Humana

Become a part of our caring community The Senior Process Improvement Professional plays a critical role within the Procurement Systems Optimization team, leading enterprise-wide procurement systems, processes, digital transformation, and AI-driven initiatives across procurement and supplier management platforms. This role requires expertise in digital transformation, AI implementation, governance frameworks, and transformation execution to support sustainable and responsible use of emerging technologies. Align business strategy with technology capabilities, driving operational efficiency, and enabling scalable, intelligent automation through the adoption of advanced analytics and AI solutions. Serve as a bridge between business stakeholders and technology teams to design, implement, and govern innovative solutions that enhance decision-making, streamline workflows, and ensure compliance with enterprise standards. Leads end-to-end transformation efforts across procurement systems (e.g., Zip Intake & Orchestration, Icertis Contract Management, Terzo.ai, SpendHQ, and other emerging platforms such as AI-enabled sourcing tools) to drive optimization, integration, and innovation. Operates with a high degree of autonomy to define business technical approaches, influence strategic direction, and deliver complex initiatives that support enterprise modernization and AI adoption. Accountable for embedding AI capabilities into business processes, ensuring governance, risk management, and compliance standards are adhered to, and enabling a scalable transformation roadmap aligned with organizational priorities. Use your skills to make an impact Required Qualifications Technical Experience Five (5) or more years of technical experience, with expertise spanning a combination of the following areas: Digital transformation and enterprise system modernization. AI/ML solution implementation and lifecycle management. AI governance frameworks (risk, compliance, auditability, and ethical AI). Process analysis, workflow optimization, and intelligent automation. Procurement systems expertise (e.g., Icertis, ZipHQ, Globality, Terzo, SpendHQ, and Oracle). System configuration, integration, and documentation. Strong knowledge of SDLC and Agile delivery methodologies. Procurement AI & Transformation Capabilities Experience and knowledge in a combination of the following Procurement AI and Transformation capabilities: Experience implementing AI solutions in procurement, sourcing, supplier management, and contracting processes. Experience integrating AI into procurement workflows such as Source-to-Contract (S2C). Knowledge of digital transformation in procurement, including automation, digital contracting, and supplier collaboration tools. Ability to identify and scale high-impact AI use cases across procurement (e.g., spend analytics, supplier selection, contract compliance). Ability to align AI initiatives to key procurement goals like savings, compliance, supply continuity, and innovation. Understanding AI risk, governance, and regulatory requirements, including supplier and third-party risk. Familiarity with procurement systems and data (ERP, e-sourcing tools, contract repositories). Soft Skills Executive-level communication and stakeholder influence. Critical thinking and problem-solving mindset. Adaptability and change leadership in complex environments. Preferred Qualifications MBA or advanced degree. Agile/PMP or equivalent project management certification. Experience leading large-scale digital or AI transformation programs. Familiarity with procurement AI platforms (e.g., intake/orchestration, autonomous sourcing, contract intelligence tools). Additional Information Workstyle: This is a remote position. Travel: As-needed travel is required for team engagement meetings and may include travel outside your state of residence. Typical Work Schedule: Monday – Friday; 8:00am – 5:00pm Eastern Time (ET) with some flexibility based on business needs. 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. 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 l

Become a part of our caring community The Director, Consumer Digital Product Operations, oversees the design and execution of transformation strategies that advance organizational priorities and operational excellence. Leads cross-functional teams in identifying opportunities, defining objectives, and implementing initiatives that deliver measurable business impact. Develops transformation frameworks, governance models, and performance metrics to guide execution and accountability. Partners with executives and senior leaders to ensure initiatives are aligned with enterprise strategy and long-term goals. Provides expert consultation and transformation methodologies, organizational design, and change management practices. Oversees resource planning, budget development, and implementation of best practices to achieve sustainable results. Leads development of communications, reporting, and executive updates to share outcomes, insights, and recommendations. Builds a culture of innovation, collaboration, and continuous improvement across departments. Exercises strategic judgment and decision-making to address complex challenges and ensure successful delivery of transformation outcomes at scale. The Director, Consumer Digital Product Operations, is a high-impact leadership role that will help define how the Consumer Digital organization delivers results for customers and the business. This leader will shape and continuously evolve the organization's operating model, establishing the governance, planning processes, tools, standards, and operating rhythms that enable teams to deliver products more effectively and consistently at scale. Working closely with senior leaders across product, technology, design, analytics, and business functions, this individual will bring clarity to decision-making, strengthen accountability, and improve execution across the organization. By translating strategy into practical ways of working, the Director will play a central role in accelerating delivery, improving organizational effectiveness, and creating better experiences for consumers. Beyond product operations, this leader will oversee key organizational operations, including budget management, workforce planning, recruiting, and onboarding, team communications, and the Consumer Digital program management team. The role also serves as a steward of culture and connectivity, helping build the operating discipline, leadership practices, and organizational cohesion needed to support a high-performing and engaged Consumer Digital organization. Use your skills to make an impact The Director, Consumer Digital Product Operations partners with Consumer Digital leaders and cross-functional teams to design, implement, and continuously improve an operating model that enables effective product delivery. The role translates strategy into clear ways of working, practical standards, and scalable operating mechanisms while maintaining a strong focus on customer needs and measurable outcomes. Design and implement the Consumer Digital product operating model, including roles, decision rights, governance, and end-to-end ways of working. Define and maintain practical tools, templates, playbooks, and standards that help teams plan, prioritize, deliver, measure, and improve products consistently. Establish governance and operating forums that clarify ownership, accelerate decisions, surface risks, and strengthen accountability without adding unnecessary process. Lead the organization’s operating cadence, portfolio visibility, communications, and follow-through on priorities and commitments. Own team operations, including budget planning and management, workforce coordination, recruiting and onboarding processes, and organization-wide communications. Drive culture and connectivity across Consumer Digital by strengthening engagement, transparency, collaboration, recognition, and shared understanding of priorities. Lead and develop the Consumer Digital program management team, setting direction, clarifying accountabilities, and ensuring disciplined execution of critical initiatives. Create performance measures and feedback loops to assess adoption and effectiveness of the operating model and identify opportunities for continuous improvement. Advise senior leaders on operating model choices, organizational tradeoffs, execution risks, and opportunities to improve customer and business outcomes. Required Qualifications Bachelor’s degree 8+ years of experience in product operations, digital transformation, enterprise transformation, portfolio management, or a related discipline, including experience designing and implementing operating models in a large, complex organization. Demonstrated experience translating enterprise or business-unit strategy into scalable governance, planning and prioritization processes, decision forums, operating rhythms, tools, templates, and performance measures adopted across multiple teams. Demonstrated ability to lead executive di

