Full-Time
Decision Intelligence Engineer
AI, NBA
Posted on 8/20/2026
Humana
10,001+ employees
Medicare Advantage health insurer for seniors
Compensation Overview
$129.3k - $177.8k/yr
Remote in USA
Remote
Occasional travel to Humana offices for training or meetings may be required.
Bachelor's, Master's
 AI & Machine Learning (1) |
|---|
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- Bachelor's degree in computer science or a related field.
- 6+ years of software engineering, machine learning engineering, AI engineering, or decision intelligence experience, including at least 1–2 years in a technical leadership capacity.
- Strong Python engineering experience building and operating production AI systems.
- Hands-on experience building agentic applications using LangGraph, LangChain, AutoGen, CrewAI, or similar orchestration frameworks.
- Experience integrating Azure OpenAI, Azure AI Foundry, Vertex AI, Anthropic, OpenAI, or comparable enterprise AI platforms.
- Strong understanding of Decision Intelligence concepts, including decision modeling, optimization, decision automation, objectives, constraints, and outcome measurement.
- Experience implementing LLM application patterns including tool calling, structured outputs, retrieval-augmented generation, memory management, and workflow orchestration.
- Experience building evaluation frameworks for AI systems, including automated evaluation, human review, performance measurement, and experimentation.
- Ability to map business processes into formal decision frameworks and communicate those models to both technical and non-technical stakeholders.
- Demonstrated ability to lead a small engineering team while remaining a hands-on contributor.
- 8 or more years of progressive IT experience as a senior developer in large IT projects.
- 2 or more years of project leadership experience.
- Analyze and formally model business decision processes, including objectives, constraints, policies, decision points, outcomes, dependencies, and feedback loops that govern member engagement.
- Break complex business processes into decision graphs, decision services, decision hierarchies, and optimization opportunities that can be measured, automated, and improved.
- Determine where rules, predictive models, reinforcement learning, optimization techniques, or agentic systems create the highest business value and operational impact.
- Design and implement production agent workflows using LangGraph and LangChain, including multi-agent collaboration, tool usage, workflow memory, planning, reasoning, and human-in-the-loop approval patterns.
- Build AI-powered capabilities embedded into the Action Library to assist users in creating, refining, validating, governing, and optimizing member actions.
- Own integration with Azure OpenAI and other enterprise models through Humana's AI Gateway, including prompt engineering, structured outputs, retrieval patterns, tool calling, function execution, and workflow orchestration.
- Design retrieval-augmented architectures using vector search, semantic retrieval, knowledge grounding, and enterprise content sources.
- Partner with data science teams to operationalize reinforcement learning and decision optimization models within NBA workflows.
- Build evaluation frameworks measuring recommendation quality, decision quality, agent effectiveness, user adoption, business outcomes, and operational performance.
- Implement guardrails, observability, traceability, policy controls, human review mechanisms, and auditability requirements for a healthcare environment.
- Lead and mentor AI engineers, establish engineering standards, conduct design reviews, and drive execution across the Decision Intelligence workstream.
- Work closely with product, business, decision science, data science, and engineering teams to convert complex decision processes into production AI capabilities.
- Architect, implement, and operate microservices for action and variant metadata, context-aware policy and eligibility evaluation, and versioned read-optimized APIs.
- Design, deploy, and maintain resilient database schemas supporting action and variant catalogs, versioning, lifecycle management, effective dating, rule bindings, and complex metadata relationships.
- Select and operate relational, document, or key-value data stores according to workload and scalability requirements.
- Integrate and manage enterprise-grade rules engines supporting eligibility, constraints, business policies, suppression, cooldowns, exclusions, and policy-driven allow/deny logic.
- Develop automated tests for database migrations, schema changes, service-level contracts, API backward compatibility, rules behavior, precedence, and edge cases.
- Ensure platforms are observable and resilient through structured logging, metrics, alerting, error handling, fallback strategies, and incident management.
- Support audit and compliance requirements through traceable and reproducible system behavior.
- Work with platform, data, and machine learning teams to maintain clean integration points and shared standards.
- Participate in architecture and design reviews to uphold platform quality.
- Mentor junior engineers and contribute to technical standards and best practices.
- Experience with Decision Intelligence methodologies, decision modeling notation, decision requirements analysis, influence diagrams, decision graphs, or business decision management frameworks.
- Experience operationalizing reinforcement learning, contextual bandits, recommendation systems, or next-best-action optimization platforms.
