Job Overview
Location
Remote Nationwide
Job Type
Full-time
Category
Human Resources
Date Posted
July 10, 2026
Full Job Description
đź“‹ Description
- • The Medical Economics Principal analyzes healthcare cost, utilization, and outcomes data to inform strategies that improve affordability and quality of care.
- • The Principal, Medicaid Medical Economics & Cost Management plays a dual role: a critical leadership role responsible for translating medical economics insight into disciplined execution across clinical, behavioral health, and pharmacy cost initiatives; and leadership role overseeing the Medicaid Corporate Trend process from a business perspective partnering with Finance & Actuary.
- • Key Responsibilities:
- • Initiative Tracking & Project Management: Lead and track specific clinical, BH, and Rx cost management initiatives across the Medicaid portfolio.
- • Medical Cost Management Strategy: Develop, represent, and integrate a medical cost management plan into annual and multi-year business plans.
- • Business Partnership with Finance: Act as the primary business partner to Finance, translating clinical and operational insights into actionable financial impact.
- • Data-Driven Analysis: Analyze historical, predicted, and competitive market data to recommend benchmarks and KPIs.
- • Continuous Improvement: Research industry standards, vendor solutions, and build requirements for internal solutions.
- • Medical Economics Trend Oversight:
- • Trend Stewardship: Lead as business accountability champion for quarterly reviews with Trend Stewardship Committee.
- • Enterprise Accountability: Hold shared enterprise domain owners accountable for medical cost, utilization, and quality targets.
- • Stakeholder Engagement: Build strong relationships with Market Presidents, Medical Directors, Clinical Strategy, Operations, Finance, and other key stakeholders.
- • Reporting & Governance:
- • Reports to senior executive leadership.
- • Supports governance forums and committees (e.g., Trend Stewardship Committee).
- • Ensures all work adheres to Humana’s compliance, data stewardship, and security standards.
🎯 Requirements
- • Bachelor’s degree in Economics, Statistics, Public Health, Healthcare Administration, or related field.
- • 10+ years of healthcare industry experience (payer, medical economics, analytics, cost management, or related).
- • Demonstrated experience leading cross-functional teams and executing complex, large-scale transformation initiatives.
- • Advanced analytic acumen; proficiency in Excel and data visualization tools.
- • Strong understanding of healthcare reimbursement models, managed care, and principles of medical cost management.
🏖️ Benefits
- • Competitive benefits that support whole-person well-being.
- • 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.
Skills & Technologies
See exactly how your profile matches this role — strengths, skill gaps, and what to do about them.
About Humana Inc.
Humana Inc. is a for-profit health and well-being company headquartered in Louisville, Kentucky. Founded in 1961, it provides health insurance, Medicare Advantage plans, Medicaid services, pharmacy benefit management, and clinical care through primary care centers. Serving millions of members across the United States, Humana focuses on integrated care delivery, home health, and wellness programs aimed at improving health outcomes and reducing costs for individuals, employers, and government partners.
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