Humana

General

• Develop strategies and execute initiatives to improve health outcomes for defined populations
• Design evidence-based population health programs
• Coordinate care management
• Collaborate with internal and external stakeholders to address health disparities, optimize resource utilization, and advance quality initiatives
• Design and implement initiatives addressing health risks, disparities, and gaps in care
• Analyze data and population metrics to identify trends and improvement opportunities
• Measure program effectiveness and adjust strategy to achieve targeted outcomes
• Build and maximize relationships with member- and provider-facing stakeholders
• Monitor initiative performance and develop deep, holistic operational reporting
• Provide regular executive summary roll-ups to Stars leadership

Stars Program Delivery Lead

Nurse

• Conduct comprehensive face-to-face assessments of newly admitted members at assigned acute care facilities
• Evaluate members’ physical, psychosocial, and health needs and refer them to Humana programs as appropriate
• Support and educate members and families on discharge planning from admission through post-discharge
• Facilitate follow-up visits with primary care providers
• Identify gaps in care, safety concerns, and barriers to discharge
• Develop and implement strategies to address care and discharge issues
• Collaborate with attending providers, facility case managers, and other healthcare professionals
• Provide education on diagnoses, medications, and preventive measures
• Complete required documentation accurately and promptly
• Maintain infection control, safety, and patient privacy standards
• Perform onsite work at NKC Health Hospital with limited remote documentation hours at the leader’s discretion

Onsite Care Coordination Nurse

Salesforce Developer

• Code software applications based on business requirements
• Serve as a strategic problem solver, trusted advisor, and Salesforce platform expert
• Connect business objectives with scalable Salesforce solutions
• Take ownership of challenges from discovery through implementation
• Leverage Salesforce technologies, integrations, automation, and data solutions to create business outcomes
• Operate independently and influence technical direction
• Make sound architectural decisions and execute in a fast-paced environment
• Identify opportunities and challenge existing processes
• Develop innovative solutions that improve efficiency, scalability, and user experience across the Salesforce ecosystem
• Partner with stakeholders to understand root causes and anticipate future needs
• Design, develop, test, deploy, and support enterprise-scale Salesforce solutions
• Integrate Salesforce with internal and external systems
• Troubleshoot complex technical issues and perform root cause analysis
• Collaborate with business stakeholders, product owners, administrators, architects, and engineering teams

Senior Salesforce Engineer

Manager

• Evaluate members' needs and requirements to achieve or maintain optimal wellness
• Guide members and families toward appropriate care and wellbeing resources
• Manage members' physical, environmental and psychosocial health issues
• Resolve barriers that hinder care
• Conduct assessments and evaluations to ensure patients progress toward desired outcomes
• Create member care plans as needed
• Understand department, segment and organizational strategy and operating goals
• Report to the Manager, Care Management Behavioral Health
• Perform mandatory field work and travel up to 50% of the time

Field Care Manager – Behavioral Health

• Provide comprehensive, holistic case management throughout the continuum of care
• Deliver specialized case management interventions using appropriate care sites and levels of care
• Prevent or reduce hospital readmissions
• Promote appropriate utilization of alternative funding sources
• Enhance coordination of care and reduce fragmentation of clinical services
• Serve as the point of contact for beneficiaries across the clinical spectrum within the complex case management program
• Coordinate and collaborate with Care Management programs, Military Treatment Facility staff, physicians, and providers
• Ensure fully integrated care plans address all beneficiary needs and conditions
• Report to a Manager of Care Management

Care Manager, Telephonic Nurse

Full-stack Engineer

• Design, build, and support SSIS packages and C# API integrations
• Enable secure, reliable file transfers and data exchange between external partners, internal systems, the Record Management System, and web applications
• Build SSIS workflows for file intake, validation, transformation, loading, delivery, archiving, logging, and error handling
• Design and implement C#/.NET APIs connecting the Record Management System with web applications and internal systems
• Support file upload, file download, metadata exchange, secure communication, and integration workflow processing
• Collaborate with business partners and technical teams to gather requirements and define technical solutions
• Troubleshoot integration issues and optimize SQL processes
• Support deployments
• Ensure solutions comply with security, privacy, and operational standards
• Report to the Associate Director, HGB IT Platform and Foundational Services for Humana Military