- Experience with Databricks, MLflow, Feature Store, Mosaic AI, or enterprise machine learning platforms.
- Experience with Azure AI Search, vector databases, semantic retrieval systems, and enterprise knowledge architectures.
- Experience with observability platforms such as LangSmith, OpenTelemetry, PromptFlow, Azure Monitor, or equivalent AI monitoring solutions.
- Experience integrating AI capabilities into enterprise software platforms and workflow-driven applications.
- Familiarity with Adobe Experience Platform, Salesforce, CRM platforms, healthcare engagement platforms, or marketing technology ecosystems.
- Background in healthcare, insurance, or another highly regulated industry with auditability, explainability, and compliance requirements.
- Master's degree.
Humana focuses on health and well-being by offering Medicare Advantage plans (HMO, PPO, and PFFS) mainly for seniors, military personnel, and communities. Its products are health insurance plans funded through a mix of government contracts and member premiums, enrolling members to provide comprehensive coverage with flexible benefits and a broad provider network. Members receive care through a network of providers, with additional services such as free language interpretation to improve accessibility. Humana differentiates itself through its emphasis on inclusivity, accessibility, and tailored benefits, aiming to deliver reliable service and high renewal rates. The goal is to improve health outcomes and overall well-being for members by delivering coverage that meets diverse needs and making care accessible to all.
Company Size
10,001+
Company Stage
IPO
Headquarters
Louisville, Kentucky
Founded
1961
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Simplify's Take
What believers are saying
- Q2 2026 revenue hit $40.87 billion, up 26%, beating estimates.
- Humana won Illinois Medicaid managed care for January 2027, expanding beyond Medicare Advantage.
- TrumpRx pricing display in 2027 positions Humana’s PBM tools for broader consumer traffic.
What critics are saying
- 2026 Star Ratings cuts slashed Humana’s GAAP EPS outlook to $6.52, crushing bonuses.
- Humana exits 600,000 MA members for 2027, signaling persistent margin weakness and churn.
- The Massachusetts broker-kickback case and AI-denial class action threaten payouts and trust.
What makes Humana unique
- Humana dominates Medicare Advantage with 7.2 million members and deep senior distribution.
- Its DrFirst partnership cuts 70,000 faxes, embedding payer decisions inside clinician workflows.
- New CMO Shantanu Nundy and board recruitments push AI and consumer-health capabilities.
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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
6 month growth
↑ 6%1 year growth
↑ 6%2 year growth
↑ 6%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.
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.
Nearly 3 million older Americans will lose their Medicare Advantage plans this year, according to Johns Hopkins Bloomberg School of Public Health research. One in 10 Medicare Advantage policyholders face forced disenrollment, with Vermont hit hardest at 92% of policyholders affected. Humana announced its exit from multiple markets for the second consecutive year, impacting 600,000 members. The company reported $1.9 billion profit in the first half of 2026. Insurers cite financial pressures from federal policy changes aimed at reducing overpayments, resulting in lower government reimbursement rates. Combined with rising medical costs, these factors are squeezing profit margins. Shannon Benton of Senior Citizens League said Humana's decision shows Medicare Advantage insurers are "prioritising profit growth over enrollment growth.
Nine pharmacy benefit managers will integrate TrumpRx prescription drug pricing into their benefit tools, effective 1 January 2027. The Pharmaceutical Care Management Association and participating PBMs—including CVS Health, Express Scripts, Humana, and OptumRx—will display cash prices from TrumpRx alongside plan coverage costs. The agreement covers commercial, Medicare, and Medicaid plans. Patients will see TrumpRx prices for all listed drugs, whether through presidential deals or standard pricing. CMS Administrator Dr Mehmet Oz said the commitment will help patients compare prices and find better deals. PCMA CEO David Marin stated the transparency will allow consumers to make better-informed choices about prescription drug costs. Some PBMs will use Real Time Benefit Tools to display pricing comparisons, whilst others may employ different methods.
Humana announced plans to exit additional Medicare Advantage plans in 2027, affecting approximately 600,000 members. The US insurer is targeting lower-return plans as part of its strategy to achieve a sustainable 3% pre-tax margin by 2028. Chief financial officer Celeste Mellet said the company expects to retain just over 40% of affected members through other offerings, similar to its 2025 experience. Humana is prioritising higher-performing plans with stronger value-based care penetration. The announcement followed Humana's second-quarter earnings report, which showed adjusted earnings of $7.61 per share on revenue of $40.89 billion. Individual Medicare Advantage membership increased 23% year-over-year to 6.45 million.