Medicaid Care Ops Product Owner & Configuration Lead

Humana

Virginia Beach (VA)

Remote

USD 95,000 - 131,000

Full time

5 days ago

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Benefits offered by this job

Bonus eligible

Job summary

Humana is seeking a Senior Configuration Professional to lead Medicaid-related capabilities within our care management and utilization management platform. You will own the product backlog, translate business needs into actionable requirements, and partner with clinical operations, compliance, and technology teams to ensure regulatory and member experience outcomes.

Ideal candidates have 5+ years in healthcare technology, experience with care management platforms, and strong agile delivery

Qualifications

Bachelor’s degree or equivalent work experience in a related field.
5+ years supporting healthcare technology platforms, preferably in PO/BA/PM roles.
Hands-on experience with care management platforms (GuidingCare, Epic or equivalent).
Strong knowledge of Medicaid care management, utilization, and clinical workflows.
Experience in Agile delivery environments (Scrum/SAFe).
Ability to manage multiple priorities in a matrixed environment.
Excellent verbal and written communication for both technical and non-technical audiences.
Strong documentation skills for requirements, decisions, and workflows.

Responsibilities

Serve as product owner for Medicaid-related capabilities within the care management platform.
Collaborate with business leaders and tech stakeholders to define product vision and roadmap.
Own and prioritize backlog based on value, regulatory needs, and implementation readiness.
Translate business needs into features, user stories, and configuration specs.
Lead backlog refinement, sprint planning, reviews, and demos with Agile teams.
Configure, validate, test, and govern Medicaid configurations; ensure compliance.
Work with vendors and internal teams on integrations, dependencies, and risks.
Ensure solutions support Medicaid workflows including care plans, authorizations, referrals, and reporting.