Lead, Medicaid Technology

Become a part of our caring community and help us put health first
 

The Lead for Medicaid Technology is responsible for driving end-to-end technology delivery for Medicaid initiatives. This role ensures successful implementation of use cases across multiple horizontal platform owners, aligning with regulatory requirements and enterprise architecture standards. The leader will serve as the primary technology point of contact for Medicaid, orchestrating cross-functional collaboration to deliver compliant, scalable, and innovative solutions.

Position Overview

The Lead for Medicaid Technology is responsible for driving end-to-end technology delivery for Medicaid initiatives. This role ensures successful implementation of use cases across multiple horizontal platform owners, aligning with regulatory requirements and enterprise architecture standards. The leader will serve as the primary technology point of contact for Medicaid, orchestrating cross-functional collaboration to deliver compliant, scalable, and innovative solutions.

Key Responsibilities

Strategic Leadership

• Own the technology roadmap for Medicaid, ensuring alignment with state and federal mandates.
• Partner with business leaders to translate Medicaid program requirements into actionable technology solutions.
• Ensure state requirements are achievable, and work with the business to influence state requirements when needed.

Cross-Platform Integration

• Coordinate across horizontals (Eligibility, Enrollment, Claims, Provider, Pharmacy, Data Management) to implement Medicaid-specific use cases.
• Drive interoperability between Humana core platforms and vendor systems for seamless data exchange.

Program Delivery

• Lead execution of critical initiatives such as new state requirements and regulatory mandates, ensuring timely delivery and risk mitigation.
• Oversee testing strategies (end-to-end, release, and connectivity) to validate compliance and performance.

Governance & Compliance

• Maintain adherence to Medicaid SMMC contract provisions and regulatory requirements.
• Establish governance frameworks for decision-making, escalation, and metrics tracking across IT workstreams.

Risk Management

• Identify and resolve technology risks impacting go-live timelines (e.g., integration performance, audit file processing).
• Implement contingency plans and communicate status to executive stakeholders.

Innovation & Optimization

Champion modernization efforts, leveraging APIs, cloud capabilities, and data fabric solutions to improve efficiency and scalability.

Use your skills to make an impact
 

Skills & Qualifications

• Bachelor’s degree in Computer Science, Information Systems, or related field; advanced degree preferred.
• 8+ years of progressive IT experience, including direct oversight of large technology implementations.
• Proven experience leading large-scale Medicaid or healthcare technology programs.
• Strong understanding of managed care platforms, eligibility/enrollment systems, and regulatory compliance.
• Expertise in cross-platform integration, interoperability, and data governance.
• Ability to manage complex stakeholder relationships and drive consensus across business and IT teams.
• Proven track record of successful delivery of complex IT initiatives in a regulated environment.
• Excellent communication, stakeholder management, and organizational skills.
• Experience in driving strategic alignment and integrating teams.
• Familiarity with cloud-based architectures and modern API frameworks.
• Understanding of insurance products, benefits administration, and healthcare industry standards.

Additional Information

This role has a hybrid remote workstyle which may require you to work approximately 2 days a week in the office depending on business needs

SSN Alert Statement
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Interview Format
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

WAH Internet Statement
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 recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
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.

 

$117,600 - $161,700 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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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.