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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.
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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.
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 yearThis 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 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.
