Human Engineer in United States

Become a part of our caring community Do you thrive on designing secure, enterprise-scale solutions that protect critical systems, data, and networks? As a Lead Security Architect in Humana, you will play a key role in shaping the security blueprint for the organization by aligning security architecture and infrastructure with enterprise business and technology priorities. In this role, you will partner with EIP and business leaders to assess emerging threats, identify architectural gaps, and design forward-looking security solutions that strengthen Humana's overall security posture. You will also lead security assessments, vulnerability analysis, and product security reviews while helping develop innovative testing approaches and mitigation strategies for evolving risks. This is a high-impact opportunity to influence enterprise architecture, guide secure technology design, and help protect the business through strategic, modern security architecture. The Lead Security Architect engages with relevant EIP stakeholders to identify current and emerging security threats and works to design security architecture elements to mitigate threats as they emerge. Additionally, the role actively works to identify gaps within existing EIP reference architecture and designs updates to impacted security architecture elements to mitigate emerging threats. Performs and oversees efforts to conduct vulnerability testing, risk analysis, and security assessments of relevant enterprise / EIP infrastructure. Ensures EIP and Humana stakeholder security requirements are necessary to protect Humana's business functions and are adequately addressed in all aspects of enterprise architecture. The Lead Security Architect role is aligned to a segment (line of business) to proactively discover security issues during solution design and prevent vulnerabilities during development.

Become a part of our caring community Humana’s Quality and Cost Strategy Analytics Team is seeking a Research Scientist 2 (Remote). Healthcare is rapidly changing, and our members are living longer, often with more chronic conditions. The Quality and Cost Strategy Analytics team identifies opportunities and build solutions to improve clinical outcomes and lower costs for millions of Medicare Advantage beneficiaries leveraging data science & analytics, clinical expertise, strategic mindset, and rigorous study designs. In this multi-disciplinary team, you will have the opportunity to work closely with strategy partners and clinicians to shape Humana’s future enterprise clinical strategies and initiatives. The Research Scientist 2 will lead research, evaluation and development of opportunities that optimize healthcare delivery, lower medical cost while improve member health outcomes, through applying mathematical, statistical, epidemiologic and data science methods. The Research Scientist 2 will also partner with stakeholders across the enterprise to identify, prioritize and measure the impact of core and novel solutions to significant problems in healthcare and improve the health of especially underserved population, using high volumes of structured and unstructured data. Responsibilities As a Research Scientist 2, you will: Research, prototype and scale new ideas to improve population health and healthcare delivery Collaborate with analytic and business teams to set objectives, approaches, and work plans Collaborate with strategy to evaluate existing programs and identify and measure new solutions to impact healthcare Leverage a wide range of analytics methods ranging from descriptive to prescriptive to transform high volumes of complex data into analytics solut

Become a part of our caring community The Business Intelligence Lead serves as the primary analytics and enrollment operations expert supporting Medicaid Enrollment. This role is responsible for leading state implementation readiness efforts, regulatory and contractual reporting support, enrollment analytics, compliance monitoring, and analytics modernization across Medicaid markets. The Business Intelligence Lead solves complex business problems and operational challenges using internal and external data sources to provide actionable insights and strategic direction to business leaders. This role serves as the primary analytics lead supporting Medicaid Enrollment Operations initiatives, with responsibility for state implementation readiness, enrollment analytics, compliance monitoring, and scalable solution architecture. This associate functions as a strategic individual contributor and internal consultant, partnering with business leaders, operational teams, compliance organizations, and technology partners to design and implement analytics solutions. The Business Intelligence Lead exercises independent judgment and decision-making authority on complex issues affecting state compliance, enrollment operations, contractual reporting obligations, membership reporting, reconciliation processes, and operational performance. The role leverages modern analytics platforms including Databricks, Power BI, SQL, and cloud-based data environments to create reusable and scalable solutions supporting current and future Medicaid market expansions. This associate is expected to influence strategy, identify opportunities for operational efficiencies, establish reporting standards, and drive modernization efforts that reduce implementation effort while improving compliance, operational visibility, and business outcomes. Use your skills to make an

