[Hiring] Claims Senior Business Analyst @Humana

Role Description

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.

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.

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.
• Occasional travel to Humana's offices for training or meetings may be required.

Benefits

• Humana, Inc. and its affiliated subsidiaries offer 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.
• 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.