Humana

0→1 Human+AI Care & Benefit Ecosystem

Screenshot of an online health insurance portal displaying options to find healthcare providers and view deductible details, with a doctor image at the bottom.

How It Started

For many members, navigating health insurance was harder than navigating their health. Disjointed systems, call center complexity, and inefficiencies left patients frustrated and at risk. Humana saw the opportunity to reinvent the experience as a service ecosystem — one that blends human care with digital enablement to simplify access, reduce friction, and build trust.

Defining Success

Design a 0→1 healthcare navigation system that would serve all users — members, clinicians, administrators, and Nurse Navigators. This included creating an integrated service model, powered by AI-enabled triage (Nuance), with digital tools to streamline how people enter, move through, and get value from Humana’s offerings.

A collage of four images showing different stages of project planning and design. The top left features pink sticky notes with handwritten ideas on a whiteboard. The top right displays a digital flowchart or diagram outlining member interaction in a call system. The bottom left shows a process flow diagram with steps for a pharmacist discussing medication with a patient. The bottom right contains a sketched wireframe of a mobile app interface for medication management and call tracking.
A flowchart illustrating a process: starting with personalized welcome experience, followed by member advocacy and building personal connections, then a care team providing whole health support, leading to sustained better health outcomes, and ending with helping members live their best life.

Making It Happen

  • 1:1 member, clinician, and admin interviews; executive and SME workshops

  • Macro trend analysis, SME surveys, and call center analytics

  • Personas, Jobs To Be Done, journey and service mapping

  • Co-creation workshops, storyboarding, and low- to hi-fi prototyping

  • Concept validation and iterative testing with multiple user groups

  • Designed mission control platform, including AI-generated “next best actions”, for Nurse Navigators to manage and escalate member care

  • Integrated AI triage for incoming member interactions to guide next-best-action

  • Production-ready UI, technical architecture planning, and agile build support

  • QA, usability testing, and documentation for scale

Dashboard interface with sections for tasks, events, callbacks, inbound calls, and chat. The top displays a welcome message to Maria, date, and item counts. The right side shows a chat window with conversation history and a profile picture.
Screenshot of a digital patient health record for Frank Jenkins, showing personal info, key health insights, allergies, medication adherence, and medication list including prescriptions for Metformin, Gabapentin, Insulin Aspart, and Tanzeum.

  • Launched Author by Humana, piloted successfully and scaled nationally across Medicare/Medicaid

  • Established a new model of insurer–member relationships: navigators as advocates, not gatekeepers

  • Positive shift in member perception — from “Humana works against me” to “Humana works for me”

  • Increased engagement in preventive care and benefit utilization

  • Reduced costs for both members and the business through streamlined navigation and escalation pathways

Outcomes That Echo

Enough about me, what can I do for you?

When it’s time to create experiences people love and drive your business forward—explore my services, drop me a note, or schedule a conversation.