advantage for future contracts. + Respond in precise, comprehensive and timely manner to beneficiary, provider, and Government inquiries regarding eligibility, enrollment, billing, claims, referrals/authorizations, network operations, access to care, Defense Health Agency/TRICARE Health Plan policy, and other TRICARE topics. Implement, track and complete self-managed tasks to process and correct uncomplicated general eligibility, enrollment, billing, claims, referral/ authorization, and network difficulties experienced by TRICARE customers. + Research and resolve difficult, complex TRICARE problems/issues elevated by a Government agent, beneficiary, or provider within required timelines. Implement self-directed activities to analyze, coordinate, process, and complete action to correct multifaceted problems relating to eligibility, enrollment, billing, claims, referrals/authorizations, network operations, access to care, Defense Health Agency/TRICARE Health Plan policy, and other TRICARE topics. + Assist in developing and sustaining a high-performing network in designated PSAs/NSPAs which meets TRICARE and Humana Government Business requirements and optimization strategies. Contribute in procuring the network discount goal assigned to each PSA/NPSA that results in annual financial incentives awarded by the Government. Conduct regular and ad hoc market laydown assessments to determine the capability and capacity of TRICARE providers, identifying and implementing action to address any gaps in the network. + Accomplish all administrative tasks as assigned, including documenting interactions, processing transactions, and submitting required reports. + Respond to and assist in contingency operations in support of the MTF and network as needed. Conduct urgent market laydown assessments to determine the capability and capacity of TRICARE providers, identifying and implementing action to accommodate changes in MTF services. + Participate in activities that promote well-being and professional growth of self and others. **Use your skills to make an impact** **Required Qualifications** + Our Department of Defense Contract requires U.S. citizenship for this position. + Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services) + **Will require living in Michigan, Indiana or Ohio, as this position will need to travel to locations in each of these states to provide briefings** + This position will require the ability to travel and work on weekends/nights as needed to provide briefings + Experience in customer relationship management, demonstrating courteous, professional interactions + Experience in analyzing information, researching problems, and determining and implementing solutions + Experience in healthcare provider relations + Exceptional public-speaking ability + Strong computer skills with business software + Superior organizational skills necessary to effectively manage multiple activities **Preferred Qualifications** + Three to four years' experience in TRICARE, including presentations to groups + Knowledge of healthcare provider contract negotiations **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 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. $59,300 - $80,900 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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. **Role Overview** + Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. + Analyzes provider reimbursement patterns and trends. + 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 - What it takes to Succeed** + 2 years experience with a coding certification (Industry-recognized coding certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and HCPCS + Medical Code editing experience + Comprehensive knowledge of Microsoft Word, Outlook and Excel + Strong attention to detail, excellent time management and organizational skills + Ability to work independently under general instructions and with a team **Preferred Qualifications** + BS in healthcare or business-related field + Knowledge of internal Medical Coverage Policies and Claims Payment Policies + CAS claims processing experience + Experience in data analysis and trend monitoring **Work-At-Home Requirements** 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 required + 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 **Additional Information** + Hours: Monday-Friday with a start time between the hours of 6am-9am EST (Candidates must be flexible and available to work in the Eastern Standard Time Zone no matter the time zone you reside in) **Additional Information** **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. **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. 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. $59,300 - $80,900 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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Value-Based Programs Lead supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Value-Based Programs Lead provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. The Value-Based Programs Lead works with senior executives to develop and drive segment or enterprise-wide functional strategies with key national value-based provider partners. 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. + Advises market executives to develop functional strategies on matters of significance for provider contracting and performance management + Consults and leads the internal and external provider engagement strategy + Leads national joint operating committee with internal and external leadership + Possess a solid understanding of how organization capabilities interrelate across department(s) **Use your skills to make an impact** **Required Qualifications** + 3+ years of experience with provider performance management and/or value-based contracting + Strong understanding of key value-based financial components including revenue drivers, expense (DOFR) components, benefit and sales process. + Experience working with senior leadership + Experience facilitating cross departmental projects + Strong communication and presentation skills, including experience developing polished presentations to influence key decision makers + Strong project management experience on mid to large scale projects + Flexible, dynamic personality who works well in a team environment **Preferred Qualifications** + Provider contracting and/or provider relations experience + Working knowledge of Service Fund reports + Advanced Degree (Bachelor's, Master's) + Experience with data extraction and analysis technologies + Experience preparing contracts and knowledge of Medicare and other reimbursement methodologies + Financial acumen with proficiency in analyzing and synthesizing provider financial trends into actionable insights + Solid experience building templates, standard documentation, and disseminating best in class knowledge **Additional Information** This role is "remote/work at home" and can be based anywhere in the United States. **Work at Home Information** 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 