Humana Logo

Humana

Claims Senior Business Analyst

Posted 2 Hours Ago
Remote
Hiring Remotely in United States
81K-110K Annually
Senior level
Remote
Hiring Remotely in United States
81K-110K Annually
Senior level
Lead stakeholder discovery and data-driven analysis for claims processes. Translate findings into system requirements, value propositions, business cases, and roadmap inputs. Document processes and requirements, perform cost-benefit and ROI analysis, partner with cross-functional teams, and communicate insights to influence decisions and support implementation.
The summary above was generated by AI
Become a part of our caring community
 
The Claims Senior Business Analysis performs analysis of business, process and user needs, documentation of requirements, cost/benefit analysis and translation into proper system requirement specifications. This position will work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Exercises considerable latitude in determining objectives and approaches to assignments.

Key Responsibilities: Discovery, Analysis, & Determining the Value Proposition

  • Lead customer and stakeholder discovery activities (e.g., interviews, usability testing, feedback analysis) to uncover needs, pain points, and opportunities.
  • Analyze customer needs, stakeholder expectations, and relevant data to understand value drivers.
  • Define discovery objectives and scope aligned to product strategy, customer outcomes, and business goals.
  • Translate analytical insights into a clear and compelling value proposition.
  • Partner with stakeholders (engineering, design, marketing, sales, operations) to align product vision, scope, and delivery with the value proposition.
  • Quantify value through business cases, cost–benefit analysis, and ROI assessments.
  • Ensure alignment between the value proposition and organizational strategy and goals.
  • Translate discovery insights into actionable outcomes such as product deliverables, roadmap inputs, and value propositions.
  • Collaborate with cross-functional partners to validate assumptions and support decision-making.
  • Communicate the value proposition effectively to diverse stakeholders.
  • Communicate findings clearly to leadership and teams to support alignment and decision‑making.

Use your skills to make an impact
 

Required Qualifications

  • Minimum 2 years of experience adjudicating claims data and completing data analysis using CAS
  • Working knowledge of ad-hoc query tools and data repositories that support data extraction and manipulation
  • Experience partnering with stakeholders (engineering, design, marketing, sales, operations) to align product vision, scope, and delivery with the value proposition.
  • Experience translating data into presentable information to influence decisions and priorities
  • Experience analyzing processes to identify recommended solutions or re-engineering
  • Demonstrated experience with process documentation, including the use of Microsoft Office applications including Word, Excel, Access, PowerPoint, and Visio

Preferred Qualifications

  • Bachelor's degree
  • Six Sigma certification
  • PMP certification

Additional Information

  • Hours for this position are based on EST or CST.

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.


 

$80,900 - $110,300 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.

Application Deadline: 07-23-2026
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.


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.

Similar Jobs

7 Minutes Ago
Remote or Hybrid
USA
115K-160K Annually
Senior level
115K-160K Annually
Senior level
Cloud • Computer Vision • Information Technology • Sales • Security • Cybersecurity
Lead deployment, configuration, optimization, and operational support of CrowdStrike Falcon AI/ML detection and response capabilities. Tune ML models, build automation playbooks, develop scripts using Falcon APIs, integrate AI features with customer toolchains, support incident response and threat hunting, deliver customer workshops, and mentor team members. Travel up to 25%.
Top Skills: AIFalcon ApisLinuxmacOSMachine LearningMS OfficeWindows
7 Minutes Ago
Remote or Hybrid
WA, USA
86K-135K Annually
Senior level
86K-135K Annually
Senior level
Cloud • Computer Vision • Information Technology • Sales • Security • Cybersecurity
Manage and execute enterprise SaaS renewal processes to protect and grow ARR. Collaborate with field sales on renewal strategy, negotiate commercial terms, convert renewals to flexible offerings, forecast renewals risk, and own contract and subscription management operations.
Top Skills: ExcelSalesforce CpqSalesforce
16 Minutes Ago
Remote or Hybrid
115K-140K Annually
Senior level
115K-140K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Machine Learning • Analytics • Biotech • Generative AI
Lead technical product management for clinical genetics software: gather and document requirements, create JIRA tickets, manage SDLC delivery, coordinate QA/validation, communicate status to stakeholders, and drive solutions with technical leads.
Top Skills: DatabaseJIRASQL

What you need to know about the Los Angeles Tech Scene

Los Angeles is a global leader in entertainment, so it’s no surprise that many of the biggest players in streaming, digital media and game development call the city home. But the city boasts plenty of non-entertainment innovation as well, with tech companies spanning verticals like AI, fintech, e-commerce and biotech. With major universities like Caltech, UCLA, USC and the nearby UC Irvine, the city has a steady supply of top-flight tech and engineering talent — not counting the graduates flocking to Los Angeles from across the world to enjoy its beaches, culture and year-round temperate climate.

Key Facts About Los Angeles Tech

  • Number of Tech Workers: 375,800; 5.5% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Snap, Netflix, SpaceX, Disney, Google
  • Key Industries: Artificial intelligence, adtech, media, software, game development
  • Funding Landscape: $11.6 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Strong Ventures, Fifth Wall, Upfront Ventures, Mucker Capital, Kittyhawk Ventures
  • Research Centers and Universities: California Institute of Technology, UCLA, University of Southern California, UC Irvine, Pepperdine, California Institute for Immunology and Immunotherapy, Center for Quantum Science and Engineering

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account