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

Are you passionate about transforming healthcare technology? Humana is seeking a visionary leader with deep expertise in the EDS Claims Adjudication platform and CA Gen to play a pivotal role in our Specialty Platform Modernization effort. Join us in reimagining how specialty claims are adjudicated for millions, driving innovation and operational excellence.

Why This Role Is Exciting:
Shape the Future: Be at the forefront of a multi-year modernization initiative, guiding Humana’s transition from legacy platforms to cutting-edge solutions.
Strategic Impact: Your insights and leadership will directly influence enterprise architecture, system reliability, and the member experience.
Cross-functional Collaboration: Work closely with high-performing teams in business, IT, and architecture—your expertise will be recognized and valued.
Challenge & Growth: Tackle complex, high-visibility challenges and be empowered to introduce best practices, new technologies, and streamlined processes.
Professional Development: Join a culture of learning and innovation, with opportunities to mentor, upskill, and expand your influence across Humana’s technology ecosystem.
Purpose-driven Mission: Make a real difference in the lives of our members by enhancing specialty benefits and claims efficiency.

Key Responsibilities:

• Serve as a subject matter expert for EDS Claims Adjudication, leading analysis, solution design, and implementation for modernization projects.
• Apply advanced CA Gen knowledge to support integration, migration, and optimization of legacy systems.
• Partner with business leaders and technical teams to define strategic requirements and deliver impactful system enhancements.
• Drive quality through code reviews, troubleshooting, and performance improvement initiatives.
• Document processes, develop technical specifications, and contribute to planning and resource management.
• Mentor and empower colleagues in claims adjudication and modernization best practices.
• Stay current with healthcare, technology, and regulatory trends to inform platform strategy.

Use your skills to make an impact
 

Required Qualifications:

• Bachelor’s degree or equivalent experience in Computer Science, Information Technology, or related field.
• 5+ years of hands-on experience with EDS Claims Adjudication platform.
• Deep expertise in CA Gen (COOL:Gen/IEF), with a proven record of legacy system transformation.
• Experience in healthcare, insurance, or large-scale modernization initiatives.
• Excellent analytical, problem-solving, and communication skills.

Preferred Qualifications:

• Specialty benefits system experience.
• Familiarity with cloud, APIs, microservices, and modern technology stacks.
• Agile/Scrum experience.

Additional Information

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.

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.
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.

 

$106,900 - $147,000 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.