Become a part of our caring community Humana is seeking a Manager, Quality Assurance (External LTSS Oversight Team Manager) who will lead a team of Quality Assurance Professionals responsible for ensuring consistency of use and compliance to state and Humana requirements for Long-Term Services and Supports (LTSS) eligibility determination and service authorization. You will collaborate with external partners such as Area Agencies on Aging (AAA) and assist with monitoring day-to-day operational activities with AAAs and other external LTSS partners. You will work within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receive assignments in the form of objectives and determine approach, resources, schedules, and goals. Oversee the External Oversight Team (Quality Assurance professionals and Care Management Support Assistants) staff and monitors compliance to HCBS eligibility determination, service authorization, and other key LTSS compliance or operational metrics as identified. Responsible for planning and overseeing daily operations of team. This includes making decisions related to resources and approach for projects and initiatives involving own departmental area and requires cross departmental collaboration. Conduct briefings, area meetings, and maintains frequent contact with internal and external stakeholders such as other Humana departments. Liaise and maintain frequent contact with external stakeholders and vendors such as Area Agencies on Aging, conducts briefings and area meetings, Develop policies and procedures to ensure compliance with state and federal requirements and incorporate industry best practices. Provide real-time training/re-training to downstream entities on ongoing compliance requirements, policies, and procedures. Support leadership in meeting goals of the department/market. May participate in Interdisciplinary team meetings. Use your skills to make an impact Required Qualifications Must reside in Michigan. An active, unrestricted licensed Registered Nurse (RN) or Licensed Social Worker (LBSW, LLMSW, LMSW) in the state of Michigan. Three (3) or more years of professional experience working with complex populations, home and community-based services or in managed care settings. Two (2) or more years of management or supervisory experience. Comprehensive knowledge of Microsoft Office applications, including Excel, and PowerPoint. Proficiency in analyzing and interpreting data trends. Exceptional oral and written communication and interpersonal skills with the ability to quickly build rapport. Preferred Qualifications Care Management certification (CCM). Three (3) or more years of managed care experience in Medicare and/or Medicaid, specifically in the delivery of care for elderly or special needs populations such as the Aged, Blind and Disabled (ABD) and those enrolled in Long-Term Services and Supports (LTSS) Waiver Services, in hospice and/or in nursing facilities. Proficiency in analyzing and interpreting financial trends. Previous experience in utilization management, discharge planning and/or home health or rehabilitation. Experience with initiating service plans for members. Experience with disease management, health promotion, coaching and wellness. Health Plan experience. Bilingual or Multilingual: English/Spanish, Arabic, Chaldean Neo-Aramaic, or other - Must be able to speak, read and write in both languages without limitations and assistance (see Additional Information for more information on language proficiency assessments). Additional Information Workstyle: This is a remote position that requires some travel. Travel: Up to 25% travel to Humana 's Detroit office for in-person team engagement and collaboration meetings. Typical Workdays and Hours: Monday – Friday; 8:00am – 5:00pm Eastern Time (ET). Direct Reports: Up to 15. Language Proficiency Assessment: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. 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 req

Become a part of our caring community As a RN Care Manager, you will enjoy a true work-life balance with no night or weekend shifts. Reporting to the Manager of Care Coaching, you will support members enrolled in the Wisconsin Family Care Program providing essential care coordination, support, and education. You will make a difference in the lives of those you serve and within your own community. You will support members in any of the following counties- Lincoln, Langlade, Forest, Oneida, Vilas You will: Assess members, focusing on health and safety needs, to develop a comprehensive Member Care Plan (MCP). Conduct regular health assessments Coordinate with acute and primary care providers. Educate members on disease processes and related risks, nutrition, exercise and lifestyle modifications to support informed decision-making while respecting each person's autonomy. Document in member files within required DHS contract timeframes. Participate in member monthly phone contacts and travel to attend in person visits in members setting. Work remotely from your home and travel approximately 40% of the time to visit your members. Use your skills to make an impact Required Qualifications Associate degree in nursing Licensed Registered Nurse in the state of Wisconsin (in good standing) Preferred Qualifications 1 year Care Management experience Reside within 45 mins or less of the assigned coverage area Previous Care Management experience Additional Information Location: any of the following counties: Lincoln, Langlade, Oneida, Forest, Vilas Travel: Up to 40% Typical Workdays/Hours: Monday through Friday, 8:00 am – 4:30 pm CST. Driving This role is part of Humana 's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. Mileage reimbursement is provided for work-related travel. Eligible mileage includes: Travel from your home to your first work location of the day. Travel between client or assignment locations during the workday. Travel from your final work location back to your home. TB Screening This role is considered patient facing and is part of Humana 's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. 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.$71,100 - $97,800 per yearThis 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana . This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.About Humana : Humana Inc. (NYSE: HUM) is a leading U.S. heal