Senior Configuration Professional

Humana Inc; Kentucky; Híbrido; USD 95.000 - 131.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Paid time off

Descripción de la vacante

Humana Inc. is seeking a Senior Configuration Professional to lead Medicaid-related product capabilities and backlog management within our care management platform.

You will partner with Medicaid market leaders, clinical operations, and IT teams to define vision and translate requirements into actionable features. Responsibilities include prioritizing the backlog, guiding Agile ceremonies, and ensuring configurations meet regulatory and member experience goals.

Formación

• Bachelor's degree in Business, Healthcare Administration, IT, Clinical Operations, Computer Science, Engineering, or related field, or equivalent work experience.
• 5+ years experience supporting healthcare technology platforms, in Product Owner, Business Analyst, Product Manager, Configuration Professional, or similar role.
• 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 in Agile delivery environments (Scrum, SAFe, etc.).
• Ability to manage multiple priorities, dependencies, timelines, and stakeholders in a matrixed environment.
• Excellent verbal and written communication skills for technical and non-technical audiences.
• Strong documentation skills for requirements, decisions, workflows, and procedures.

Responsabilidades

• Serve as the product owner for Medicaid-related capabilities within the care management platform.
• Define product vision, roadmap, and priorities with stakeholders to drive business outcomes.
• Own and prioritize the backlog based on value, regulatory requirements, operational impact, and dependencies.
• Translate business needs into features, user stories, acceptance criteria, and configuration specs.
• Lead Agile ceremonies and stakeholder reviews with teams and delivery leadership.
• Oversee configuration management activities including design, validation, and governance.
• Collaborate with vendor and internal teams on options, integrations, and release impacts.
• Ensure solutions support Medicaid workflows: assessments, care plans, authorizations, referrals, and reporting.
• Comply with Medicaid state/federal requirements and security/privacy standards.
• Configure, validate, test, and deploy system changes per change management processes.
• Support release readiness, production validation, and post-release adoption.
• Analyze data, feedback, and defects to identify optimization opportunities.
• Facilitate decision-making and prioritize initiatives using value and risk.
• Support change management, training, and adoption activities for new capabilities.
• Monitor performance, adoption, and outcomes to meet stakeholder needs.
• Identify risks and impediments early and drive resolutions.
• Maintain documentation of rules, decisions, and baselines.

Conocimientos

Product ownership

Backlog management

Agile methodologies

Stakeholder management

Excellent communication

Educación

Bachelor's degree or equivalent

Herramientas

Jira

Azure DevOps

ServiceNow

Confluence

Rally

Git-based repositories

CI/CD tools

CMDB platforms

Descripción del empleo

Become a part of our caring community The Senior Configuration Professional is responsible for leading Medicaid-related product capabilities, configuration strategy, backlog management, and implementation support within the care management and utilization management platform. This role partners with Medicaid market leaders, clinical operations, care management, utilization management, compliance, quality, technology teams, vendor partners, and Agile delivery teams to define product vision, prioritize work, translate business needs into actionable requirements, and ensure delivered solutions support clinical, operational, regulatory, and member experience outcomes. This position combines senior-level configuration management expertise with product ownership responsibilities, ensuring system capabilities are properly configured, tested, documented, governed, and continuously optimized to support Medicaid care and utilization management workflows.

Key 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.
• Use your skills to make an impact.

Required Qualifications

• Bachelor's degree in Business, Healthcare Administration, Information Technology, Clinical Operations, Computer Science, Engineering, or a 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.
• Ability to manage multiple priorities, dependencies, timelines, and stakeholders in a matrixed environment.
• 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.

Preferred Qualifications

• Experience supporting Medicaid implementations across multiple states or markets.
• Experience supporting clinical operations teams such as care management, utilization management, behavioral health, long-term services and supports, population health, or interdisciplinary care teams.
• Experience with tools such as Jira, Azure DevOps, ServiceNow, Confluence, Rally, Git-based repositories, CI/CD tools, CMDB platforms, or similar Agile, IT service management, and work management platforms.
• Experience with automation, scripting, reporting tools, or infrastructure-as-code concepts.
• Experience supporting enterprise-scale technology transformation, product modernization, platform modernization, or operational improvement initiatives.

Additional Information

Location: Remote 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. $94,900 - $130,500 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 atHumana.comand atCenterWell.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, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, at all levels of employment.