Human Resources in United States

Become a part of our caring community Humana is a publicly traded, Fortune 60 health benefits company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in the ’60s, to the largest US hospital corporation in the ’80s, to a leading health benefits company beginning in the ’90s. Today, Humana is a leader in consumer-focused health solutions and is one of the largest health benefits organizations in the country. The Enterprise Growth Strategy team is a newly created organization supporting growth across Humana’s businesses. The team has a strong dotted-line partnership with the Medicare and Medicaid organization, Humana’s largest, which comprises over 80% of the company’s total revenue and the majority of its earnings. Team members partner with the senior leaders of the business unit, and more broadly with leaders throughout the enterprise, as they deliver strategy projects addressing some of the businesses’ most important opportunities and challenges. These high-profile strategy projects place the team at the forefront of helping to define the future of Humana’s largest businesses. Humana is seeking an experienced team member to support delivering some of Medicare and Medicaid’s highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Manager, you will deconstruct issues and challenges, perform targeted research and analysis, and craft sound, logical solutions and recommendations. You will also shape implementation considerations, and work with business owners as appropriate to transition analysis into execution. While doing so, you will have the opportunity to collaborate with fellow team members, subject matter experts, members of Humana’s executive Management Team, and corporate, functional, and business unit leaders. </s

Become a part of our caring community The Lead Technology Leadership Professional is responsible for all aspects of software or hardware product delivery and performance. The Lead Technology Leadership Professional works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Technology Leadership Professional works with design engineering and test team to drive products from design completion to volume production release. Performs various engineering tests to verify and validate product designs. Supports product evaluation and qualification on leading edge technology components. Ensures that production schedules are followed and product(s) meet specifications and quality requirements. Interacts with product engineering, quality, manufacturing and marketing teams to analyze and provide technical support to help resolve customers' product related problems/issues. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. Use your skills to make an impact Required Qualifications Bachelor's degree 2 or more years of project leadership experience Experience with the technologies in use in the application(s) or infrastructure Experience with unit testing and mocking Ability to manage multiple tasks and deadlines with attention to detail. Ability to communicate effectively and deliver presentations to senior leaders Advanced experience leading special projects and producing metrics, measurements and trend reports Must be passionate about

Become a part of our caring community The Automation Engineer identifies and implements solutions (hardware and software) for improvement of the high-quality automation infrastructure. The Automation Engineer work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Automation Engineer designs, programs, simulates, and tests automated processes, and is responsible for detailed design specifications and other documents. 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 or relevant and equivalent years of experience in lieu of degree requirement. 4&#43; years of technical experience related to automation. Strong knowledge and understanding of Claude code Experience using AI coding assistants such as Claude code, Github, Copilot, or similar developer productivity tools. Hands-on experience leveraging Claude Code for test automation development, debugging, script generation, and software quality engineering. Experience developing automation using Java, Python, or JavaScript. Experience with Selenium, Playwright, Cypress, or equivalent frameworks. Experience testing REST APIs and backend services. Experience with CI/CD pipelines and automated deployments. 2&#43; years of experience in Software QA testing in a SAFe Agile environment. Strong experience with black box, web-service integration and server back-end testing.</

Become a part of our caring community Services represent one of the organization’s most consequential sources of capability, capacity, transformation and external spend. The Associate Vice President, Services Procurement will lead the enterprise strategy for contingent workforce, outsourcing and offshoring, consulting and clinical services, converting third-party services into measurable business outcomes, workforce agility, operating leverage and sustainable value. The AVP will serve as the senior Procurement partner to leaders across the Insurance segment and Corporate Services, helping shape operating-model, workforce and transformation decisions before sourcing begins or a supplier solution is selected. The leader will bring deep expertise in global business services, business process outsourcing, workforce solutions and complex professional services. The mandate is to strengthen business-case quality, establish clear make, buy, build, automate and partner choices, create fit-for-purpose commercial models, manage transitions and hold providers accountable for committed outcomes. Success will be measured by whether business leaders make better services and workforce decisions, transformations deliver their promised value, and suppliers improve performance and innovation. Key Responsibilities Serve as the Strategic Services Partner to Business Leaders Serve as the senior Procurement relationship leader and trusted commercial advisor to Insurance segment and Corporate Services leadership. Develop a deep understanding of business strategy, operating plans, transformation roadmaps, workforce needs and financial commitments, and translate them into integrated services, workforce and supplier strategies. Engage upstream of supplier selection to frame the problem, test demand and assess make, buy, build, automate, offshore, outsource

