Lead the development and execution of data-driven digital media strategies for National and Local campaigns to drive member acquisition and retention. Manage agency relationships and collaborate cross-functionally to optimize performance and maximize ROI across various digital channels.
Humana
184 Remote Job Openings at Humana
Analyze and forecast financial and economic data to support strategic and operational business decisions. Develop data integrity processes and collaborate with stakeholders to resolve complex business problems through root cause analysis.
Develop security architecture requirements and secure designs for AI technology solutions across the enterprise. Lead threat modeling, risk analyses, and the implementation of security safeguards for GenAI and Agentic AI solutions.
The Lead Systems Engineer serves as the primary technical lead for the design, configuration, and support of endpoint and virtual desktop platforms. They are responsible for ensuring system stability and security while acting as the senior escalation point for complex technical issues.
Maintain and modernize a long-standing enterprise application using Windows Forms and .NET. Collaborate with offshore teams to improve application performance, stability, and maintainability across all stack layers.
The Senior Application Architect designs scalable, event-driven IT solutions and contributes to implementation through 35-40% hands-on coding. They collaborate with development teams to build AI-driven solutions and ensure alignment with enterprise architecture standards.
Develop and maintain secure file transfer solutions between external partners and internal systems. Design and implement API integrations with the Record Management System and web applications to support file uploads and downloads.
The role focuses on monitoring and improving EPSDT and maternal health services for Ohio Medicaid enrollees. Key duties include analyzing data to increase screening rates, coordinating member needs, and implementing educational plans for internal and external teams.
Support pharmacists and patients by conducting outbound and inbound calls to collect medication history and prepare members for comprehensive medication reviews. Assist in improving health outcomes through prescription drug optimization and patient education campaigns.
The Consumer Experience Lead optimizes interactions between the company and members by identifying friction points and automation opportunities. They advise executives on functional strategies and use data-driven insights to improve the overall member experience.
The role serves as the primary architect for the EIP Cybersecurity Strategy, shaping a multi-year roadmap to strengthen enterprise resilience. It involves advising executive leadership and the board on security maturity, AI integration, and investment priorities.
Lead the optimization of CRM systems and sales enablement tools to provide actionable insights and reporting for the Group Segment. Manage the centralized content repository and partner with cross-functional teams to develop high-impact sales collateral.
Lead the technical design and implementation of cloud-based contact center solutions using GCP and Google CX Agent Studio. Drive platform modernization initiatives and manage vendor partnerships to optimize CCaaS investments.
Research and analyze insurance rules and regulations to ensure product compliance for Medicare and Medicaid offerings. Draft and negotiate approval for service area expansions and product documents with state and federal regulators.
Develop and optimize real-time personalized member journeys using Adobe Experience Platform and Adobe Journey Optimizer. Collaborate with cross-functional teams to build audience segments and monitor journey performance to improve business outcomes.
Acts as a liaison between vendors and the organization to negotiate contracts and manage day-to-day vendor relationships. Monitors vendor performance and resolves contractual or invoice discrepancies while influencing departmental strategy.
Lead end-to-end localization workflows from intake to delivery, ensuring high-quality and compliant communications for diverse audiences. Optimize operations using AI/ML-enabled tools and manage relationships with internal stakeholders and external vendors.
Provide comprehensive whole-person care for Disease Management programs through telephonic interaction with beneficiaries. Coordinate with providers and Military Treatment Facility staff to ensure integrated care plans and healthy behavior development.
Develop and maintain long-term relationships with the dental provider network to improve financial and quality performance. Provide support for credentialing, claims resolution, and contract issues while educating providers on network products.
Collaborate with healthcare providers to improve STARs ratings and overall performance through strategic initiatives and action plans. Act as a liaison between providers and internal teams to resolve abrasion issues and optimize the use of Humana resources.
Analyze and audit complaints to ensure the integrity of claims, authorization processes, and business operations. Perform root cause analysis to identify trends and recommend change management to reduce redeterminations and rework.
The role involves solving complex business problems by collecting, integrating, and analyzing raw data to provide actionable insights for Medicaid Risk Adjustment. Responsibilities include managing big data quality and creating reporting and visualizations to support organizational strategy.