required; 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: 12-11-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Business Intelligence Lead solves complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Business Intelligence Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Business Intelligence Lead describes the tools, technologies, applications and practices used to collect, integrate, analyze, and present an organization's raw data to create insightful and actionable business information. This individual advises executives to develop functional strategies (often segment specific) on matters of significance. The Business Intelligence Lead exercises independent judgment and decision making on complex issues regarding job duties and related tasks and works under minimal supervision. The Business Intelligence Lead uses independent judgment requiring analysis of variable factors and determining the best course of action. **Use your skills to make an impact** **Required Qualifications** + Undergraduate degree + Minimum 8 years of technical experience in data reporting and analytics utilizing Power BI or similar tool + Minimum 2 years of experience in leading business intelligence strategy and/or processes + Experience working with large and complex data sets within large organizations and/or the analysis of healthcare data + Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction + Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs + Excellent communication and presentation skills to include the ability to communicate and present technical/financial details to Senior/Executive level leadership and/or Senior Government officials **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 **Preferred Qualifications** + Advanced Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field + Minimum 4 years of experience working in the LI NET program and 4 years' technical experience in data reporting and analytics + Experience or exposure to generative AI models for data analysis tools + Advanced experience in SQL, SAS, Azure Synapse Analytics (ASA), and/or Databricks + Expertise in data mining, forecasting, simulation, and/or predictive modeling + Experience creating analytics solutions for various healthcare sectors + Experience in Medicare/Medicaid, CMS (Centers for Medicare & Medicaid Services) or other Federally regulated healthcare programs + Demonstrated capability with coaching, mentoring and developing associates formally and informally + Ability to monitor and recommend improvements to increase team productivity by patiently providing expert advice and assistance to other associates on the team **Additional Information** + As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you. + If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview 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. $117,600 - $161,700 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. **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Payment Integrity Professional 2 uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. Contributes to the investigations of fraud waste and our financial recovery. The Payment Integrity Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Payment Integrity Professional 2 contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems and by ensuring correct claims payment. 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** **Required Qualifications** + At least 1 year of work experience reading and interpreting claims + Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel + Strong attention to detail + Can work independently and determine appropriate courses of action + Ability to handle multiple priorities + Capacity to maintain confidentiality + Excellent communication skills both written and verbal **Preferred Qualifications** + Bachelor's Degree + Experience in Financial Recovery + Experience using the following systems: CAS, Pareo, CISpro and CIS + Experience with PowerBI and Reporting + Knowledge of Microsoft Office Programs & Lucid + Experience in a fast paced, metric driven operational setting **Additional Information** 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 required; 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. $59,300 - $80,900 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: 12-29-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. 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. 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's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. **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 Regional VP Health Services. 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. **CANDIADATES MAY LIVE ANYWHERE THE IN THE US AND MUST WILLING TO WORK CENTRAL TIME ZONE HOUR** **S** . **Required Qualifications** + MD or DO degree + **OK and LA licenses, or ability to obtain** + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some 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, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists + Advanced degree such as an MBA, MHA, MPH + Exposure to Public Health, Population Health, analytics, and use of business metrics. + Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health. + The curiosity to learn, the flexibility to adapt and the courage to innovate **Additional Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also engage in 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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Encounter Data Management Lead supports the Encounter Data Management team within the Healthcare Quality Reporting and Improvement (HQRI) organization. This position is responsible for ensuring the accurate and timely submission of encounter data to Medicaid, Medicare, and DSNP states, while maintaining adherence to all regulatory requirements. The Lead utilizes strong analytical skills and attention to detail and collaborates effectively with cross-functional teams to drive process improvements and enhance communication and collaboration across the organization. The Encounter Data Management Lead is responsible for ensuring the integrity and accuracy of Medicaid and Medicare encounter data across multiple trading partners. This role collaborates with Product Owners and business contract owners to facilitate accurate and compliant encounter data submissions. The Lead manages the resolution of complex data issues while supporting business contract teams across multiple trading partners. **Use your skills to make an impact** **Required Qualifications** + Minimum of 2 years' professional experience in Medicaid data management, healthcare operations + Ability to monitor product performance, resolve production environment issues, and communicate timely updates to business stakeholders. + Strong ability to facilitate effective meetings, lead collaborative discussions, and clearly communicate project status, issues, and solutions to business stakeholders. + Knowledge in Agile ceremonies, including backlog refinement, sprint