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Humana

Sells Medicare health plans and runs senior clinics

Lead Decision Intelligence Engineer

Full-TimeDeadline 10/30/26
$129.3k - $177.8k/yr+ Bonus incentive plan
Expert
Bachelor's
Remote in USA
RemoteOccasional travel to Humana offices for training or meetings may be required.
AI & Machine LearningApplied Machine Learning
No H1B Sponsorship

About the job

Requirements
  • Bachelor's degree in computer science or a related field.
  • At least 8 years of software engineering experience building and operating large-scale production systems, emphasizing data-intensive platforms, recommendation systems, or optimization engines serving millions of users.
  • At least 3 years of hands-on experience implementing reinforcement learning or deep learning systems in production, using policy gradient methods such as PPO or A3C, value-based approaches such as DQN or Q-learning, or offline reinforcement learning algorithms such as CQL or Decision Transformer.
  • Deep familiarity with the Bellman equation, reward shaping, exploration-exploitation tradeoffs, and constraint mapping in real-world reinforcement learning systems.
  • Demonstrated ability to diagnose reinforcement-learning failure modes, including policy collapse, credit assignment issues, and distributional shift across large populations.
  • Proficiency in Python 3.x and experience with PyTorch or TensorFlow for policy network implementation.
  • Experience with Ray RLlib for distributed reinforcement-learning training at scale.
  • Experience with Databricks, PySpark, and Delta Lake for large-scale machine-learning pipelines processing tens of millions of records.
  • Experience with MLflow for experiment tracking, model registry, and artifact management.
  • A track record of shipping machine-learning systems that operate reliably under production load, rather than only in research or prototype settings.
Responsibilities
  • Design, implement, and evaluate reinforcement-learning algorithms suited to long-horizon, sparse-reward healthcare decisioning, including policy gradient methods (PPO, A3C), value-based approaches (DQN, Q-learning), and offline reinforcement-learning methods (CQL, Decision Transformer).
  • Define and maintain the member state representation and action space, evolving them as new programs and data sources are onboarded.
  • Apply the Bellman equation, reward shaping, and constraint mapping to encode clinical eligibility, suppression rules, and program-specific objectives directly into the learning objective.
  • Manage exploration-exploitation tradeoffs appropriate for a production healthcare environment where poorly explored actions have real member impact.
  • Build simulation and backtesting environments to evaluate policy quality before production promotion using historical member journey data.
  • Diagnose and remediate reinforcement-learning failure modes, including policy collapse, credit assignment errors across long member journeys, and distributional shift between training and serving populations.
  • Define reward-threshold criteria and automated evaluation gates within the nightly Databricks training workflow, and block promotion of underperforming policies to MLflow production.
  • Instrument training runs with MLflow tracking of hyperparameters, reward curves, action distribution, and feature importance for every training cycle.
  • Own the nightly Databricks training workflow, including feature engineering from Gold Activity History and Gold Patient Profile, state-vector normalization, distributed reinforcement-learning training via Ray RLlib, and batch scoring of all 8 million eligible members.
  • Collaborate with the Data Engineering team (Decisioning Team 2) to ensure training inputs are correctly joined, reward signals are accurately computed from disposition outcomes, and the feature pipeline is reproducible and auditable.
  • Write production-quality PySpark feature-engineering jobs and maintain data lineage through Databricks Unity Catalog.
  • Manage model artifacts, versioning, and lifecycle in the MLflow Model Registry, ensuring rollback capability is maintained at all times.
  • Apply multi-agent reinforcement-learning concepts (MARL via PettingZoo) where member household or population-level coordination is required.
  • Implement constraint mapping to enforce hard business rules—member caps, cooldown periods, and clinical eligibility—as constraints within the reinforcement-learning objective rather than downstream filters.
  • Collaborate with the Rules Engine team to ensure Drools eligibility guards and reinforcement-learning policy priorities are correctly aligned and do not conflict.
  • Partner with Decisioning Team 1 (Decision Engine, Rules Engine) to ensure model outputs integrate cleanly with the real-time decisioning hot path and that scored recommendations cached in Redis are correctly structured and interpreted.
  • Collaborate with platform architects to define feedback-loop contracts for disposition outcomes flowing from Kafka through Databricks Delta Live Tables into the next training cycle.
  • Document model behavior, known limitations, and failure modes for clinical and compliance stakeholders, and support explainability requirements for member-facing decisions.
  • Use AI-assisted engineering tools for scaffolding, testing, and documentation while ensuring core model logic and reward design remain human-authored and subject to rigorous peer review.
Desired Qualifications
  • Experience with multi-agent reinforcement-learning frameworks such as PettingZoo or equivalent.
  • Familiarity with probabilistic modeling, Markov Decision Processes, and linear programming for constraint-aware action selection.
  • Experience operating reinforcement-learning systems in regulated domains such as healthcare, finance, or insurance, where member safety, auditability, and explainability are requirements.
  • Experience with Gymnasium for simulation environment development and backtesting.
  • Familiarity with Kafka-based feedback loops and how disposition signals feed reinforcement-learning retraining pipelines.
  • OpenTelemetry instrumentation experience for machine-learning training-pipeline observability.

About the company

Humana sells health insurance paid for by government programs, chiefly Medicare Advantage plans that private insurers run for Americans 65 and older in place of traditional Medicare. It ranks among the largest Medicare Advantage insurers in the country and also runs Medicaid plans for low-income families in several states. Its CenterWell business operates senior primary care clinics, a mail-order pharmacy and home health services, so many members get care from a company the insurer owns. Medicare and states pay Humana a set monthly amount per member, and it keeps the difference between those payments and members' medical costs. Humana was founded in 1961 as a nursing home company and is based in Louisville, Kentucky.