Become a part of our caring community The Grievances and Appeals Representative 4 role in the Internal Review Team is responsible for managing appeal denials, by reviewing clinical documentation, determining whether further action is needed, and validating final determinations in coordination with clinical and internal Humana partners. Key Responsibilities: Manage Level 1 appeal cases , ensuring accuracy, completeness, and compliance with CMS requirements Review clinical documentation to support appeal determinations and escalation decisions Coordinate with clinical teams and internal partners to finalize appeal outcomes Investigate and resolve member and provider issues with a focus on timely resolution Maintain high productivity and quality standards in a production-driven environment Ensure strict adherence to confidentiality and compliance regulations Independently prioritize and manage multiple high-volume case assignments Proactively embraces change and supports smooth transitions in a dynamic work environment Use your skills to make an impact Required Qualifications: 1&#43; year of grievance & appeals and/or customer service experience Strong data entry skills Proficiency in Microsoft Office Applications Experience in a production-driven environment Experience prioritizing and delivering multiple assignments Strong commitment to confidentiality and high-quality results Preferred Qualifications: Associate's or Bachelor's degree 2–4 years of grievance and appeals experience Medical claims processing experience Previous inbound call center experience Experience wi

Become a part of our caring community The Market Finance Lead is a key member of the Gulf South Region’s finance team responsible for connecting market financial performance with operational effectiveness. This role will partner closely with Corporate Finance, Network Performance, Network Contracting, and regional Health Services teams. This individual will manage a team covering a diverse set of responsibilities around Medicare Advantage financial business operations with a heavy focus on value-based providers. This role reports to the Market Finance Director. This role analyzes financial results, claims experience, utilization trends, contract performance, membership, and provider performance data to identify opportunities, influence business decisions, and support market growth and operational improvement. The Market Finance Lead will partner closely with regional leadership, actuarial, corporate finance, clinical, risk adjustment, market operations, network performance, network contracting, sales/MarketPoint, and value-based care providers. This individual will translate complex financial and operational data into meaningful insights, recommendations, and action plans that improve performance across the market. As the Market Finance Lead, you will: Manage a team to review value-based providers’ financial performance, membership, cost and utilization trends, contractual results, and opportunities for improvement. Lead the financial portion of provider engagement prep sessions prior to joint operating committee meetings to advise the Network Performance team on contract performance and opportunities for improvement. Lead analysis and reporting related to value-based provider and contract performance, including financial results, utilization, claims experience, membership, and operational trends. Leverage data analytics, business ins

Become a part of our caring community Become a valued member of Humana's Internal Review Team as a Grievances & Appeals Representative 2, where you will play a critical role in addressing client concerns and denials. You will perform thorough reviews of clinical documentation to assess whether grievances, appeals, or additional requests are justified. Then, you will provide final determinations utilizing your expertise and collaboration with clinical and other Humana teams. Your contributions will directly support Humana's commitment to delivering high-quality service and making a positive difference in the lives of those we serve. Must be passionate about contributing to an organization focused on continuously improving consumer experiences. Key Responsibilities: Assign cases to team members for submission to an independent entity for 2nd level review. Monitor and record the number of cases assigned to the team, as well as the distribution of cases among individual associates. Operate within established guidelines to maintain work expectations and quality standards, while exercising discretion in prioritizing tasks and managing timelines with minimal supervision. Demonstrate flexibility and resilience in adapting to evolving processes and a fast-paced work environment. Use your skills to make an impact Required Qualifications Minimum of 1 year of customer service experience Minimum of 1 year of data entry experience Experience in a production-driven environment Must have strong experience using multiple Microsoft systems simultaneously (Teams, SharePoint, Excel, etc.) Ability to manage large volume on inventory daily Preferred Qualifications Previous inbound call center or related customer service experi

Become a part of our caring community The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Your work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Actuarial Analyst 2, Analytics/Forecasting will report to the Actuary, Analytics/Forecasting. You will play a key role in the Medicare actuarial forecasting process. This position entails the maintenance of the provider revenue and expense projection model and associated tools supporting the projection model. The Actuarial Analyst 2, will be responsible for integrating value-based provider impacts into financial and bid forecasts, managing tools associated with these impacts, and providing guidance on effective risk modeling practices. The Actuarial Analyst 2, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. You will collaborate with stakeholders to understand business needs/issues, troubleshoots problems, conduct root cause analysis, and develop cost effective resolutions for data anomalies. You will understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. You will make decisions regarding own work methods, occasionally in ambiguous situations, and require minimal direction and receives guidance where needed. You will follow established guidelines/procedures. Use your skills to make an impact Required Qualifications Bachelor's Degree Successful completion of at least 3 actuarial exams<