planning, and Program Increment (PI) planning. + Proficiency in Azure DevOps, including experience reviewing high level testing activities. + Demonstrated ability to lead cross-functional collaboration and foster effective team engagement. + Exceptional interpersonal and relationship-building skills, with the ability to engage and influence diverse stakeholders, including technical teams and business partners. + Ability to translate complex data findings into clear, actionable business recommendations for non-technical audiences. + Experience delivering professional presentations, reports, and documentation to support cross-functional initiatives and decision-making. + Experience using SQL and data analytics tools to track, trend, and resolve data issues. + Demonstrated authority to define product direction, with a consistent focus on advancing key business objectives. **Preferred Qualifications** + Lean or Six Sigma certification. + Hands-on experience in encounter data submissions + Background in Medicare and/or Medicaid product management or support. + Familiarity with Claims Adjudication Systems (CAS). + Knowledge of X12 transaction sets and standards. + Proficiency in SQL for data analysis and management. **Work-At-Home Requirements** + WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. + A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Interview Format** 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. 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. $94,900 - $130,500 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: 12-15-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Medical/Financial Risk Evaluation Professional 2 is responsible for supporting the development, implementation and monitoring of medical/financial risk. The Medical/Financial Risk Evaluation Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical/Financial Risk Evaluation Professional 2 identifies, assesses, and mitigates any medical or financial risk that arises from inadequate or failed processes, people, systems, or external events. Maintains a balance between risk mitigation and efficiency. 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** **Required Qualifications** + Bachelor's degree + Experience with identifying and/or reporting fraud, waste and abuse within the healthcare industry + Knowledge of the Medicare and Medicaid programs + Experience in data analysis + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + 2 years of Humana Experience + Knowledge of Humana Medical and Pharmacy Claims Processing Systems + Experience with data query/data programming applications (i.e SQL, Python) + Knowledge of data visualization tools (i.e. Power BI, QlikView, Tableau) **Additional Information** 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 required; 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. $65,000 - $88,600 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: 12-14-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors. **_Earn a $5,000 hiring bonus!_** **Bonus is paid after 180 days of employment; you must be employed until that date to be eligible to receive the payment."** **Location:** **Remote - United States** **Schedule:** + 8-hour shifts, Monday through Friday, between 10:30 AM and 11:00 PM EST **OR** + 10-hour shifts, Tuesday through Friday, between 10:30 AM and 11:00 PM EST + Required to work **every 5th Saturday** + Required to work **1 company holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting comprehensive reviews of medication care plans. This includes evaluating medical necessity, analyzing overall utilization, and identifying unusual usage patterns. The pharmacist may intervene and provide clinical guidance to patients and providers to support cost-effective medication use and promote high-quality patient outcomes. **Use your skills to make an impact** **Required Qualifications:** + **Bachelor's degree or Doctor of Pharmacy (Pharm.D.) from an accredited college of pharmacy** + Active pharmacist license in the state of residence + Eligibility to participate in federal prescription programs (e.g., Medicare/Medicaid) + Self-directed with the ability to work effectively both independently and in a team environment + Strong problem-solving skills and the ability to foster collaborative solutions + High attention to detail with a strong work ethic focused on accuracy and productivity + Excellent verbal and written communication skills + Proficiency with computer systems, including but not limited to: + Microsoft Office Suite (Word, Excel, Outlook) + Clinical decision support tools (e.g., Micromedex, Lexicomp) + Pharmacy benefit management (PBM) platforms + Electronic health records (EHRs) + Passion for contributing to an organization focused on continuously improving the consumer experience **Preferred Qualifications:** + Experience in managed care pharmacy, particularly in utilization management review **Additional Information:** **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. **WAH Requirements:** 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. **SSN Statement:** 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. 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. $94,900 - $130,500 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: 12-12-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Care Manager, Telephonic Behavioral Health 2 is a **Licensed, Masters level, Social Worker** who functions as a Support Social Services associate (Support SS) in our Special Needs Plan (SNP) program and serves as part of an interdisciplinary care team member working with other disciplines, such as nurse care managers, dieticians, behavioral health, and pharmacists to help promote and support member health and well-being. This role requires the use of structured assessments along with critical thinking skills to determine appropriate interventions such as care coordination, health education, connection to community resources, full utilization of benefits and advocacy. This role requires effective and professional communication with providers, community resources, and other members of the interdisciplinary team to address member needs. The Support SSs daily job duties include making outbound call attempts to members with social determinants of health (SDOH) needs to assess and assist with coordinating care with available plan benefits and/or appropriate community resources in a telephonic, call center, work from home environment. This role does not carry a caseload but may require additional member follow-up to ensure that all needs have been assessed and addressed. The Support SS may also receive inbound calls from members needing additional assistance. This role is also responsible for assessing the member to determine if a referral to any other discipline is needed depending on member's individualized needs. Creating and updating member care plans may be required. Documentation in the member's record is required to ensure CMS compliance, and accurately reflect work with members, providers, and