Humana

Role Description The Vice President Enterprise Risk Management (ERM) is responsible for rebuilding and leading a best-in-class ERM program in a complex healthcare environment. This executive will be accountable for designing the risk management strategy, reestablishing organizational capabilities, and overseeing a hybrid staffing model that includes internal and outsourced risk management services. The VP, ERM will drive enterprise-wide engagement to ensure effective risk identification, mitigation, and monitoring across all aspects of the organization. This executive works collaboratively with senior leadership, business units, and functional teams to embed a strong risk management culture and to develop and maintain frameworks, policies, and procedures that support effective risk governance. Responsibilities - Lead the transformation and modernization of the ERM function, building new processes, structures, and tools aligned with enterprise objectives. - Reassess existing risk management frameworks, policies and tools to enhance visibility, agility and accountability across the organization. - Drive a strategic program that is proactive in monitoring and analyzing trends, identifying risks (threats and opportunities) and developing actionable insights or impacts to Humana’s objectives, growth and reputation. - Build and establish a proactive risk and resilience program that is adopted across Humana and drives value. - Champion and promote a risk-aware culture throughout Humana, aligning Humana’s strategy with ERM’s objectives and risk appetite. - Establish an ERM roadmap, including program milestones, technology implementation, and staffing strategy. - Monitor changes in the regulatory environment and ensure the organization’s risk management practices are compliant with federal, state, industry and COSO requirements. - Enhance integrated risk reporting for executive leadership, the board and key governance committees, using dashboards, key risk indicators, and risk heat maps. - Partner closely with internal audit, compliance, legal, operational risk, IT and business partners to ensure a coordinated and risk-aware culture. - Build and manage a high-performing ERM team using a hybrid model of internal staff and the selected outsourced provider. - Collaborate closely with outsourced provider to ensure adherence to service-level agreements and performance standards. - Foster a collaborative, high-accountability environment where both internal and external staff contribute to program maturity. - Establish and lead effective enterprise risk management committee governance and reporting, providing valuable reporting and insights to the leadership team and Audit Committee. - Ensure process and tools are established to identify risk themes and effectively communicate and escalate those to leadership as applicable. - Present risk findings and recommendations to executive leadership and the Audit Committee. - Lead risk assessment activities, including risk identification, prioritization, and the establishment of risk appetite and tolerance levels. - Facilitate scenario planning sessions with key stakeholders. - Champion the development and execution of risk education and awareness programs across the enterprise to embed risk awareness into daily operations. - Develop a governance structure for approvals and oversight of new projects (transformation, systems, processes, etc.). Lead execution of the developed governance structure to provide appropriate oversight for alignment with organizational risk tolerance and strategy. Qualifications - Bachelor’s Degree - Minimum 15 years of progressive risk management or compliance experience within the healthcare industry; minimum of 10 years of leadership experience - Strategic thinker with ability to think “Big Picture” and partner across teams to develop and support best-in-class risk solutions to protect and drive value. - Proven success in rebuilding or maturing an ERM function and managing outsourced or co-sourced teams. - Strong knowledge of healthcare regulations, quality and safety principles, and payer-provider risk arrangements. - Excellent strategic thinking, change management, stakeholder engagement and communication skills. - Familiarity with GRC tools and risk analytics platforms. - Able to challenge the status quo constructively and positively, leading relevant strategies. - Strong written and verbal communication skills, with ability to read and understand regulatory communications, able to effectively articulate compelling arguments, positions, strategy and vision. - Strong enterprise mindset, financial acumen, and customer centricity to navigate complexity and support the broader growth aspirations of the business, leverage strategic analysis of data to inform business making decisions. - Demonstrated ability to transition between strategic and operational aspects to deliver on growth, driving innovation/change to improve the business model. - Demonstrated critical thinker that can offer innovative solutions. - Exceptional written, oral, interpersonal, and presentation/communication skills and the ability to effectively interface with senior management and team members. - Strong process improvement skills and demonstrated ability to influence and optimize processes to drive business synergies and productivity. - Excellent judgment and creative problem-solving skills including negotiations and conflict resolution skills. - Individual with enthusiasm and infectious energy to advance new ideas and methods for proactive, forward-looking risk framework that produces results. Requirements - This person would ideally be based in the Midwest or East Coast. Travel is 20-25%. - 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. - While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Application Deadline 07-23-2026 Company Description 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.