Become a part of our caring community The Director, Product Management Conceives of, develops, delivers, and manages products for customer use. The Director, Product Management requires an in-depth understanding of how organization capabilities interrelate across the function or segment. The Director, Product Management Leads all phases of the product life cycle, from inception to introduction into the marketplace, by developing products to meet specific customer needs and achieve specific cost and success outcomes. Once products are launched, monitors efficacy of products and uses customer and business partner feedback to ensure products are meeting customer needs across each customer segmentation, adjusting products over time to continue to achieve the desired outcomes. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, andimplements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy. This is a remote position that reports to the Associate VP, Mail Order Pharmacy Distribution. Use your skills to make an impact Required You will be a Certified SAFe® 5 Product Owner/ Product Manager You will have 5&#43; years of Product Owner/Product Manager experience You will have 3&#43; years of leadership experience You will have a Bachelor's degree Preferred You will have an ability to drive significant transformation You will have competence working on very large and most complex assignments You will have asStrong ability to drive cross functional teams to alignment in the midst of ambiguity You will have an abili

Become a part of our caring community Help shape practical, responsible AI solutions that improve healthcare experiences and outcomes. Humana’s Enterprise AI organization develops safe, scalable AI solutions across our Insurance and CenterWell businesses. We bring together product managers, data scientists, engineers, policy experts, and business leaders to apply emerging technology to meaningful healthcare challenges. As Associate Director of Applied AI, you will lead teams that design, build, and deploy enterprise AI solutions, with a focus on generative AI and intelligent agents. You will connect technical strategy to business needs, guide responsible delivery in a regulated environment, and help teams turn promising ideas into measurable outcomes for members, patients, and associates. Key Responsibilities Lead and mentor teams developing production-ready AI solutions that improve healthcare delivery, member experiences, and business operations. Help define and execute the roadmap for applied AI initiatives in alignment with enterprise priorities and business needs. Guide the evaluation and adoption of machine learning, generative AI, large language models, multimodal models, and intelligent agent technologies. Oversee scalable APIs, frameworks, data pipelines, retrieval-augmented generation solutions, and agent orchestration capabilities. Partner with product, data science, engineering, architecture, security, and business teams to translate requirements into reliable solutions. Establish standards for AI evaluation, obse

Become a part of our caring community The Actuarial Analyst 2, Analytics/Forecasting supports value-based initiatives within the HealthCare Economics team, partnering across actuarial, finance, analytics, and business teams to develop actionable financial insights and forecasting solutions. This role will play a key part in the design and development of a holistic modeling solution, building new methodologies and frameworks from the ground up to support performance measurement, financial reconciliation, and strategic decision-making across multiple value-based care programs. You work assignments are varied and frequently require interpretation of complex business issues, independent judgment, and the ability to recommend and execute appropriate courses of action with limited guidance. The Actuarial Analyst 2, Analytics/Forecasting will be responsible for analyzing and forecasting claims and revenue trends, developing innovative forecasting methodologies, and translating complex business requirements into scalable analytical solutions. This individual must be able to independently evaluate data, identify gaps, propose holistic approaches, and develop end-to-end solutions that integrate financial, operational, and claims-based insights. Responsibilities include designing forecasting methodologies, establishing reporting metrics, validating model results, and supporting the evolution of value-based care analytics. You will understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. You will make decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Use your skills to make an impact Required Qualifications Bachelor's Degree Successful completion of

Become a part of our caring community The Senior Portfolio Enablement Lead is a strategic portfolio transformation role responsible for shaping and enabling Humana's portfolio operations, Agile Release Train (ART) design, and Ways of Working across the portfolio. Acting as a trusted advisor to senior executives (SVPs, VPs, and portfolio leaders), the role translates transformation strategy into scalable execution by diagnosing portfolio delivery challenges, guiding organizational design, and improving alignment, flow, and value delivery. As a Senior Portfolio Enablement Lead, you will: Partner with portfolio and organization leadership to develop and enable portfolio, aligned to enterprise portfolio operations to achieve portfolio initiatives their outcomes. Perform quantitative and qualitative assessments, including stakeholder analysis and change impact assessments, to develop data-driven change strategies for key stakeholder groups. Build and manage portfolio transformation roadmaps to drive executive buy-in and sponsor engagement across technology and business/product leadership and leadership to drive understanding and adoption of key changes Develop Release Train Engineers to our Humana Ways of Working and enterprise tooling subject matter experts for Agile Release Trains and Scrum Teams Measure effectiveness of change interventions through defined metrics and continuously evolve plans to optimize adoption outcomes Regularly report activity status to organizational, portfolio and transformation leadership; proactively escalate and help resolve risks and issues Partners with leaders to align all continuous improvement goals and objectives Partner with Release Train Engineers in the portfolio to monitor activity level of continuous improvement, adoption of Humana Ways of Working, risks patterns