Become a part of our caring community The Clinical Programs Pharmacist Lead will be a part of a collaborative Pharmacy Stars team which is accountable for Humana’s Stars patient safety measure performance. The Clinical Pharmacist Lead autonomously develops, implements, and manages clinical program strategies to improve Medicare members' medication adherence and appropriate medication use. The Clinical Pharmacist lead exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works under minimal supervision, and analyzes variable factors to determine the best course of action. Use your skills to make an impact Required Qualifications Degree of Doctor of Pharmacy (PharmD or RPh) from an accredited School of Pharmacy Active, unrestricted pharmacy licensure 5+ years of clinical experience in managed care or pharmacy related field, or equivalent Proficient in Microsoft Office applications (especially Word, Excel, and PowerPoint) Excellent written and oral communication skills Thrives in a fast paced, multi-project work environment while still ensuring attention to detail Successful track record in facilitating and consulting across teams and managing projects Strategic thinking and planning capabilities, organized, and detail-oriented Ability to learn quickly, work under pressure and timeline, work with ambiguity, and make complex decisions as necessary to meet business need Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data Preferred Qualifications Previous experience in Medicare Stars Managed care and/or community pharmacy experience or residency/fellowship Previous experience in clinical program development and leader

Become a part of our caring community The Associate Vice President, Model & AI Governance, is the enterprise leader responsible for establishing and overseeing the organization’s framework for model governance, artificial intelligence (AI) risk management, responsible AI and AI governance. Reporting to the Chief Audit & Risk Officer, this executive provides independent second-line oversight and challenge of the organization’s use of models, advanced analytics, machine learning, generative AI, and emerging AI technologies. The role establishes the governance, risk-management, control, monitoring and escalation framework necessary to ensure AI models are deployed in a manner that is safe, ethical, transparent, explainable, compliant, secure and aligned with the organization’s mission and risk appetite. The Associate Vice President, Model & AI Governance, partners closely with executive leadership, technology, data and analytics, clinical/business leaders, compliance, legal, privacy, cybersecurity, information security, internal audit, enterprise risk management and other control functions to ensure AI-related risks are identified, assessed, governed, monitored, and appropriately reported. This leader will serve as an advisor to executive management on emerging model and AI risks, while maintaining appropriate independence from the teams developing and deploying models and AI solutions. Key Responsibilities Own and continuously enhance the enterprise model governance framework, including model identification, inventory, classification, risk tiering, development, validation, approval, implementation, monitoring, change management, retirement and documentation. Define model risk appetite, risk taxonomy, minimum control standards, governance requirements and escalation thresholds. Provide effective challenge over model

Become a part of our caring community The Regional Senior TRICARE Community Liaison (TCL) is an important Humana Military representative committed to operational excellence, consistency, and accountability in the administration of TRICARE services within a defined territory in the East Region. You will provide expert guidance to nationally contracted healthcare providers and support facilities who have footprints across both East and West Regions. The primary focus of the Regional Senior TCL is to develop and sustain strong, collaborative relationships with all National Health System providers in the East Region. You will be cover all National contracted providers and large health systems regardless of location or type of care provided. Through clear and concise written and verbal communication, the Regional Senior TCL ensures provider understanding of the TRICARE health plan, TRICARE Policy and Regulations and how to navigate the Military Health System. The Regional Senior TCL is self-directed and uses independent, critical decision-making in managing time, setting priorities, addressing general inquiries, and resolving both straightforward inquiries, complicated problems and concerns raised by providers. This position upholds rigorous operational standards and ensuring consistent, high-quality delivery of TRICARE services. You will support customer service, conduct outreach, maintain network adequacy and access to care. You will manage provider relations and education, and ensure effective provider management within the assigned area. You will lead the review of TRICARE inquiries, complaints, and concerns from beneficiaries, providers, and government personnel, ensuring a resolution through professionalism and integrity. Additional responsibilities involve supporting the implementation of Alternative Payment Methodologies and Demonstration Pilots that adv

Become a part of our caring community The Financial Analytics Professional 2 manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Financial Analytics Professional 2 collates, models, interprets and analyzes data in order to identify, explain, influence variances and trends. Explains variances and trends in clinical and financial data and enhances modeling techniques to improve forecast accuracy. May possess financial or actuarial background. 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 1&#43; years SQL and Python experience Microsoft Office (Excel, Power BI, etc.) Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends Explain variances and trends and enhance modeling techniques Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Business Intelligence, Financial, or Actuarial background Azure Databricks experience</