Role Description The Actuarial Analyst 1, General provides entry-level actuarial and analytical support for Humana product lines and business areas. This role may support pricing, valuation, forecasting, risk analysis, compliance, operations, and reporting. The Actuarial Analyst 1 supports actuarial work through data analysis, model updates, reporting, documentation, and communication of results. Responsibilities may vary by team and business need. - Compile, validate, and analyze claims, membership, premium, financial, and operational data. - Support pricing, reserving, valuation, forecasting, risk, compliance, and operational analytics. - Assist with actuarial models, spreadsheets, dashboards, reports, and recurring analyses. - Perform reasonability checks, variance analysis, and actual-to-expected comparisons. - Help prepare exhibits, summaries, and documentation for internal reviews, audits, regulatory filings, or business planning. - Document data sources, assumptions, methods, calculations, and results. - Communicate findings clearly to actuarial team members, leaders, and business partners. - Follow actuarial standards, internal controls, confidentiality requirements, and documented procedures. - Manage assigned work priorities, meet deadlines, seek guidance when needed, and escalate unusual results or issues. - Participate in Humana’s Actuarial Professional Development Program and continue progress toward actuarial credentials. Qualifications - Bachelor's degree in Actuarial Science, Mathematics, Data Analytics, or equivalent and less than 3 years of technical experience. - Successful completion of at least 1 actuarial exam. - Meets requirements for Humana's Actuarial Professional Development Program (APDP). - Strong communication skills. - Strong analytical, quantitative, and problem-solving skills. - Must be passionate about contributing to an organization focused on continuously improving consumer experiences. Requirements - To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service 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. - Occasional travel to Humana's offices for training or meetings may be required. Benefits - Humana, Inc. offers competitive benefits that support whole-person well-being. - 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.

• Initiates, negotiates, and executes dental provider contracts and agreements for the organization • Communicates contract terms, payment structures, and reimbursement rates to providers • Analyzes financial impact of contracts and terms • Maintains contracts and documentation within a tracking system • Assists with identifying and recruiting providers based on network composition and needs • Makes decisions regarding own work methods, occasionally in ambiguous situations

Role Description The Medical Economics Principal analyzes healthcare cost, utilization, and outcomes data to inform strategies that improve affordability and quality of care. The Medical Economics Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. The Principal, Medicaid Medical Economics & Cost Management plays a dual role: - A critical leadership role responsible for translating medical economics insight into disciplined execution across clinical, behavioral health, and pharmacy cost initiatives. - Leadership role overseeing the Medicaid Corporate Trend process from a business perspective partnering with Finance & Actuary. Key Responsibilities: - Clinical Strategy Initiative Tracking & Project Management: - Lead and track specific clinical, BH, and Rx cost management initiatives across the Medicaid portfolio. - Synthesize cost, utilization, and outcomes data to drive strategic decision-making, ensure initiative execution, and support enterprise-wide cost management and medical economics strategies. - Project manage best practices to drive execution, measure progress, and ensure timely delivery. - Medical Cost Management Strategy: - Develop, represent, and integrate a medical cost management plan into annual and multi-year business plans. - Collaborate with leaders across Clinical, Pharmacy, Network, Product, and Claims teams. - Business Partnership with Finance: - Act as the primary business partner to Finance, translating clinical and operational insights into actionable financial impact. - Develop and enhance models, metrics, and reports for effective monitoring and communication of cost management outcomes. - Data-Driven Analysis: - Analyze historical, predicted, and competitive market data to recommend benchmarks and KPIs. - Generate insights to guide pricing, reimbursement, and value-based care initiatives. - Continuous Improvement: - Research industry standards, vendor solutions, and build requirements for internal solutions. - Develop new approaches to improve utilization and health outcomes, collaborating flexibly with providers and cross-functional teams. - Medical Economics Trend Oversight: - Lead as business accountability champion for quarterly reviews with Trend Stewardship Committee. - Hold shared enterprise domain owners accountable for medical cost, utilization, and quality targets. - Ensure alignment with Humana’s strategic objectives through robust governance and reporting processes. - Build strong relationships with Market Presidents, Medical Directors, Clinical Strategy, Operations, Finance, and other key stakeholders. - Ensure engagement and consensus for initiative execution and performance monitoring. - Reports to senior executive leadership. - Supports governance forums and committees (e.g., Trend Stewardship Committee). - Ensures all work adheres to Humana’s compliance, data stewardship, and security standards. Qualifications - Bachelor’s degree in Economics, Statistics, Public Health, Healthcare Administration, or related field. - 10+ years of healthcare industry experience (payer, medical economics, analytics, cost management, or related). - Demonstrated experience leading cross-functional teams and executing complex, large-scale transformation initiatives. - Advanced analytic acumen; proficiency in Excel and data visualization tools. - Strong understanding of healthcare reimbursement models, managed care, and principles of medical cost management. - Proven organizational, planning, and prioritization skills. - Highly collaborative mindset, with excellent stakeholder engagement and executive-level communication skills. - Ability to synthesize data into actionable business insights and drive measurable improvements. Requirements - To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service 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. - While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Benefits - Humana provides competitive benefits that support whole-person well-being. - 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.

