Humana

Medicaid State Technology Lead

San Antonio, Texas, United States

Not SpecifiedCompensation
Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Health Insurance, Information TechnologyIndustries

Employment Type

Full time

Role Overview

Become a part of our caring community and help us put health first. The State Technology Lead understands departmental and IT organizational strategy and operating objectives, including their linkages to related areas. They build partnerships between IT, state markets, implementation teams, and horizontal partners. In ambiguous situations, they require minimal direction and receive guidance where needed. This role serves as the primary state IT implementation contact and works closely with the Market CIO, IT Readiness team, IT Program team, Test Leads, and Technology Solution Professionals.

Key Responsibilities

  • Accountable for understanding the priorities of all delivery for their assigned state, supporting the business goals of the Medicaid IT program.
  • Identifies and implements best practice changes within their organization and across Medicaid IT to drive faster and more streamlined delivery cycles.
  • Coordinates resolution of major initiatives deliverables requiring urgent attention/escalation.
  • Guides state and market implementations, ensuring IT technical requirements are delivered effectively.
  • In conjunction with other Market CIOs:
    • Maintains end-to-end accountability for the ongoing quality control, development, and delivery of IT products and services for their assigned state.
    • Partners with strategy advancement to drive initiatives such as vendor RFPs, innovation pilots, and test/learn efforts.
    • Develops, shares, and leverages best practices across IT.
    • Influences key stakeholders, team members, and peers outside of direct control to deliver optimal solutions aligned with business partner expectations.
    • Conducts executive-level briefings and presents solution recommendations in support of state-level initiatives.
    • Supports Medicaid IT leadership in preparing readiness review materials.
    • Acts as a point of delivery escalation for their respective workgroup.
    • Ensures state leads remain organized and aligned with delivery goals.
    • Guides Medicaid Technology Solutions teams in developing technical process documentation.
    • Produces weekly, monthly, and quarterly Kanban updates for state-level initiatives.
    • Partners with business teams to ensure implementation go-live activities are transitioned smoothly to markets.
    • Works with the Test Lead to develop plans of action for testing new technology products, including identifying areas to be tested and designing targeted test strategies.
    • Works closely with implementation teams to promote responsible, high-quality testing practices.
    • Guides the testing team in developing test plans and strategies for implementations, setting priorities and direction for testing activities.
    • Builds strong working relationships with cross-department teams and demonstrates excellent interpersonal, written, and oral communication skills.
    • Identifies opportunities for implementation, testing, or IT process improvements that deliver measurable value.
    • Provides direct or indirect oversight of test leads and technical solution professionals.
    • Offers matrixed oversight of IT Program Managers to ensure new state implementations and existing market capabilities are delivered on time, within budget, and with high quality.

Required Qualifications

  • Bachelor’s degree in healthcare administration, public health, information systems, business, policy administration or related field; work experience may meet this need.
  • 5+ years managed care experience.
  • 5+ years in Medicaid program implementation or healthcare operations, with demonstrated leadership of complex, multi-disciplinary projects.
  • Solid understanding of payor operations, technology, communications, and processes.
  • Solid understanding of healthcare operations, particularly around claims processing, enrollment, provider data management, and clinical operations; Medicaid preferred.
  • Comprehensive understanding of a Medicaid Managed Care architecture, tools, utilities, and processes utilized to deliver on core competences.
  • Delivery focused – time, budget, and quality.

Skills

IT strategy
Stakeholder management
Project management
Vendor management
RFP process
Quality control
Delivery management
Problem-solving
Executive communication
Medicaid IT

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.

Land your dream remote job 3x faster with AI