Lead the development and integration of clinical care management technology solutions to align with enterprise strategy. Act as the primary interface between business and technology teams to drive transformation and operational reliability.
Lead the design, development, and management of scalable and secure database architectures to meet business requirements. Create plans for architecture updates and integrate new systems with existing warehouse structures to optimize performance.
The consultant will lead high-priority strategy projects focusing on Medicare Advantage growth and business performance. Responsibilities include conducting market and competitor analysis to provide actionable recommendations to executive leadership.
Maintain, repair, and troubleshoot desktop hardware and software packages while providing customer service and end-user training. Resolve moderately complex technical problems escalated from first-line support and document all issues using applicable tools.
Oversee and manage eligibility strategy, execution, and data integrity for in-home Quality Focused Visit (QFV) and related vendor programs. Partner with cross-functional teams to design eligibility criteria, minimize program overlap, and transition manual processes to automated solutions.
Provide non-clinical administrative support for care management by triaging risk assessments and guiding members toward appropriate wellness resources. Perform high-volume outreach calls and health risk screenings to identify member needs and assign them to care managers.
Develop and execute clinical solutions to improve health outcomes for members with chronic conditions. Lead cross-functional teams to translate clinical insights into operational playbooks and actionable provider dashboards.
The Senior Quality Compliance Nurse works with physicians and physician groups to ensure high accountability for compliance and quality. They analyze complex data and influence department strategy to improve member outcomes.
Assess and evaluate member needs to guide them toward appropriate resources for optimal wellness and health maintenance. Monitor patient progress through data and active care planning while resolving barriers to effective care.
Conduct security assessments and audits of acquired companies' IT environments against frameworks like NIST and HITRUST. Identify security gaps and collaborate with internal teams to implement remediation plans and integrate acquired entities securely.
Establish and scale Humana's Over the Counter (OTC) line of business as a digitally enabled, consumer-focused capability. The role involves defining the enterprise strategy, managing business performance, and integrating OTC benefits into the broader Medicare Advantage ecosystem.
Develop and implement Medicare formulary strategies using clinical and financial data to mitigate costs and improve health outcomes. Communicate data-driven insights to executive leadership and collaborate across departments to ensure accurate implementation of decisions.
Collaborate with healthcare providers to improve STARs ratings and overall performance through strategic initiatives and data analysis. Act as a liaison between providers and internal teams to resolve abrasion issues and implement quality improvement plans.
Analyze and forecast financial and economic data to support strategic and operational decision-making. Manage underwriting margin forecasts for Medicare Advantage and enhance claims and premium forecasting methodologies.
The Senior Accreditation Professional manages health plan accreditations by ensuring compliance with national standards across multiple operational areas. This includes developing quality improvement interventions, conducting audits, and preparing documentation for NCQA presentation.
Insurance Product Management Principal - Supplemental Benefits Operations
Humana
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Full Time
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2 days ago
Humana
Lead the execution and optimization of the Humana Spending Account Card as the primary partner to the Director of Supplemental Benefits Operations. This involves translating strategy into actionable plans, managing vendor relationships, and ensuring regulatory compliance with CMS guidelines.
Provide non-clinical administrative support for utilization management policies and procedures to ensure appropriate member care. Perform moderately complex operational assignments and computations under minimal direction.
Lead the execution of an AI-native digital playbook to simplify services and improve stakeholder experiences. Collaborate cross-functionally to integrate generative AI tools for discovery, prototyping, and iterative solution refinement.
Lead the technical planning and modernization of Humana's environments by guiding the enterprise toward a target cloud-native architecture. Collaborate with teams to define cloud patterns, reference architectures, and author guidance publications to enable scalable cloud adoption.
Perform research, analysis, and documentation for provider reimbursement programs to ensure accurate pricing and compliance with government regulations. Maintain fee schedules and analyze reimbursement patterns to make process recommendations.
The Senior HEDIS Data Manager oversees the transformation of clinical data to support Medicare Stars and Medicaid programs. This includes managing vendor relationships, ensuring regulatory submission accuracy, and creating data visualizations to drive strategic decision-making.
