Medicaid Configuration Product Owner – Remote

Humana; Illinois; Remote; USD 95,000 - 131,000; Full time

Job summary

Humana is seeking a Senior Configuration Professional to lead Medicaid-related product capabilities, backlog, and implementation support within care management platforms. You will partner with Medicaid market leaders, clinical operations, and Agile teams to translate business needs into actionable requirements and ensure compliant, value-driven solutions.

You will own backlog prioritization, configuration analysis, testing, and deployment, driving optimization of workflows such as assessments,

Qualifications

• Bachelor's degree in Business, Healthcare Administration, Information Technology, Clinical Operations, Computer Science, Engineering, or related field, or equivalent work experience.
• 5+ years experience supporting healthcare technology platforms, preferably in a Product Owner, Business Analyst, Product Manager, Configuration Professional, or similar capacity.
• Hands-on experience with GuidingCare, Epic, or comparable care management, utilization management, case management, or population health platforms.
• Strong understanding of Medicaid care management, utilization management, case management, prior authorization, member engagement, clinical workflows, and operational processes.
• Experience working in Agile delivery environments, including Scrum, SAFe, or similar methodologies.
• Excellent verbal and written communication skills, including the ability to communicate effectively with both technical and non-technical audiences.
• Strong documentation skills, including the ability to maintain requirements, decisions, workflows, configuration standards, and operational procedures.

Responsibilities

• Serve as the product owner for Medicaid-related capabilities within the application or comparable care management, utilization management, or population health platform.
• Partner with Medicaid market business leaders, clinical operations, care management, utilization management, compliance, quality, and technology stakeholders to define product vision, roadmap, priorities, and business outcomes.
• Own, maintain, and prioritize the product backlog based on business value, regulatory requirements, operational impact, member experience, configuration complexity, technical dependencies, and implementation readiness.
• Translate business needs into clear features, user stories, acceptance criteria, process flows, functional requirements, business rules, and configuration specifications.
• Lead backlog refinement, sprint planning, requirement reviews, product demos, and stakeholder walkthroughs in partnership with Agile teams, other product owners, business stakeholders, and delivery leaders.
• Lead configuration management activities for Medicaid capabilities, including configuration analysis, design, validation, implementation, documentation, and governance.
• Collaborate with vendor partners and internal technology teams to evaluate configuration options, integrations, enhancements, defects, technical dependencies, release impacts, and operational risks.
• Ensure delivered solutions support Medicaid care management and utilization management workflows, including assessments, care plans, authorizations, referrals, case management, interdisciplinary care team activities, member engagement, and reporting needs.
• Partner with compliance and regulatory stakeholders to ensure system functionality aligns with Medicaid state, federal, contractual, audit, accreditation, privacy, and security requirements.
• Configure, validate, test, and deploy system changes in accordance with approved change management, release management, and governance processes.
• Support implementation planning, release readiness, production validation, post‑release adoption, and operational stabilization activities.
• Analyze operational data, user feedback, production issues, defects, configuration gaps, and process inefficiencies to identify opportunities for product and platform optimization.
• Facilitate cross‑functional decision‑making and help resolve competing priorities using a value‑driven and risk‑informed approach.
• Support change management, training, communications, stakeholder readiness, and adoption activities for new or enhanced Medicaid capabilities.
• Monitor product performance, adoption metrics, configuration quality, incident trends, and business outcomes to ensure solutions meet stakeholder and operational needs.
• Identify risks, dependencies, impediments, and configuration impacts early, and work with delivery leadership and business partners to drive resolution.
• Maintain strong documentation of business rules, requirements, configuration decisions, workflows, acceptance criteria, version histories, operational procedures, and product changes.
• Develop and maintain configuration baselines, reusable templates, controls, documentation standards, and process improvement recommendations.

Skills

Product ownership

Stakeholder management

Agile execution

Documentation

Education

Bachelor's degree or equivalent

Job description

Humana is seeking a Senior Configuration Professional to lead Medicaid-related product capabilities, backlog, and implementation support within care management platforms. You will partner with Medicaid market leaders, clinical operations, and Agile teams to translate business needs into actionable requirements and ensure compliant, value-driven solutions.

You will own backlog prioritization, configuration analysis, testing, and deployment, driving optimization of workflows such as assessments,