Company Size

10,001+

Company Stage

IPO

Headquarters

Louisville, Kentucky

Founded

1961

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Simplify Jobs

Simplify's Take

What believers are saying

  • Enrollment is surging: in July 2026 Humana affirmed about 25% individual Medicare Advantage membership growth for 2026.
  • Owned clinics create clinical careers: CenterWell Senior Primary Care added 130,900 patients, up 27%, in early 2026.
  • Medicaid is widening: Illinois chose Humana in June 2026 to run Medicaid coverage statewide.

What critics are saying

  • Low quality scores cut Medicare bonuses: only 20% of Humana's members sat in 4-star or better plans for 2026.
  • The insurer is shrinking to save margins: about 600,000 Medicare Advantage members got plan-closure notices in October 2026.
  • Stock grants carry risk: in July 2026 Humana cut its 2026 GAAP earnings floor to $6.52 a share from $8.36.

What makes Humana unique

  • Military families are a second market: Humana runs the Pentagon's TRICARE health plan across 24 eastern states and Washington, DC.
  • Florida anchors the business: Humana's Medicare Advantage contracts there produced 14% of its 2025 revenue.
  • Medicaid is a quiet second insurer: Humana covers over 1.54 million low-income members across 11 states.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Unlimited Paid Time Off

Paid Vacation

Paid Parental Leave

Short-term Disability

Long-term Disability

401(k) Retirement Plan

401(k) Company Match

Wellness Program

Growth & Insights and Company News

Headcount

6 month growth

6%

1 year growth

6%

2 year growth

6%
Yahoo Finance
Oct 9th, 2026
Humana soars 15% as 95% of Medicare members join four-star plans, beating analyst expectations

Humana shares surged 15% after the insurer announced 95% of its Medicare Advantage members will be in plans rated four stars or higher for 2027, up from just 20% a year ago. The result significantly exceeded J.P. Morgan analysts' expectations of 60% to 70%. Plans with four-star ratings or higher qualify for government bonus payments worth billions across the industry. The industry average for 2027 stands at roughly 71%. However, these ratings will determine bonus payments for 2028, not 2027. The improved ratings are particularly significant given Humana's thin margins. The company's EBIT margin has declined from 4.3% in 2023 to 2.3% on a last-twelve-months basis. Meanwhile, competitors moved in the opposite direction. UnitedHealth's four-star share is estimated to fall to approximately 67% from 81%, whilst CVS Health's drops to around 70% from 84%. CVS shares declined roughly 3%.

Yahoo Finance
Sep 13th, 2026
US health insurers rebound as medical costs stabilise, analysts predict 16% earnings growth through 2030

The health insurance industry may have recovered from high medical costs, with analysts predicting strong growth through 2030. Morningstar forecasts 16% annual earnings per share growth for major insurers, above the industry's typical low-double-digit target. Health insurers are improving profitability by raising rates to cover increased medical utilisation. UnitedHealth Group reported over $5 billion in second-quarter net income, with its medical care ratio falling to 86.7% from 89.4% year-over-year. The outlook also improved for pharmacy benefit management operations at companies like UnitedHealth, CVS Health, and Cigna. Despite increased regulatory scrutiny, the "big three" PBMs maintain strong competitive positions. Third-quarter earnings reports next month should provide further clarity on the industry's financial health.

PR Newswire
Sep 2nd, 2026
Thyme Care raises $125M at $2B+ valuation to expand oncology care model

Thyme Care, a Nashville-based oncology company, has closed a Series E funding round of more than $125 million at a valuation exceeding $2 billion. Morgan Health led the round, with participation from CVS Health Ventures, Humana, AlleyCorp, HealthQuest Capital, Foresite Capital, Concord Health Partners, Frist Cressey Ventures, Town Hall Ventures, and a16z Bio + Health. The company now serves over 10.5 million people across all 50 US states and manages more than $7 billion in oncology spend. Thyme Care reports it is profitable with positive free cash flow whilst delivering validated reductions of 5 to 10 per cent in total cost of care. Alongside the funding, Thyme Care is establishing Thyme Companies, a parent entity that will build a portfolio of independent oncology businesses addressing care barriers. Co-founder Robin Shah will serve as executive chairman of the new entity.

Associated Press
Aug 20th, 2026
Humana appoints Dr. Shantanu Nundy as chief medical officer to lead AI and digital care strategy

Humana has appointed Dr Shantanu Nundy as Chief Medical Officer, effective 31 August. Dr Nundy, a practicing physician and healthcare executive, will help shape the company's products, platforms, and use of AI whilst bringing clinical expertise to the enterprise. He most recently served as Executive Vice President of Care Delivery and Chief Health Officer at Accolade, a healthcare navigation company. Previously, he was Managing Director for Clinical Innovation at Evolent Health, driving value-based and digital care transformation across health systems. Dr Nundy will report to Jim Rechtin, Humana's President and CEO, and join the company's Enterprise Leadership Team. He continues to practice primary care and hospital medicine.

Yahoo Finance
Aug 19th, 2026
Humana beats Q2 revenue estimates with $40.87B as health insurers face regulatory scrutiny

Humana reported Q2 revenues of $40.87 billion, up 26.2% year on year, exceeding analysts' expectations by 0.6%. The health insurance provider also beat earnings per share estimates. Despite the relatively strong results, Humana's stock has fallen 2.7% since the earnings announcement and currently trades at $378.11. The health insurance sector as a whole showed resilience in Q2, with the 12 tracked providers beating revenue consensus estimates by 2.8% on average. However, share prices across the sector have declined an average of 5.8% since reporting. Humana derives over 80% of its revenue from federal government contracts and serves approximately 17 million members, with a strong focus on Medicare Advantage plans for seniors.