Associate Vice President of Marketing, CenterWell Senior Primary Care
Humana
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Full Time
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3 days ago
Humana
Lead the end-to-end marketing strategy for CenterWell Senior Primary Care to drive awareness, acquisition, and retention. Serve as a strategic partner to business leadership while managing a high-performing team and the overall marketing budget.
Lead the strategy and execution of Next Best Action frameworks using Adobe Journey Optimization to deliver personalized customer engagement. Collaborate with cross-functional teams to architect scalable journey patterns and govern dynamic content across digital touchpoints.
Lead the hands-on design, development, and modernization of full-stack applications for the Wisconsin Medicaid Market. Drive technical architecture across UI, API, and data layers while mentoring engineers and reducing technical debt.
Translate strategy into real-time member journeys using Adobe Experience Platform and Adobe Journey Optimizer. Lead the product lifecycle from ideation to launch, focusing on optimizing Next Best Action journeys and monitoring performance.
Lead the modernization, optimization, and stabilization of the Wisconsin Medicaid Market's data platform, including the Data Warehouse and ODS. Partner with the Market BI team to establish Databricks pipeline patterns and direct the work of contract resources.
The Senior Compliance Professional ensures adherence to governmental requirements by managing complex data analysis and timely filings. They coordinate with regulatory agencies and internal business partners to resolve barriers and respond to state and federal inquiries.
Align business vision and strategy with technology execution to improve member experiences and health outcomes. Lead the creation of technology roadmaps, architecture standards, and governance processes within an agile framework.
The consultant will lead high-priority strategy projects focused on Medicare Advantage growth, performing research and analysis to craft logical solutions. They will collaborate with executive leadership to transition these strategic insights into actionable execution.
Develop learning solutions to address knowledge and performance gaps using instructional design and adult learning theories. Collaborate with subject matter experts to create storyboards, scripts, and eLearning materials while measuring training effectiveness.
Develop and implement a scalable data framework and operational logic for hospital-focused value-based quality measures. Provide strategic guidance to senior executives to drive enterprise-wide functional strategies and ensure program payment integrity.
The Senior Pharmacy Clinical Advisor collaborates with cross-functional leaders to combine clinical pharmacy expertise with holistic health outcomes. They use data-driven methods to create value propositions and communicate clinical messages to executive-level audiences.
Analyze and forecast financial and economic data to support strategic and operational decision-making. Develop and maintain complex cloud-based reserving models using tools like Databricks and Power BI to optimize reporting processes.
Provide comprehensive telephonic behavioral health case management for TRICARE beneficiaries to improve clinical outcomes and quality of life. Coordinate care plans by collaborating with Military Treatment Facilities, physicians, and other care management programs.
Oversee the operational excellence, stability, and evolution of the enterprise data platform for CenterWell Pharmacy and PBM. Lead a blended team of associates and contractors while managing cloud costs, financial governance, and SDLC adherence.
The auditor extracts clinical information from medical records to assign appropriate procedural terminology and medical codes. They review inpatient hospital claims for proper reimbursement and ensure correct DRG assignments to reduce costs.
Design and deliver innovative cybersecurity training programs and curriculum to reduce human-level risk across the organization. Collaborate with stakeholders to develop technical resources and advocate for security principles within the corporate vision.
Conduct comprehensive clinical reviews of prior authorization requests for behavioral health services to determine medical necessity and benefit eligibility. Coordinate with healthcare providers and medical directors while documenting findings in clinical systems to ensure regulatory compliance.
Design and develop next-generation IT network infrastructure solutions, focusing on scalability, resiliency, and software-defined networking. Lead the engineering, planning, and implementation of network fabrics for data centers and private cloud platforms.
Lead infrastructure operations and managed service providers across multi-cloud environments while driving the strategic roadmap for AI and GenAI integration. Focus on automating incident response, predictive analytics, and improving system reliability within a healthcare context.
The lead is responsible for translating business strategy into scalable cloud-first data solutions and managing the implementation of finance data platforms. This includes gathering requirements, coordinating testing, and advising executives on functional strategies and industry-leading cloud practices.
