Key skills
Claims data adjudicationCAS (Claims Analysis System)Ad-hoc query toolsData extraction and manipulationStakeholder partnershipData presentation for decision makingProcess analysisProcess documentationMicrosoft WordMicrosoft ExcelMicrosoft AccessMicrosoft PowerPointMicrosoft VisioLeadershipUsability TestingSales
About this role
Humana Inc. is a leading U.S. healthcare company that focuses on delivering care and service to millions of people. The Claims Senior Business Analyst will perform business analysis, documentation of requirements, and translation into system specifications, working on moderately complex to complex issues.
Responsibilities:
- 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
Requirements:
- 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
- Bachelor's degree
- Six Sigma certification
- PMP certification