other members of the interdisciplinary care team. **Use your skills to make an impact** **Required Qualifications** + Master's degree in social work from an accredited university + Current, unincumbered, social work license; **LMSW, LCSW, LICSW** + Must have passed ASWB Exam (Master, Advance Generalist, or Clinical level) + Minimum 3 years of experience working as a social worker in a medical healthcare setting + Proficient in Microsoft applications including Word, Outlook, Excel + Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously + Must be willing to obtain/maintain social work licensure in multiple states, based on business need **Preferred Qualifications** + Experience working with geriatric, vulnerable, and/or low-income populations + Licensure in LA, MD, MI, MS, NV, NM, OK, VA + Bilingual English/Spanish + Bilingual English/Creole + Experience working with Medicare and Medicaid **Additional Information** **Work-At-Home Requirements:** 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 required; 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. **Social Security Notification:** 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. **HireVue Interview Process:** 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. **Benefits Day 1:** Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities **START DATE after completion of background/onboarding-** *Projected start dates for these positions will be throughout Feb 2026 with all interviews being conducted Dec/Jan **Schedule:** + Hours for this position are Monday - Friday 9:30am - 6pm EST. + Hours for the first 2 weeks of training are M-F 8:30am-5pm EST 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. $59,300 - $80,900 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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Technology Solution Implementation Professional delivers new technological solutions to meet business needs within a specified scope while aligned to enterprise objectives. The Technology Solution Implementation Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. **Role Description:** Support Medicaid Implementations and Operations in electronic transmissions set-up for state regulatory partners, health information exchanges, and vendor partners. **Responsibilities:** Works with ETL developers, data stewards, project managers, and business SMEs to obtain programming specifications needed to submit information in our proprietary ticketing system that moves data from its origin to its ultimate destination. + Ensures proper documentation is completed so that the programming and testing occurs + Tracks and maintains documentation on ET work + Communicates between both IT and non-IT departments on updates, as well as educating non-IT departments on the process + Ensures proper access for authorized users and provides support to data tool users + Conducts connectivity testing when needed + Coordinates establishing connections to SFTP sites in collaboration with the State Technology Market Lead + Coordinates resolution of resolving ETL issues for the market + Participates on vendor and market calls when necessary + Produces reports and analytics outlining progress and resolution + Maintains inventory of market ET transmissions + Other duties as assigned **Use your skills to make an impact** **Required Qualifications** + Two years + experience using technology in data analysis projects or in projects that dealt with business data flows. + 1 + years of ETL experience. + Demonstrated understanding of the information needs and processing flows in healthcare environments + Experience with the SDLC phases of a project and general knowledge of project management. + Demonstrated excellent written and verbal communication skills. + Demonstrated ability to maintain confidentiality, follow directions, and use good judgment in an environment that can be ambiguous and time sensitive. + Ability to work EST + SFTP Experience + Process Improvement **Preferred Qualifications:** + Power BI, Jira and ADO training preferred + Experience with Agile Methodology and/ or Scaled Agile Methodology + Experienced in introducing new processes into a new or existing environment while minimizing disruption and mitigating risks + Experience with Medicare and/or Medicaid + Ability to coordinate with development and user teams to assess risks, goals, and needs and ensure that all are adequately addressed + Bachelor's degree in CS, Engineering, Math, Information Systems, Data Science, Data Analytics, or Statistics **Additonal Information** Candidates should be prepared to work outside regular hours when required to meet essential timelines. 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 required; 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 informatio 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. $60,800 - $82,900 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: 12-14-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Associate Director, Finance Data Management supports all aspects of configuration control, data management, and deficiency reporting. The Associate Director, Finance Data Management requires a solid understanding of how Finance organization data capabilities interrelate across department(s). The Associate Director, Finance Data Management supports implementation of government and industry policies for requirements management, document management, change management, production and delivery, and configuration management of the performance, functional, and physical baselines. Acquires, validates, stores, protects, and processes required data to ensure the accessibility, reliability, and timeliness of the data for its users. Develops and executes architecture, policies, practices and procedures that properly manage the full data lifecycle needs of an enterprise. Decisions are typically related to identifying and resolving complex technical and operational problems within Finance and highly specialized professional associates. Associate Director, Finance Data Management, is responsible for executing and delivering a multi-year roadmap to help the Finance organization achieve target state architecture. The target state architecture helps the Finance org achieve: + Standardized Finance Data Definition & Ownership + Optimize Cost to Operate in Finance + Empower Finance with Self Service Analytics + Strengthen Compliance & Audit Readiness + Accelerate Finance Close, Budgeting and Forecasting Cycle times + Build a predictive, AI ready Finance Platform Associate Director, Finance Data Management will also focus on leading the team to operationalize the data foundations and continuous improvement is processes and quality associated with data management in Finance. Associate Director, Finance Data Management will work closely with enterprise data governance and data strategy to ensure alignment and extension of enterprise goals and strategy in the data management space. Similarly, will also work at enterprise scale with the various data platform teams to achieve the finance data management goals. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree in business or technology + Hands-on operational experience in Finance functions (Accounting, FP&A or CFO org) + 6 or more years of technical experience + 2 or more years of management experience + Understands and analyzes complex data and can articulate to various units within the company at the appropriate level + Experience with Enterprise Scale ERP systems + Experience working with large datasets both on prem and cloud **Preferred Qualifications** + Master's degree in business/technology or CPA + Certification/Advanced understanding of Oracle Fusion Cloud (ERP, GL, AP, AR other modules) + Experience working with modern cloud platforms like Databricks or Snowflake + Understanding of applied AI in a Finance function + SQL, ability to manipulate and analyze data using modern analytical tools **Additional Information** **SSN Alert Statement** 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. **WAH Internet Statement** 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 required; 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. $117,600 - $161,700 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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. **The first 4 weeks of training will be from 8:30AM to 5:00PM EST. No time off is permitted during the first month of training.** **Following training, the start time is 10:00AM EST.** Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition. We contact members with multiple chronic conditions as well as financial and functional barriers in order to assist them in achieving and maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers to achieving health and independence, while using a multidisciplinary team. This position will be part of our Special Needs Program (SNP) team. All of our SNP RN Care Managers are work at home associates, working from a dedicated home office space. Work at home care managers are responsible for meeting quality and productivity measures daily and maintaining working home internet at all time with demonstrated advanced communication and interpersonal skills. This is a very compliance driven and highly visible program at Humana. The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system. Environment is fast paced and requires ability to engage quickly with member while concurrently navigating multiple computer applications. Due to the auto dialer process and compliance needs of the business there is limited day to day flexibility in care manager's schedule. **Duties:** + Telephonically assess Medicare, Medicaid, and/or and Group Account members and create actionable and measurable care plans to help guide and track the members' progress toward goals + Use nursing judgment to assess and coordinate care for acute situations (APS, EMS) + Discuss transitions of care to assist with safe discharge to the home and coordinate care for DME, home health, provider appointments, etc. + Guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members + Assess member's physical, environmental and psycho-social health issues and work in collaboration with a multi-disciplinary team, such as social workers, dietitians, pharmacists, etc., employing a variety of strategies/techniques to manage appropriately and provide timely intervention **Use your skills to make an impact** **Required Qualifications** + Active Registered Nurse (R.N.) license with no disciplinary action. + **Hold an active Compact nursing license and** **reside in the state that holds your compact license.** + The National Council of State Boards of Nursing (NCSBN) developed the Nursing Licensure Compact (NLC), which is an agreement between states that allows nurses to have one license and the ability to practice in all the states that participate in the program. License must be current with no disciplinary action. + Minimum education of an Associates degree in Nursing. + Seasoned RN with a **minimum of 3 years of clinical nursing experience.** + Demonstrated clinical knowledge and expertise as evidenced by providing intervention to manage variety chronic conditions, including development and implementation of individualized care planning. + Intermediate to advanced computer skills as evidenced by ability to navigate multiple systems, utilizing dual computer monitors. + Provide autonomous decision-making, troubleshooting and problem solving related to periodic system issues. + Experience with Microsoft and Excel + Ability to quickly learn and navigate software programs and applications. + Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously. + Effective communication and interpersonal skills. + Effective problem solving and appropriate application of clinical knowledge + Must have a separate room with a locked door that can be used as a home-office to ensure you and your members have absolute and continuous privacy while you work. + Must possess advanced telephonic and virtual communication skills. **Preferred Qualifications** + BSN or MSN degree in nursing or equivalent + Previous adult chronic conditions care management + Previous experience in care management including knowledge of complex care management and care management principles + Experience with motivational interviewing + Experience with MCG or CMS guidelines, assessment and documentation practice + Case Management certification (CCM) + Bilingual in English and Spanish **Work-At-Home Requirements** 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: + You must provide your own HARD WIRED high-speed internet. Satellite is not allowed for this position + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended + 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 **Additional Information - How we Value You** - Benefits starting day 1 of employment - Competitive 401k match - Generous Paid Time Off accrual - Tuition Reimbursement - Parent Leave - Go365 perks for well-being 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 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 ***************************************************************************