Become a part of our caring community Join our Payment Integrity Letters team at Humana where you will help draft and implement outbound communication templates for the Payment Integrity Operations teams as a Payment Integrity Professional 2. You will help ensure compliance with state contractual requirements and Humana brand standards in drafting communication templates and working with the approvers and developers. You will report to the Associate Director, Business Systems Analysis. Main responsibilities: Collaborate with business partners to draft new communications Review existing communications on an annual basis to ensure compliance with all state requirements and Humana brand standards Ensure intake requests are completing all required steps in a timely manner and escalate off track tasks as needed Work with the EMME development team to ensure communication requirements are documented clearly and implemented correctly Validate communications in QA and Production environments on a regular basis to identify gaps Use your skills to make an impact Required Qualifications 2&#43; years' experience tracking process deliverables Experience editing documents with Microsoft Office Programs Word, PowerPoint, and Excel Experience handling multiple priorities Experience with com

Become a part of our caring community The Field Care Manager Nurse 2 assesses and evaluates member's 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. You will report to the Manager, Care Management of Behavioral Health. The Field Care Manager 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. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. In this role, you will travel up to 50% of the time to support collaboration, conduct face-to-face meetings, and engage directly with staff, providers, members, and their families. NOTE: You should reside close to the Midlands OR Upstate area where your region will be. Use your skills to make an impact Required Qualifications Bachelor's in nursing (BSN) and have an active license in the state of South Carolina without disciplinary action. Must reside in the State of South Carolina 2 or more years of experience of case/care management 2 or more years working with the behavioral health population Knowledge of community health and social service agencies and additional community resources Use a variety of electronic information applications/software programs including electronic medical recor

Become a part of our caring community The Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Pre-Authorization Nurse completes medical necessity and level of care reviews for requested services using clinical judgment, and refers to team members for review depending on case findings. Educate providers on utilization and medical management processes. Enter and maintain relevant clinical information in various medical management systems. Understand 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 2&#43; years of RN experience Active RN license in the state of Indiana Ability to be licensed in multiple states without restrictions Previous experience in utilization management, case management, discharge planning and/or home health or rehab Proficient with MS Office products including Word, Excel and Outlook Ability to work independently under general instructions and with a team Preferred Qualifications Bachelor's degree MCO experience Health Plan experience working with large carriers Previous Medicare/Medicaid experience Outpatient or home health experience in Utilization Manageme

Become a part of our caring community The Strategy Advancement Advisor is a member of Humana’s People Innovation team, which helps shape and advance the future of HR by translating enterprise and workforce priorities into focused strategies and measurable outcomes. This role partners with HR and business leaders to frame complex challenges, develop fact-based recommendations, and move high-priority initiatives from strategy through execution. The Advisor will work across a varied portfolio of enterprise people priorities and transformation efforts, bringing structure to ambiguity, connecting work across functions, and helping leaders make informed decisions that improve business, workforce, and associate outcomes. Humana is seeking an experienced strategy professional to join the People Innovation team. The team serves as a strategic partner to HR and the business, helping identify, shape, and advance high-impact opportunities that support Humana’s people strategy and broader enterprise transformation. Our work spans emerging workforce priorities, talent and organizational strategies, operating model and work redesign, and other cross-functional initiatives that require enterprise perspective, disciplined problem solving, and coordinated execution. As a Strategy Advancement Advisor, you will lead and support a portfolio of complex, high-visibility initiatives from early problem definition through recommendation and activation. You will work with senior leaders, HR partners, subject matter experts, and cross-functional teams to clarify business needs, synthesize internal and external insights, evaluate strategic choices, and translate direction into practical plans. The role requires the ability to move between strategy and execution, build alignment across a matrixed organization, and produce clear, executive-ready recommendations that enable timely decisions and