Senior Software Engineer

Security Engineer

• Serve as a trusted cybersecurity advisor for supported Primary Care Organization subsidiaries and affiliated entities
• Enable secure business growth through scalable security architecture, risk-informed decision making, and innovative security solutions
• Plan, design, implement, and continuously enhance security solutions
• Evaluate business strategies, technology initiatives, and organizational growth objectives
• Develop security requirements and architectures across infrastructure, cloud, applications, third-party services, and emerging technologies
• Ensure alignment with enterprise standards, regulatory requirements, and business objectives
• Support subsidiary-specific security architecture, governance, risk management, application security, acquisition integration, and compliance efforts
• Leverage automation and AI-enabled capabilities to improve operational efficiency and strengthen security controls
• Provide security architecture support for business growth, technology modernization, and acquisition integration initiatives
• Partner with business and technology leaders to develop scalable solutions balancing risk management, compliance, efficiency, and business enablement
• Influence cybersecurity strategy across multiple organizations and stakeholders

Senior Security Architect

Director

• Collaborate with the business portfolio team to align the IT portfolio and demand
• Understand how organizational capabilities interrelate across the function or segment
• Organize and prioritize projects and programs based on IT strategy, strategic roadmap, available and prioritized budgets, and changing schedules
• Ensure appropriate financial and organizational support is allocated to strategic goals
• Implement new or updated programs and large-scale projects for the function
• Support technical and operational procedures and processes
• Implement strategic plans and drive goals and objectives
• Improve performance
• Provide input into functional strategy
• Lead special projects and produce metrics, measurements and trend reports
• Run large-scale, highly visible programs involving multiple project teams

Director, IT Portfolio Management

Medical Director

• Create and oversee clinical strategy for the region
• Provide medical leadership and strategy for Health Services Operations with fiscal responsibility for trend management
• Oversee regional utilization management and case management for inpatient cases, LTSS services and the Humana Medicare Model of Care
• Chair the Quality Management Committee and participate in Quality Operations
• Complete initial peer review on quality-of-care complaints
• Complete peer-to-peer written and verbal communications
• Oversee the administrative budget for regional Health Services Operations and Quality Improvement
• Approve or deny expense reports and requisition requests for department members
• Oversee Quality Improvement and HEDIS/STARS metrics improvement with PCP offices and IPAs
• Participate in regional committees and meetings that set medical necessity strategies
• Oversee and direct implementation of regional clinical programs and strategies
• Develop and implement market-level strategies
• Manage internal operational and functional relationships related to profitability
• Assist with network development and provider contracting
• Serve as clinical liaison with inpatient facilities and joint operating committees
• Maintain facility relationships and resolve problems, including reviewing contracts regarding clinical services
• Apply knowledge of financial aspects of risk-bearing contracts to gain provider traction and adoption
• Work effectively in a highly matrixed environment

Chief Medical Officer – CMO

Cloud Engineer

• Partner with development teams to design and implement cloud-native application solutions on Humana’s Cloud 3.0 Azure platform
• Translate business and application requirements into scalable application designs using approved Cloud 3.0 design patterns
• Advise teams on shared versus dedicated deployment model decisions
• Support application modernization and acceleration efforts for services moving to Cloud 3.0
• Help teams identify application dependencies, integration patterns, and deployment requirements
• Develop application code using Humana-approved technology stacks and approved Humana AI tools
• Guide development teams through Cloud 3.0 onboarding prerequisites and deliverables
• Support application portfolio setup in ServiceNow and artifact definition in iServer/LeanIX
• Assist with logical architecture, data flow, accessibility, disaster recovery, database failover, and deployment sizing documentation
• Enable development teams to set up Argo onboarding for application components
• Validate CI/CD tools and pipelines for build, test, deploy, and release processes
• Promote automated testing, code quality, code coverage, release governance, and deployment consistency
• Establish reusable development patterns and standard delivery approaches
• Prepare teams for production release readiness, including GLAPI certification where required
• Ensure alignment with approved security, architecture, and technology standards
• Review development and deployment approaches for enterprise conformance
• Identify risks, gaps, and non-standard implementation needs and coordinate mitigation
• Provide technical guidance during onboarding, development, deployment, and post-deployment troubleshooting
• Diagnose application deployment, platform integration, and release pipeline issues
• Partner with platform and shared services teams on cross-team issue resolution
• Improve engineering support documentation and reusable guidance
• Collaborate with software engineering, enterprise architecture, security and compliance, cloud platform enablement, DevOps/release engineering, and product/delivery stakeholders
• Act as a technical advisor on approved cloud capabilities and supported patterns