Assess and evaluate members' needs in a telephonic environment to facilitate optimal wellness and guide them toward appropriate resources. Monitor patient progress through data and active care planning while resolving barriers to effective care.
Insurance Product Management Principal - Supplemental Benefit Operations
Humana
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Full Time
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6 days ago
Humana
Lead the execution and optimization of the hearing benefit and other supplemental benefits within the Medicare Mandatory Supplemental Benefits framework. Partner with cross-functional teams and vendors to ensure benefit solutions are compliant, scalable, and operationally sound.
The Senior Internal Auditor evaluates the efficiency of operational processes by leading audit engagements and performing detailed reviews. They identify process gaps, recommend improvements, and mentor staff and interns throughout the project lifecycle.
Develop, implement, and administer competitive incentive programs aligned with business objectives and talent strategy. Support plan governance through quarterly analytics, cost modeling, and the creation of plan documentation and training.
Provide clinical leadership and oversight for post-acute utilization management across home health, SNF, and DME. Drive strategic initiatives to optimize site-of-care, improve quality, and reduce the cost of care for Medicare Advantage members.
The professional is responsible for identifying, assessing, and mitigating medical and financial risks resulting from failed processes or systems. They must balance risk mitigation with operational efficiency while following established organizational guidelines.
Lead the architecture and engineering of a centralized Finance reporting data platform using Databricks lakehouse and medallion architecture. Oversee the operationalization of month-end close processes and the creation of optimized datasets for Power BI reporting.
The Director is responsible for setting and executing the enterprise strategy for FMO and call center sales partnerships to drive revenue growth. This includes managing large-scale partner relationships, overseeing operational excellence, and ensuring alignment with compliance and brand standards.
The Utilization Management Nurse coordinates and documents medical services and benefit determinations to ensure members receive appropriate care. This involves interpreting clinical criteria and policies while communicating with providers and members to facilitate optimal treatment.
The Product Owner defines the product vision and roadmap for the Threat Management and Response team by managing the product backlog and user stories. They act as the voice of the customer to translate operational security needs into deliverable technical features.
The Quality Audit Professional analyzes and investigates quality issues, conducts comprehensive medical reviews of behavioral health claims, and implements corrective actions. They coordinate peer review committees and ensure compliance with organizational strategy and operating goals.
The role acts as a connector between the organization and the community by building strategic partnerships and driving outreach initiatives. It involves representing the organization at events and using data-driven strategies to improve member engagement and health outcomes.
The Director initiates, negotiates, and executes contracts with physicians and hospitals while analyzing the financial impact of reimbursement rates. They are responsible for implementing strategic plans, driving performance goals, and maintaining contract documentation.
Conduct investigations into fraudulent and abusive healthcare practices and coordinate with law enforcement authorities. Perform on-site audits of provider records and prepare complex investigative reports to influence department strategy.
Support the development of member experience visions through research, prototyping, and service blueprinting. Collaborate with cross-functional teams to integrate digital tools with offline touchpoints to improve healthcare insurance experiences.
Lead complex, cross-functional design initiatives to orchestrate member experiences across the entire service ecosystem. Define service strategy and create blueprints to align member needs with operational capabilities.
Design and develop comprehensive learning solutions for new and existing associates using instructional design and adult learning theory. Partner with subject matter experts to create engaging content, conduct needs analyses, and evaluate training effectiveness through operational metrics.
The RN Care Manager provides telephonic support to members with chronic and complex health conditions to maintain optimal wellness. Responsibilities include developing individualized care plans, monitoring member progress, and collaborating with interdisciplinary teams to resolve barriers to care.
The role focuses on developing growth strategies and investment optimization for Medicare and Medicaid, specifically regarding enrollment and product trade-offs. The manager will lead high-impact strategy projects, conduct deep competitor research, and collaborate with executive leadership to transition analysis into execution.
Lead the Medication Therapy Management (MTM) team by overseeing strategy, planning, and outcome monitoring. Collaborate with internal executive leaders and external partners to optimize MTM services and improve member healthcare quality goals.
