Core Responsibilities

Claims Insight Generation & Root Cause Analytics

• Investigate trends surfaced in claims dashboards and operational metrics to uncover underlying drivers, process failures, policy impacts, and behavioral patterns.

• Lead structured root cause analyses across claim types, product lines, providers, vendors, and workflows.

• Translate complex findings into clear, actionable insights for Claims Operations and executive leadership.

• Proactively surface issues and opportunities without waiting for formal asks — this role is expected to find the problems.

Strategic Advisory & Executive Engagement

• Serve as a trusted analytics advisor to senior Claims, Clinical, and Enterprise leaders.

• Synthesize insights into concise executive narratives, not technical readouts.

• Frame findings in terms of financial impact, operational risk, member experience, compliance, and scalability.

• Support executivedecision‑makingwith scenario analysis, impact sizing, andtrade‑offperspectives.

Advanced Analytics & Tooling (Applied, Not Academic)

• Leverage AI, machine learning, and advanced analytics as tools, not ends in themselves, to accelerate insight generation and pattern detection.

• Partner with data science and reporting teams as needed, whileremainingfocused on problem solving vs. model building.

• Rapidly prototype analyses to test hypotheses andvalidatesignals.

Cross‑FunctionalPartnership

• Collaborate closely with Claims Operations and Technology partners.

• Ensure insights are grounded in real operational context, not abstract metrics.

• Support continuous improvement initiatives and transformation efforts with >

  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.

  
  

  $184,800 - $254,100 per year

  
  

  This 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.Application Deadline: 07-06-2026

  
  About us
  

  About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

  ​
  Equal Opportunity Employer

  It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.