Jobs at Humana

Lead discovery, prototyping, and delivery of AI/GenAI products. Define PRDs, build prototypes, scope requirements, run evaluations, partner with engineering/data/design, and shepherd solutions through enterprise AI governance to production.

Defines enterprise AI architecture, technical strategy, standards, and roadmaps while remaining hands-on with prototyping and software development. Designs scalable LLM, retrieval, agentic, orchestration, evaluation, governance, and human-in-the-loop systems. Leads model and vendor decisions, architecture reviews, platform investments, and responsible AI practices across teams. Partners with executives and regulated-industry stakeholders, mentors technical leaders, and ensures secure, reliable, compliant, observable, and cost-effective production AI systems.

Lead the architecture and hands-on development of production AI systems using LLM pipelines, retrieval, agentic workflows, structured outputs, and human review. Establish standards for evaluation, reliability, observability, security, cost, and compliance. Guide technical design across projects, mentor engineers, manage production operations, and partner with product, clinical, and operational stakeholders to deliver scalable, auditable AI solutions in a regulated healthcare environment.

Design, develop, deploy, and operate production AI applications that process clinical documents using LLMs, RAG, agentic workflows, structured extraction, and human-in-the-loop review. Build full-stack services, document pipelines, evaluation frameworks, observability, and cloud-native infrastructure. Optimize systems for accuracy, reliability, scalability, latency, and cost while meeting healthcare privacy, security, compliance, and auditability requirements.

Define strategy and drive delivery for a portfolio of enterprise AI products. Responsibilities include business discovery, AI prototyping, requirements, product execution, evaluation frameworks, solution architecture, governance, responsible AI, executive communication, and cross-functional leadership. The role establishes reusable AI standards, playbooks, and solution patterns while mentoring product leaders and guiding products from concept through production.

Lead development of AI products from discovery through production: define strategy and roadmap, prototype with agentic tools, translate business problems into scoped AI use cases, own requirements and delivery, design evaluation and quality metrics, support solution architecture, lead cross-functional teams, navigate enterprise AI governance, and mentor product managers.

Leads Medicaid member and associate journey mapping and service experience optimization. Develops personas and journey maps, analyzes feedback and engagement data, identifies pain points, and partners with digital, IT, product, and support teams on improvements. Implements experience programs, tracks KPIs, facilitates workshops, leads optimization projects, and shares insights to improve satisfaction, loyalty, retention, and administrative efficiency.

Design and advance Humanas mobile-first member experiences across apps, web, SMS, notifications and emerging channels. Lead end-to-end journey design, apply user-centered research, create accessible interaction and visual designs, and collaborate with product, engineering, research, and stakeholders to drive engagement, adoption, retention, and measurable business outcomes.

Conduct clinical claims review and utilization management for medical services and benefit determinations. Coordinate with providers, members, and other parties; assess medical necessity and appropriateness of care; interpret clinical criteria; document decisions; and communicate determinations. The role requires maintaining RN licensure across multiple states, applying acute-care nursing expertise, navigating multiple systems, protecting PHI, and supporting improved member experiences remotely.

Design, build, and deploy LLM-based applications and multi-step AI workflows (retrieval, orchestration, agents) using large-scale structured and unstructured data. Partner with engineering to productionize solutions, implement evaluation and safety measures, ensure compliance and data governance, and communicate results to technical and non-technical stakeholders.

Review utilization management activities and documentation to ensure policy and regulatory compliance. Collect and analyze outcome and operational metrics, process QIO fast-track appeals and expedited authorizations, make independent determinations, and follow regulatory turnaround times. Work a four-day, 10-hour shift schedule (Wed–Sun or Thu–Sun) in an EST-operating, remote role with strict home-office and internet requirements.

Lead AI-driven reconciliation and automation to improve encounter data quality. Own model performance, identify root causes, partner with technical and business teams to enhance models, prioritize roadmap, and scale automation while communicating results to stakeholders.

Lead the digital product vision and roadmap for mobile-first and responsive experiences. Lead discovery, prioritize investments using analytics and customer insights, drive platform capability evolution, partner cross-functionally with Design, Engineering, Operations and Analytics, and manage delivery, documentation, and success metrics across multiple workstreams.

Manages national partner relationships and develops strategies to grow Humana’s business. Responsibilities include coordinating cooperative marketing initiatives, facilitating partner meetings, analyzing performance metrics, delivering partner webinars and training, communicating enterprise priorities, and representing Humana at meetings and events. The role requires account management or sales strategy experience, health and life insurance licensing, strong analytical skills, and experience with large-scale partners.

Build production-ready AI applications, services, APIs, reusable frameworks, and autonomous agents for enterprise quality engineering. Lead architecture and complex technical initiatives, integrate AI into software development and testing workflows, evaluate emerging technologies, and establish AI governance, security, observability, and development best practices. Partner across engineering, product, security, architecture, and data teams while mentoring engineers and shaping long-term AI strategy.

Designs and develops scalable technical learning solutions supporting Enterprise AI initiatives. Responsibilities include needs analysis, instructional design, SME collaboration, multimedia content creation, assessments, performance support, facilitation, LMS administration, and learning effectiveness measurement. The role applies generative AI and emerging technologies to improve learning design and learner engagement, manages learning projects, and communicates recommendations and outcomes to stakeholders. Remote work is expected, with occasional travel to Humana offices.

Designs and leads AI-focused learning pathways, translating business and performance needs into measurable objectives, assessments, practice opportunities, and performance support. Creates digital, live, virtual, cohort-based, and experiential learning solutions; collaborates with business partners, subject matter experts, vendors, and AI teams; coordinates timelines and dependencies; measures learner and performance outcomes; and develops reusable standards and templates to scale learning design.

Manages TRICARE provider relationships, network adequacy, access to care, stakeholder outreach, and resolution of beneficiary, provider, and government inquiries. Provides guidance on TRICARE policies and the Military Health System, supports provider education and management, and contributes to value-based care pilots and alternative payment methodologies. Maintains compliance, documentation, reporting, and data integrity while independently prioritizing work and collaborating with diverse stakeholders.

Leads enterprise strategy and external partnerships for Humana by identifying growth opportunities, developing business cases, managing executive relationships, measuring partnership performance, and driving cross-functional implementation. Builds strategic recommendations, evaluates financial and market data, influences senior stakeholders, represents Humana externally, and leads a team of strategy professionals. Requires extensive strategy, business development, partnership, leadership, analytical, negotiation, and communication experience.

Develops and executes Humana’s external technology partnership strategy, manages executive relationships and governance with strategic partners, builds investment business cases, and identifies opportunities to improve efficiency, member experience, growth, and innovation. The role leads cross-functional alignment, executive business reviews, strategic roadmaps, innovation pilots, and enterprise initiatives while translating technology capabilities into measurable business value.