Become a part of our caring community *(Selected candidate will be required to live within 60 mins of one of the following metro locations OR be willing to relocate to within 12 months of hire date: Louisville KY, NYC Metro, Dallas Metro, Charlotte NC Metro, Tampa, Miami, Washington DC metro, Chicago, Boston, Atlanta, Nashville) The Senior Security Architect for AI works with EIP Department leaders and Humana enterprise stakeholders to identify, define, and develop security architecture requirements and secure designs for AI technology solutions across Humana's business, information technology, and security domains. The Security Architect leads the development of technical architecture &amp; designs, develop security requirements, perform threat modeling and ensures alignment of security &amp; risk imperatives with business priorities. The Security Architect is responsible for the high-level design and patterns of security program infrastructures to enable the protection of Humana tools, data, systems, and networks. Working with EIP Leaders, the security architect drives alignment between the EIP security strategy, security architecture and infrastructure, and Humana's overall business and technology strategic priorities. In this capacity, the role is responsible for planning, designing, and proposing architectural patterns or security enhancements for Humana's information security and technology infrastructures. The role works with EIP and Humana leaders to review and reconcile Humana business priorities with EIP security requirements. The role engages with relevant EIP stakeholders to identify current and emerging security threats and works to design security architecture elements to mitigate threats as they emerge. Additionally, the role actively works to identify gaps within existing EIP reference architecture and designs updates to impacted sec

Become a part of our caring community The Transition Coordinator (Care Coach 2) evaluates member's needs and requirements. This evaluation aims to achieve and/or maintain an optimal wellness state. The Coordinator does this by guiding members/families toward resources and facilitating interaction with them. These resources are appropriate for the care and wellbeing of members. The Care Coach 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Position Responsibilities: Support the ongoing member transitions in and out of the Indiana Medicaid programs, the Contractor's enrollment, and among care settings. Complete transitions and assists with the planning and preparation for them, and the follow-up care after. Works with the Member Advocate Coordinator and other member-focused departments of the plan. This collaboration ensures continuity and coordination of care and member and provider communication through the initial transition, ongoing benefit plan, and MCE transfers. Ensure the transfer and receipt of all outstanding prior authorization decisions, utilization management data, and clinical information such as prevention and wellness programs(s), care management and complex case management notes. Help with transitions from the custodial setting to the home and community-based setting. We ask that you have telephonic and in-person meetings within an assigned region. The purpose of these meetings is to work with various stakeholders, including long-term care members, hospital/rehab staff discharge planners, family members/POA's, PCP's, and other healthcare professionals. The ultimate goal is to prevent custodial placements whenever possible. Assess and evaluate member's needs to establish a member specific car

Become a part of our caring community CenterWell is looking for dedicated, compassionate, and experienced candidates with Medical Receptionist experience who want to grow with the company and being a part of something great! Location : CenterWell Senior Primary Care BVL office address: 2577 Simpson Road, Kissimmee, FL 34744 Medical Receptionist Role Overview: The Medical Receptionist operates a switchboard or multi-line phone and maintains long distance call logs. Take and distribute accurate messages. Greet visitors and determine the nature of their visit, issues visitor passes and maintain visitor logs, alerts appropriate party of visitor arrival or directs visitors to appropriate office, department or employee. Respond to routine inquiries from internal or external sources such as our location, hours of operation, phone numbers, and email address. Additional responsibilities may include miscellaneous administrative activities such as booking meeting rooms, typing, organizing and distributing mail, receiving and sending courier packages. Decisions are limited to defined parameters around work expectations, quality standards, priorities and timing, and works under close supervision and/or within established policies/practices and guidelines with minimal opportunity for deviation. Use your skills to make an impact Additional Information Required Qualifications Experience in a fast pace/high volume environment Minimum of 1-year professional experience as a Medical Receptionist in 'front-office' direct patient care contact Bilingual (English/Spanish) Experience with MS Outlook Basic Computer knowledge Must be a team player with excellent communication skills Willingness to learn an

Become a part of our caring community With over 10 million sales interactions annually, Humana understands that while great products are important, it’s the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8–12 Medicare Sales Agents, you’ll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you’ll help bring Humana’s strategy to life: Deliver on the fundamentals, differentiate through exceptional service, and grow by expanding our reach and impact. What You’ll Do in This FIELD Based Role: Deliver : Build trust and educate individuals on Humana’s Medicare Advantage plans and additional offerings like Life, Dental, Vision, and Prescription coverage. Differentiate : Create meaningful, face-to-face connections through grassroots marketing, community events, and in-home visits—providing a personalized experience that sets Humana apart. Grow : Drive self-generated sales, meet performance goals, and expand Humana’s presence in the market by becoming a valued resource in your community. You’ll engage with customers in the FIELD through a mix of in-person, virtual, and phone interactions. Face-to-face visits in prospective members’ homes a