Senior Cloud Solutions Engineer

Software Engineer

• Develop and maintain secure and reliable file-transfer solutions between external partners and internal systems
• Design and implement API integrations between the Record Management System and web applications
• Support file upload and download functionality
• Configure and troubleshoot automated file-transfer jobs
• Establish FTP/SFTP connections
• Gather business requirements
• Ensure compliance with operational and security standards
• Report to the Associate Director, HGB IT Platform and Foundational Services for Humana Military
• Collaborate effectively and maintain documentation

Actuary

• Analyze healthcare claims, membership, authorization, financial, and other relevant data to evaluate medical cost, utilization, unit cost, and emerging experience
• Investigate emerging cost and utilization patterns, identify key drivers, and summarize findings for actuarial and business partners
• Prepare summaries, visualizations, and presentation materials explaining analytical findings, assumptions, limitations, and business implications
• Collaborate with actuarial, finance, clinical, market, operations, and technology partners
• Investigate data anomalies, perform root-cause analysis, and resolve issues with business and technology partners
• Support development, maintenance, validation, and enhancement of actuarial models, datasets, reports, and analytical tools
• Develop and maintain processes and controls supporting reliable data, models, reporting, and recurring analytical deliverables
• Maintain documentation of data sources, business rules, methodologies, assumptions, controls, and recurring processes
• Identify opportunities to improve, automate, and standardize data, modeling, reporting, and quality-control processes
• Apply actuarial and analytical methods to increasingly complex assignments using sound judgment and seeking guidance when appropriate
• Support Humana's Medicaid actuarial analytics capabilities and business intelligence needs

Actuary 2, Analytics/Forecasting

General Counsel

• Provide legal advice and support for Humana’s Medicare Advantage lines of business
• Advise on Medicare Advantage rules and regulations and related healthcare fraud and abuse laws, including the Anti-kickback Statute and False Claims Act
• Draft contract provisions addressing regulatory concerns
• Collaborate and consult with company leaders to ensure compliance with applicable laws and regulations
• Protect Humana against external risk
• Occasionally travel to Humana offices for training or meetings

Counsel

Pharmacist

• Define and execute a multi-year technology strategy aligned with business priorities
• Lead large-scale modernization and transformation initiatives
• Balance short-term delivery with long-term platform evolution
• Provide hands-on technical leadership and guide design decisions, architecture reviews, and solution trade-offs
• Define and govern target-state architecture across application, integration, data, and cloud platforms
• Collaborate with vendor partners on architecture, solution delivery, governance, and technical resiliency
• Lead architecture forums and ensure alignment with enterprise standards
• Drive engineering excellence through scalability, reusability, and performance optimization
• Evaluate emerging technologies, platforms, and tools
• Lead technology selection decisions, including build versus buy
• Drive adoption of AI, automation, and advanced analytics
• Continuously modernize the technology stack
• Own end-to-end delivery and lifecycle of enterprise platforms
• Ensure systems are scalable, secure, and resilient
• Drive outcome-based delivery across teams
• Manage IT spend across labor, vendors, and platforms
• Optimize cost and delivery efficiency
• Lead engineering and architecture teams
• Develop a strong technical leadership bench
• Foster a culture of innovation and accountability
• Partner with business and enterprise leaders
• Communicate with senior stakeholders
• Manage strategic vendor relationships

Associate VP, Pharmacy Benefits Management Technology Solutions

Chief of Staff

• Report to an SVP/President
• Serve as a trusted strategic advisor and gatekeeper to the Enterprise Leadership Team
• Ensure alignment of priorities, efficient decision-making, and seamless execution of initiatives and strategic priorities
• Manage the SVP/President's agenda and strategic priorities
• Collaborate on cross-functional projects
• Prepare briefing materials and oversee follow-ups
• Support implementation of new or updated programs and large-scale projects
• Support technical or operational procedures and processes
• Implement strategic plans and drive goals and objectives
• Improve performance and provide input into function strategy