Role Description The Associate Actuary will support Medicare Market & Provider Finance with a focus on hospital unit cost financial impacts, provider reimbursement analytics, and actual-to-expected cost evaluation. You will develop and maintain analyses that assess hospital contract performance, support unit cost assumption development, and quantify the financial impact of provider and network strategies. You will partner with Network, Provider, Finance, and other cross-functional stakeholders to deliver clear, actionable insights using actuarial methods, claims data, reimbursement assumptions, and analytical tools. The Associate Actuary will report to the Associate Director, Actuarial Analytics/Forecasting. Key Responsibilities - Develop and maintain hospital unit cost analytic models to evaluate provider reimbursement levels, contract performance, and network financial impacts. - Perform actual-to-expected analyses to assess the appropriateness of unit cost assumptions and support assumption refinement. - Quantify financial impacts related to hospital contracting changes, reimbursement updates, and provider-specific assumptions. - Apply actuarial methods and business judgment to support scenario modeling, sensitivity analysis, and financial impact estimates. - Build, validate, and maintain analyses using Excel and other analytical tools, including SQL Server and Databricks. - Develop summarized reporting, dashboards, and executive-ready exhibits, including Power BI reports, to communicate hospital unit cost performance and modeled financial impacts. Qualifications - Bachelor's Degree - Associate of Society of Actuaries (ASA) designation - MAAA - Demonstrated ability to articulate ideas effectively in both written and oral forms - SQL or Python experience - Microsoft Excel experience Requirements - This is a remote position. - To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service 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. - 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. - While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. 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 based upon company and/or individual performance. Benefits - 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 - Many other opportunities Application Deadline 07-31-2026

• Lead Medicaid Clinical Operations, including clinical and nonclinical teams supporting utilization management, care management/service coordination, program operations, process improvement, training, and project execution. • Establish clear operating rhythms, accountability structures, workforce productivity expectations, and performance management processes across distributed clinical operations teams. • Build and sustain an engaged, high-performing leadership culture focused on associate development, retention, operational discipline, and measurable outcomes. • Develop and execute Medicaid clinical operations strategies that support growth, market expansion, state contract requirements, enterprise priorities, and scalable operating model transformation. • Translate clinical strategy, market commitments, and program designs into operational workflows, staffing models, performance targets, and implementation plans. • Oversee Medicaid utilization management and care management/service coordination functions, ensuring consistent clinical practices, regulatory compliance, timely decision-making, and appropriate escalation management. • Strengthen care navigation, member access, provider coordination, and interventions that reduce avoidable utilization and improve health outcomes. • Partner with Product, Technology, Data, Analytics, and Operations teams to translate Clinical Operation’s needs, regulatory requirements, workflow gaps, and performance priorities into clear business requirements, use cases, and solution expectations. • Establish, monitor, and improve key performance metrics, including quality, compliance, cost of care, access, utilization, productivity, service levels, member experience, provider experience, revenue, margin, and client or contract performance commitments.