**Become a part of our caring community and help us put health first** The NoSQL Database Engineer will design, implement, and support MongoDB, Neo4j, and vector database solutions within Humana's enterprise architecture. The role requires hands-on experience with cloud platforms (Azure and/or GCP) and strong development skills using Python. The engineer will ensure secure, scalable, and high-performing database environments, collaborating with cross-functional teams to advance business goals and support modern technology initiatives. **Job Description Summary:** Humana is seeking a seasoned NoSQL Database Engineer to join the Data Platform Engineering team. The successful candidate will design, implement, and support MongoDB Atlas and MongoDB Enterprise, Neo4j, and Vector enabled database solutions within Humana's enterprise architecture. This role requires at least 10 years of experience, hands-on expertise with cloud platforms (Azure and/or GCP), strong Python development skills, and significant experience with Kubernetes for container orchestration. The engineer will ensure secure, scalable, and high-performing database environments, collaborating with cross-functional teams to advance business objectives and support modern technology initiatives. **What you'll do:** Design, implement, and optimize NoSQL database solutions using MongoDB Atlas, MongoDB Enterprise, Neo4j and AI features. Develop and maintain infrastructure automation using Terraform, integrating with Azure and/or GCP. Deploy, manage, and scale database workloads using Kubernetes to ensure reliability and operational efficiency. Ensure robust database security, backup, recovery, and regulatory compliance in alignment with Humana's standards. Monitor database performance, troubleshoot issues, and provide L3 support for production environments. Collaborate with stakeholders and cross-functional teams to integrate database solutions within the enterprise architecture. Develop Python-based automation and data workflows. Document processes and solutions in accordance with established SDLC and cloud engineering standards. **We're looking for someone who:** Minimum of 10 years of experience in Database engineering experience working with MongoDB Atlas / Enterprise and Neo4j (equivalent). Hands-on experience with Azure and/or GCP cloud platforms (Azure and/or GCP). Strong proficiency in Python (preferred) for automating database tasks. Demonstrable expertise with Kubernetes for managing containerized database workloads. Hands-on experience with GitOps workflows and tools. Experience utilizing AI development tools within engineering and data environments. Experience with infrastructure-as-code tools, especially Terraform. Familiarity with cloud security, access management, and regulatory compliance best practices. Excellent communication and documentation skills. Is eager to solve tough problems. Has excellent communication skills. Is curious, collaborative, and motivated. **Success Measures** **3 Month Goals:** + Successfully onboard to the Data Platform Engineering team and develop strong working relationships with cross-functional stakeholders. + Review Humana's enterprise architecture, DevOps governance, and cloud security standards (reference (********************************************************************************************************* ). + Assess current MongoDB Atlas, MongoDB Enterprise, Neo4j, and vector database environments; document initial findings and opportunities. + Demonstrate proficiency with Kubernetes orchestration and GitOps workflows through setup or enhancement of development environments. + Begin contributing Python automation scripts and infrastructure-as-code solutions using Terraform for cloud platforms (Azure and/or GCP). **6 Month Goals:** + Lead the implementation or optimization of secure, scalable NoSQL solutions, with measurable improvements in performance and reliability. + Integrate AI development tools into data workflows to support analytics and innovation. + Deliver at least one successful production deployment using Kubernetes and GitOps principles. + Establish and document best practices for database security, backup, and compliance. + Collaborate with DevOps and cloud teams to refine CI/CD pipelines and ensure alignment with Humana's standards. + Track key performance indicators (KPIs) such as deployment frequency, reliability, and code quality metrics. **12 Month Goals:** + Deliver fully operational, compliant, and high-performing NoSQL database environments supporting critical business applications. + Provide thought leadership in data platform modernization, leveraging AI, automation, and cloud-native technologies. + Achieve demonstrable improvements in uptime, incident response, and regulatory compliance across managed database environments. + Mentor junior engineers and contribute to knowledge sharing within the Data Platform Engineering team. + Document and present lessons learned, successes, and future recommendations to leadership. + Ensure continued alignment with Humana's enterprise cloud and security engineering standards. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree in Computer Science, Engineering, Information Technology, or related field. or 10 years of hands on NoSQL Cloud Architecture experience. + Proven experience with MongoDB and Neo4j in an enterprise environment. + Practical knowledge of vector databases and modern data technologies. + Strong experience with cloud platforms (Azure and/or GCP), including cloud-native application deployment. + Proficiency in Python development for automation and database management. + Hands-on experience with Kubernetes, including AKS (Azure Kubernetes Service) or GKE (Google Kubernetes Engine) for deployment, scaling, and management of containerized applications. + Solid understanding of database and cluster security, automation, and DevOps practices. + Excellent problem-solving and communication skills. **Preferred Qualifications** + Certifications in NoSQL database technologies or cloud platforms. + Good knowledge of Kubernetes + Experience in healthcare, insurance, or other regulated industries. + Familiarity with data governance frameworks and compliance standards. **Additional Information** **Work-At-Home Requirements** + WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. + A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI-Remote 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: 12-14-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence Engineer will be an integral part of the Pricer Business and System Support team responsible for administering complex Medicaid provider reimbursement methodologies. The associate will support existing Medicaid business and expansion into new states. The business needs of the team continue to evolve and grow, changing the composition of the team as it expands to accommodate the increased responsibilities. The Senior Business Intelligence Engineer will be primarily responsible for implementation, maintenance and support of Medicaid provider reimbursement for hospitals and facilities. They will work closely with IT, the pricing software vendor, CIS BSS, Medicaid operations, claims operations, and other business teams involved in the administration of Medicaid business at Humana. The Senior Business Intelligence Engineer will develop and maintain expertise in Medicaid reimbursement methodologies rooted in complex grouping concepts (EAPG, APR-DRG, MS-DRG, etc). This role is within the Integrated Network Payment Solutions (INPS) department which falls under the Provider Process and Network Organization (PPNO). The Senior Business Intelligence Engineer will be responsible for: Researching state-specific Medicaid reimbursement methodologies for hospitals and facilities Developing expertise in complex groupers (EAPG, APR-DRG, MS-DRG, etc) utilized in Medicaid reimbursement Reviewing Medicaid RFPs and state contracts to identify provider