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The Associate Vice President, Specialty Core Administration Platforms, will lead the technology strategy and implementation for Specialty product core systems (including claims processing and payment as well as all-inclusive platforms that wrap in broader functionality such as product, enrollment and so forth) covering Humana’s Dental and Vision plans across both Individual and Group lines of business. This position requires an individual with a thorough understanding of health plan operations and how to support these operations with technology, given that the role will be asked to balance continuing ongoing business with the legacy mainframe systems of today while implementing the innovative cloud and SaaS-based platform of the future. The individual in this role will have frequent interaction with and be accountable to the senior leaders of Humana’s Specialty line of business, where the Dental and Vision plans cover over 11M members and account for nearly $1Bn in annual revenue today with additional groups and growth signed for the future.

Join Humana’s Specialty Insurance technology team and leverage your skills and to ensure our members receive the right dental and vision care! The Associate Vice President, Specialty Core Administration Platforms partners with the operational leadership of the Specialty line of business to formulate a future technology strategy and then drives the implementation of core technology, primarily focusing on claims adjudication and payment but also extending into adjacent areas of membership and provider data and downstream data strategies. This position requires an individual with a thorough understanding of health plan operations and how to support these operations with technology, including the modernization of legacy technology platforms. The AVP, Specialty Core Admin Platforms will be tasked with continuing to support ongoing business operations on today’s platforms while implementing the systems of the future, including both commercial and in-house developed systems in a combined cloud and SaaS-based ecosystem.

Key Responsibilities

• Technology Strategy & Planning: Develop and execute a strategic technology roadmap that balances legacy platform management to support ongoing business with a rapid transition to a modern core administration platform that will support specialty business and, ideally, other business lines going forward.

• Technology Leadership: Provide executive level oversight to ensure the reliable operation, optimization and compliance of current technology systems that provide access to care for 11M dental & vision members.

• Project Management: Lead the rapid implementation, integration and adoption of a new specialty core platform, ensuring a seamless migration of this high-visibility effort on tight timelines while minimizing disruption to current business operations.

• Business Case & Financial Acumen: Integrate business ROI with technology solutions, making informed decisions that align with the company's financial goals and deliver the needed solutions within budget.

• Compliance: Ensure adherence to regulatory requirements, working closely with CMS, state and contractual guidelines to maintain compliance in specialty projects.

• People Management: Lead a significant team with a focus on employee satisfaction, professional development, and performance management, including maintaining needed legacy skillsets while developing the new skills needed to transition the team along with the technology.

• Innovation: Ability to analyze complex technical and operational issues and develop innovative solutions. Drive continuous improvement and innovation within the core administration IT department, staying abreast of emerging technologies and industry trends.

• Business Partnership: Team-oriented approach with a focus on collaboration and partnership across departments – be seen as the trusted partner for business operations.

• Tracking Success: Monitor and report key performance indicators for both legacy and modern platforms, providing actionable insights and executive recommendations.

• Vendor Management: Oversee vendor selection, contract negotiations, and ongoing management for outsource and global technology partners on both labor and software.

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s degree (or equivalent) in Computer Science, Information Technology, Engineering or a comparable technical discipline.

• 10+ years of progressive technology leadership experience, with a demonstrated ability to build high performing teams including attracting, developing, and retaining key technical talent.

• Proven track record (5+ years) of leading teams through complex transformation initiatives in a highly regulated environment, including migration from legacy to new platforms and delivering high-visibility programs within tight timelines.

• Deep understanding of core health plan operations, including claims, enrollment, billing, and provider management processes with an ability to see the bigger picture and build a path to a stronger future.

• Excellent business acumen, communication, and change management skills; able to influence across all levels of the organization and be seen as a key partner to operations.

• Extensive experience in strategic planning, budgeting, allocation and vendor negotiations / management, including outsourcing and offshoring for select activities.

Preferred Qualifications

• Master’s degree (or equivalent, including equivalent work experience) in Computer Science, Engineering, Business, Healthcare Administration, or related field.

• Proven capability of delivering in a highly matrixed environment, leveraging and holding accountable cross-functional and outsourced teams for DevOps, Architecture, Security and other key functions.

• Familiarity with Humana’s technology platforms and governance frameworks.

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.

 

$189,400 - $260,500 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, volunteer time off, 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 at Humana.com and at CenterWell.com.

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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, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.