Role Description The Nurse Clinical Lead reports to, and partners closely with, the National Medical Director, Risk Adjustment and Stars. They support corporate and regional strategies for provider success in Medicare Stars, Risk-Adjustment (MRA), and Interoperability. This individual provides clinical and coding expertise and serves a vital individual contributor role. They provide clinical guidance for programs, policies, and educational materials to optimize provider performance in these domains. - Inform clinical strategy and increase adoption of Humana's Stars, MRA, and Interoperability programs - Serve as a clinical coding expert, which may include working through escalations on coding disputes, policy development or refinement, and coordination and education with providers or Humana associates - Serve as a clinical consultant and subject-matter expert in MRA and Stars across the Quality and Cost Strategy organization - Serve as the first-line clinical resource as appropriate for the MRA, Stars, and Interoperability teams - Co-develop internal and external provider education materials for MRA, Stars, Utilization Management and Trend - Educate and train market associates - Provide Clinical Support to Provider Education, Communication, and Strategy teams - also reporting to the National Medical Director, Risk Adjustment and Stars Qualifications - Registered Nurse (RN) - At least 5 years of clinical experience in a healthcare setting - Medical Coding Certification (CPC or equivalent) - Strong knowledge of Medicare Risk Adjustment - Strong knowledge of Medicare Stars - Significant experience educating and influencing the behavior of healthcare providers - Proven track-record of driving provider practice improvement, including in MRA and Stars - Exceptional communication and interpersonal skills with the ability to quickly build rapport at all levels within an organization 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. - While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Benefits - Humana, Inc. and its affiliated subsidiaries offer 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. - 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 - Many other opportunities

• Design and deliver end-to-end user experiences for Humana’s medical benefits products and services • Collaborate with product, engineering, marketing, analytics, and research partners to identify opportunities and develop innovative solutions • Utilize user research, usability testing, analytics, and member feedback to inform design decisions • Create user flows, wireframes, prototypes, and high-fidelity designs • Advocate for accessibility, inclusivity, and design best practices • Present design recommendations to stakeholders, incorporating feedback and building alignment across teams

• Gather, compile, and verify information and enters it into documents such as reports, presentations or forms; • Provide data entry of provider contacts and documentation into business systems. • Coordinate activities related to annual AFH certifications. • Code and sort documents to be processed or filed. • Respond to, or redirect, routine inquiries from external or internal sources about our company, its activities, or processes. • Perform other routine administrative activities according to our established procedures.

Senior Clinical Pharmacist Location: United States Job Description: Become a part of our caring community The Senior Clinical Pharmacist monitors clinical criteria in order to provide clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM to implement strategies and programs to mitigate cost trend and improve health outcomes. The Senior Clinical Pharmacist work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Clinical Pharmacist develops, maintains, and/or operationalizes preferred drug lists related to coverage, utilization management edits, or clinical coverage policies for pharmacy and medical administered drug products. Conducts analysis on drug utilization trends to evaluate and inform process and build needs. Supports trend management by conducting analysis of drug spend, utilization, and/or approval scenarios. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Use your skills to make an impact Required Qualifications - Pharmacy Degree (PharmD or RPh) from an accredited School of Pharmacy - Must have an active Pharmacist license with the Board of Pharmacy in the appropriate state - Must be passionate about contributing to an organization focused on continuously improving consumer experiences - Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data - Flexible, dynamic personality who works well in a team environment and is also an effective individual contributor Preferred Qualifications - Health Plan experience - Knowledge of Medicaid as it relates to pharmacy - Six Sigma and/or Project Management Professional certification - Pharmacy practice residency or similar pharmacy practice experience - Proficient in Microsoft Applications (Excel, PowerPoint, Word) 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. $126,300 - $173,700 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. 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.