reimbursement requirements Supporting implementation of new Medicaid pricers including: + Reviewing pricing software vendor specifications. + Identifying system changes needed to accommodate state-specific logic. + Assisting with requirements development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root causes driving issues and developing solutions + Working closely with IT and pricing software vendor to resolve issues + Developing Policies & Procedures + Identifying automation and improvement opportunities + Researching and resolving provider reimbursement inquiries **Use your skills to make an impact** **Required Qualifications** + 3+ years of experience researching state Medicaid hospital reimbursement methodologies that utilize MS-DRG, APR-DRG, APC or EAPG + 2+ years of experience with Optum Rate Manager + 2+ years of experience with Optum WebStrat or PSI applications + Experience reviewing facility claims + Prior professional experience utilizing Microsoft Excel (e.g. performing basic data analysis and utilizing pivot tables or various formulas or functions such as VLOOKUP) **Preferred Qualifications** + Experience researching and resolving provider reimbursement inquiries + Experience researching MS-DRG, APR-DRG and/or EAPG grouper logic + Experience interacting with a State Medicaid or Federal government agency + Intermediate Microsoft Access skills **Additional Information** This role is "remote/work at home" and can be based anywhere in the United States **Work at Home Information** 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 required; 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. \#LI-Remote 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. $89,000 - $121,400 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: 12-15-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and providers, with full accountability from strategy to execution. The Lead Product & Strategy Manager - Provider Practice Management role is a critical member of the multidisciplinary clinical initiatives team within Clinical Strategy and Analytics. This role is not a traditional software product manager role. Instead, it requires demonstrated expertise in healthcare delivery, provider performance improvement, operational redesign, and translating insights into actionable workflows for clinical practices. The Lead Product & Strategy Manager will work across clinical initiatives focused on reducing 30-day Plan All-Cause Readmissions (PCR). They will partner closely with high-performing and low-performing provider groups to identify clinical best practices, understand operational gaps, and design and operationalize provider-facing improvements that lead to measurable performance lift. They must be highly collaborative, able to work cross-functionally across Humana and external provider partners, and able to drive execution (not just strategy) in a fast-moving environment. **Key responsibilities of the position are as follows:** Best Practice Identification + Engage with high-performing provider groups to understand clinical workflows, transitional care processes, and operational drivers that contribute to lower readmission rates. + Conduct targeted discovery with low-performing providers to identify barriers, workflow breakdowns, staffing constraints, or data usability issues that inhibit execution of best practices. + Translate field insights into a clear set of best practices and operational playbooks that provider organizations can adopt to meaningfully reduce readmissions. Product & Insight Development + Partner with Clinical Analytics to understand key data patterns and root causes of readmissions and convert these signals into provider-friendly insights. + Lead the design and refinement of provider-facing data views (dashboards, insights, performance summaries) to ensure they are actionable, timely, and aligned to provider workflows. + Work with product leads and data teams to prioritize enhancements that make insights easier for providers to use - e.g., surfacing patients most likely to readmit, highlighting missed touchpoints, or flagging operational risk. Execution With Providers & Internal Stakeholders + Serve as the primary operational liaison with targeted provider groups, ensuring best practices are activated and sustained. + Co-develop and support rollout of interventions such as transitional care workflows, follow-up protocols, huddle tools, or care-team guidance that directly reduce readmission risk. + Work with enterprise partners (e.g., care management, clinical programs, analytics, population health) to ensure alignment and remove operational barriers to provider adoption. Strategy & Impact Measurement + Define the strategic roadmap for provider practice improvements related to PCR. + Set measurable targets, track provider engagement, and monitor performance lift over time. + Synthesize complex clinical, operational, and analytic information into clear recommendations for executive leadership. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + 7 or more years of experience in population health strategy, health outcomes strategies and/or provider practice management OR 3 years of management consulting with additional 2-3 years of professional work experience + Strong understanding of transitional care management + Experience working directly with provider groups, clinical leaders, or care teams + Experience in advanced primary care or high-performance provider model organizations (e.g., ChenMed, Oak Street, Cityblock, Iora, CareMore) + Strong data literacy with demonstrated experience using analytics to drive operational insights + Excellent communication, relationship-building, and cross-functional collaboration skills + Ability to independently manage complex initiatives, work across departments, and drive execution without day-to-day oversight **Preferred Qualifications** + Background as a clinician (RN, NP, PA, MD, PharmD, or similar) + Experience with population health workflows and drivers of 30-day readmissions + Experience in management consulting and clinical practice (ideal but not required) + Expertise in provider workflow optimization, care transitions, or readmission reduction programs + Familiarity with EHR workflows and system integrations + Demonstrated ability to translate analytics into operationally executable solutions **Additional Information** 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 required; 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. 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. 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. 