Become a part of our caring community We are seeking a highly experienced Lead Full Stack Engineer to drive engineering excellence across front-end, back-end, API, and data layers. This role is responsible for setting technical direction, ensuring consistent delivery across teams, and aligning engineering solutions with business priorities. The ideal candidate will be a strong technical leader who thrives in complex environments, drives modernization initiatives, and develops high-performing engineering talent. This role offers the opportunity to shape the future of our engineering landscape, influence enterprise-scale decisions, and lead transformation initiatives that directly impact customer experience and business growth. Location : Louisville, KY or Dallas, TX (Work At Home with occasional office visits) Key Responsibilities Engineering Leadership & Strategy Lead full stack engineering strategy and execution across UI, APIs, and data platforms Define architectural direction and ensure high standards for code quality, scalability, and maintainability Select frameworks, languages, and platforms across front-end, back-end, APIs, and data layers Approve architectural patterns (monolith vs. microservices, cloud strategy, and integrations) Identify opportunities to refactor, modernize, or retire legacy systems Delivery Execution & Prioritization Drive consistent delivery across multiple engineering teams through: Sprint planning and execution Dependency management Risk mitigation Removal of technical and organizational blockers Prioritize feature development, platf

Become a part of our caring community The Director, Provider Solutions Engineering devises an effective strategy for executing and delivering on IT business initiatives. We ask that you have an in-depth understanding of how organization capabilities interrelate across the function or segment. The Director, Provider Solutions Engineering serves as the strategic technology leader responsible for defining Humana's Provider engagement and engineering. In partnership with business and operational teams, this role is responsible to identify and implement strategic technology solutions that improve provider engagement, associate effectiveness, and business outcomes. The Director collaborates across a highly matrixed organization to establish technology strategy, drive large-scale transformation initiatives, and deliver modern customer relationship management capabilities that support the end-to-end provider experience. This leader is accountable for translating business priorities into actionable roadmaps, driving execution excellence, strengthening engineering discipline, and ensuring technology investments align with enterprise architecture, regulatory requirements, and organizational objectives. The role is responsible for establishing the future-state Provider engagement vision, accelerating AI-enabled capabilities, modernizing technology platforms, and fostering a high-performing engineering culture that consistently delivers measurable business value. Key Responsibilities Technology Leadership Serve as the strategic technology leader for Provider engagement and related provider experience capabilities. Partner effectively within a matrixed organization to align business priorities, regulatory requirements, architecture standards, and technology investments. Provide strategic dir

Become a part of our caring community As a Medical Assistant, you will be a part of the Clinical Care Team engaging with our patients to develop lifelong well-being and health. The Medical Assistant role makes a difference in the patient care we offer and assists physicians and other clinicians by providing a unique blend of skills to perform prescribed medical treatment. Medical Assistants are multiskilled health professionals responsible for performing administrative and clinical tasks in our primary care facilities while delivering outstanding customer service and maintaining positive patient engagement. Location : CenterWell Senior Primary Care Poinciana office address: 1050 Cypress Parkway; Kissimmee, FL 34759 Medical Assistant Job Tasks: Perform pre-visit planning based on patient visit type Manage the provider's schedule to ensure efficient workflow Obtain and record medical history and vital signs Room patients and assist healthcare providers with medical procedures and treatments Perform specimen collection and point of care testing Prepare and administer medications under the direction of healthcare providers Ensure accurate documentation in the electronic health record (EHR) and electronic medical record (EMR) systems, including documentation of HEDIS and Stars quality measures Maintain established quality control standards Use your skills to make an impact Additional Information Required Successful completion of MA school/training program or a Certified/Registered Medical Assistant or 5&#43; years of experience and approval from Provider High school diploma or equivalent CPR Certified Bilingual proficiency in English and Spanish - must pass proficiency exam befo