Why This Role is Different
Own the full integration fabric (not just one pipeline or domain)
Move from batch-heavy ecosystems → real-time, event-driven healthcare data
Directly impact Stars, HEDIS, and risk adjustment performance
Build point-of-care experiences inside EMRs, not just downstream analytics
Stand up a COE that scales across the enterprise, not siloed teams
Build the Integration & Interoperability COE
Stand up and lead a centralized COE for integrations, interoperability, and data exchange
Define enterprise standards across:
FHIR-first and API-first architectures
Event-driven patterns (Kafka, streaming, real-time triggers)
Canonical data models across payer + provider domains
Rationalize and modernize legacy integration patterns (ETL, flat files, point-to-point)
Next-Gen Data Ingestion & Exchange
Architect pipelines across:
Claims (837/835), Eligibility (834), Authorizations, Encounters
Clinical data (Epic, Cerner, Athena)
Pharmacy (PBM), labs, ADT feeds, HIE integrations
Enable near real-time ingestion and bidirectional data exchange
Solve for identity, matching, and longitudinal member record creation
Point-of-Care Integration (Where Others Fall Short)
Push insights directly into EMRs:
Care gaps (HEDIS) surfaced during visits
Suspected conditions (HCC) at time of documentation
Utilization signals (ED/IP events) via ADT feeds
Build FHIR APIs, SMART on FHIR integrations, and event triggers that actually get used by providers
Value-Based Care & Quality Enablement
Build data products that influence:
Star Ratings performance (Medicare Advantage)
HEDIS gap closure at scale
Risk adjustment accuracy and recapture
Move from retrospective reporting → prospective, actionable insights
Platform & Architecture Leadership
Design cloud-native platforms leveraging:
AWS / Azure / GCP
Spark, Kafka, Databricks, Delta Lake
Implement:
Data observability (freshness, lineage, quality)
Scalable API layers and microservices
Ensure HIPAA-compliant, secure, governed architectures
Enterprise Influence
Act as a bridge between engineering, clinical, and business teams
Influence roadmap across interoperability, data platforms, and AI
Mentor teams and elevate engineering standards across the org
Required Qualifications
10+ years in data engineering, with deep healthcare experience
Experience at scale in organizations like:
Optum / Change Healthcare
CVS Health / Elevance Health
Proven track record building integration platforms, not just pipelines
Strong expertise in:
FHIR (R4), HL7v2, CCDA, ADT, APIs
Streaming + batch architectures
Hands-on with:
Python / Scala / Java
Spark, Kafka, SQL
Cloud-native data platforms
Deep understanding of:
Claims, clinical, and pharmacy data models
HEDIS, Star Ratings, Risk Adjustment (HCC)
Experience integrating with EMRs and provider workflows
What Will Make You Stand Out
You’ve tried to modernize legacy healthcare integrations—and know where they break
You’ve seen the gap between data platforms and provider adoption
You want to build systems that actually change behavior at the point of care
You’re ready to move from incremental improvements → foundational transformation
Additional Information
Location/Work Style: Remote in Frisco/Dallas, TX area
Work at Home Guidance
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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
Associates 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 associates 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
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.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay 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.
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.
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.