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: 01-02-2026 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** Software Engineer for Anaplan focuses on building and enhancing the core platform capabilities that support high-throughput workloads, AI-powered insights, and efficient data flows to meet the business needs. This role is responsible for developing resilient, observable, and scalable systems, often using technologies like cloud-native tools. This role involves full-stack development, including front-end and back-end components, and requires a strong emphasis on clean, maintainable, well-tested code with a focus on performance and reliability. Key Responsibilities: + Building and maintaining core platform capabilities that support various workloads for buisness + Developing data integrations with data lakes, event stores, and analytics systems. + Contributing code to both front-end and back-end components + Quality and well-tested code with a focus on performance and reliability. + Participating in design reviews and technical discussions + Coordinating technical deliverables across sprint cycles and collaborating with cross-functional teams, including those in other time zones. Ensuring the platform is scalable, observable, and resilient. + Utilizing cloud-native tools and services to build and deploy the platform. **Use your skills to make an impact** **Required Qualifications** + Anaplan OWP implementation experience and understanding of other Anaplan modules + Experience with cloud platforms and services. + Excellent problem-solving and communication skills. + Experience with DevOps principles and practices. + Experience with data engineering and data processing pipelines is a plus. + Experience with cloud infrastructure and cost optimization is a plus. + Bachelor's Degree in Computer Science or related field + 5 years of experience in systems analysis or application programming development + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Master's Degree **Additional Information** **Work-At-Home Requirements** + WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. + A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information\#LI-Remote 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. $80,900 - $110,300 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: 12-15-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Principal Solutions Architect is a role within CenterWell IT, responsible for shaping architectural strategy and integrating advanced technologies across various healthcare sectors. The role involves strategic planning, application portfolio management, designing integrated health solutions, executive-level communications, AI strategy implementation, and technology innovation. As the **Principal Solutions Architect** , you will play a pivotal role in shaping our architectural strategy and driving the integration of cutting-edge technologies across our diverse healthcare sectors, including Primary Care, Home Health, Pharmacy, and Integrated Health. Your expertise will directly impact patient care, operational efficiency, and business growth. Here are the key responsibilities, qualifications, and specific technical skills, with a focus on integrated health solutions: **Key Responsibilities:** **Strategic Architecture Planning** : + **Architectural Blueprint** : Develop and maintain an overarching architectural blueprint for CenterWell. This includes defining standards, best practices, and reference architectures. + **Business Alignment** : Collaborate closely with business stakeholders to align architectural decisions with organizational goals and long-term vision. **Application Portfolio Management** : + **Assessment and Optimization** : Lead the assessment, optimization, and management of our application portfolio. Evaluate existing systems, identify redundancies, and recommend consolidation or modernization. + **Scalability and Resilience** : Ensure that applications are designed for scalability, high availability, and disaster recovery. **Integrated Health Solutions** : + **Patient-Centric Approach** : Architect solutions that seamlessly connect Humana to Pharmacy, Primary Care, and Home Health. Prioritize patient experience and continuity of care. + **Interoperability** : Design interfaces and data exchange mechanisms to enable seamless information flow between different care settings. + **Care Coordination** : Implement technologies that facilitate care coordination, allowing providers to collaborate effectively across domains. **Executive Level Communications** : + **Strategic Communication** : Create clear, persuasive communications for stakeholders and executive leadership. Translate technical concepts into business value. + **Influence and Advocacy** : Represent architectural strategies and visions in executive meetings, advocating for technology investments that drive innovation. **AI Strategy and Implementation** : + **AI Roadmap** : Design and guide the implementation of AI solutions. Identify use cases where AI can enhance clinical decision-making, patient engagement, and operational efficiency. + **Ethical AI** : Stay informed about AI trends and technologies, incorporating ethical considerations into AI implementations. **Technology Innovation** : + **Emerging Technologies** : Continuously evaluate emerging technologies and assess their applicability to healthcare. + **Proof of Concepts (PoCs)** : Lead PoCs to validate new solutions and demonstrate their value. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree in Computer Science or a related field + 10 years of experience in solution architecture, and proficiency in cloud technologies, security standards, integration, data architecture, and AI/ML. + 2 + years of project/people leadership + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Hands‑on experience delivering generative and agentic AI on Google Cloud, Azure, and AWS + Expereince leveraging services like Vertex AI, Azure OpenAI, and Amazon Bedrock-to implement production‑grade capabilities including RAG, fine‑tuning, prompt/knowledge management, and secure data integrations. + Demonstrated depth in agent orchestration (tools/function calling, planning, memory, multi‑agent collaboration), enterprise guardrails (security, compliance, responsible AI), and robust MLOps/LLMOps practices for observability, evaluation, and cost/performance optimization. + Proven ability to integrate AI systems with event‑driven microservices, vector databases/feature stores, and CI/CD pipelines, while leading reference architectures and cross‑cloud patterns that scale reliably. **Agentic AI Skills** + Agent orchestration: planning, tool/function calling + Long/short-term memory and context management + Multi-agent collaboration and role assignment + Human-in-the-loop review and overrides workflow + Safety guardrails, policy enforcement, governance + Telemetry: tracing, evaluation, A/B testing + Reliability: retries, fallbacks, deterministic handoffs + Tool ecosystem integration (APIs, MCPs) + Task decomposition, summarization, iterative refinement + Secure data access, least-privilege controls **Additional Information** 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 required; 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. $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: 01-18-2026 **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 ***************************************************************************