[Remote] Medicaid Product Manager - Clinical Intake at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor’s degree or 2+ years of relevant work experience
2+ years of experience in product management, operations, or process improvement – Preferably in Medicaid or healthcare delivery
Experience with product intake or portfolio management tools (Jira, SmartSheet, Sharepoint), process governance, and stakeholder engagement in regulated environments

Responsibilities

Develop and manage the Clinical operations intake process using Agile product tools
Capture and validate requests from cross-functional teams, ensuring submissions meet Medicaid-specific documentation guidelines
Facilitate governance reviews and decision-making forums to evaluate requests against capacity and strategic alignment
Translate approved requests into actionable work items for product delivery teams
Monitor process performance metrics (cycle time, volume, backlog, market satisfaction) and identify opportunities for improvement
Ensure the intake process maintains alignment with Medicaid business priorities and enterprise portfolio standards
Drive communication and visibility of intake status and decision outcomes across stakeholders

Skills

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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