Administer and configure HashiCorp Vault for secure secrets management across Azure and GCP environments. Develop automation scripts and collaborate with cross-functional teams to design secure, scalable cloud architectures.
Associate Vice President, Insurance Product Product/Platform Management
Humana
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Full Time
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9 days ago
Humana
Lead the vision and roadmap for modernizing insurance product platforms to ensure accuracy and compliance for millions of members. Act as the primary business partner to IT and Data & AI teams to drive automation and enterprise-scale transformation.
Design and implement reinforcement learning policies and decision-making algorithms for the Next Best Action platform in healthcare. Develop training pipelines using Databricks and MLflow while ensuring clinical eligibility and production safety through simulation and backtesting.
Manages and executes Stars, Clinical, and Pharmacy projects for the In-home Health and Well-being Assessment Team. Oversees operational performance dashboards, data collection compliance, and budget tracking for the program.
Perform medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. Intervene and advise patients and providers to promote cost-effective utilization and quality patient outcomes.
Initiates, negotiates, and executes contracts with physicians and hospitals for a health insurance organization. Analyzes the financial impact of contract terms and communicates reimbursement rates to providers.
Director, State Public Policy for Pharmacy and Pharmacy Benefit Management
Humana
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Full Time
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13 days ago
Humana
Lead the development and execution of state-level pharmacy policy strategy, focusing on PBM, licensure, and federal preemption. Collaborate with internal business teams and external consultants to translate policy changes into actionable business strategies and mitigate risks.
Responsible for growing membership within existing accounts and managing business relationships with client accounts. Represents the company at employer open enrollment meetings, health fairs, and other market events.
Review and audit DRG and ICD-10-CM/PCS coding assignments for accuracy within the coding disputes team. Collaborate with coding professionals to ensure compliance, quality, and timeliness of dispute outcomes while communicating results to providers.
The advisor drives the product lifecycle for behavioral health portfolios, translating strategy into delivery to improve network quality and access. Key duties include monitoring network access, managing provider performance scorecards, and leading value-based Pay-for-Performance initiatives.
Identify and contract qualified dentists to join the Medicaid dental network while ensuring compliance with regulatory standards. Develop outreach strategies and deliver educational programs to providers to improve quality of care and network accessibility.
Identify and contract qualified dentists to join the Medicaid dental network while ensuring compliance with regulatory standards. Develop outreach strategies and deliver educational programs to providers to improve quality of care and network accessibility.
The Principal IT Disaster Recovery Architect defines and implements the enterprise-wide DR strategy to ensure operational resilience across systems and applications. This role involves providing strategic guidance to infrastructure teams and collaborating with senior leadership to mature DR capabilities.
Analyze and forecast financial and economic data to support strategic and operational decision-making. Establish metrics and ensure data integrity through the development of processes and controls.
Research and develop dental and medical coverage policies for Medicare and Medicaid using evidence-based medicine and CMS guidance. Collaborate with medical directors and stakeholders to provide research summations and update clinical policies independently.
Design and deliver scalable, reusable, and modular solution architectures for consumer-facing digital platforms. Integrate AI and generative AI capabilities into digital solutions while partnering with cross-functional teams to ensure security and production readiness.
Supports a defensive litigation practice by assisting attorneys with subpoenas, bankruptcy, and medical malpractice matters. Manages a diverse caseload and coordinates complex projects within a collaborative team environment.
The Medical Director provides clinical interpretations and defensible medical decisions regarding the appropriateness of services for complex appeal cases. They collaborate with cross-functional teams to resolve grievances and participate in quality improvement initiatives to enhance consumer experience.
The representative is responsible for selling ancillary group insurance products to new and existing accounts by developing and maintaining brokerage relationships. They must execute strategic plans to increase sales and profitability while collaborating with internal executives to expand market penetration.
Supports pharmacists in the preparation and dispensing of specialty medications while handling inbound member and provider calls. Provides education and resources to new members and ensures adherence to operational processes for healthy outcomes.
The Medical Director determines authorization for requested services and levels of care for acute inpatient rehabilitation based on clinical guidelines and CMS policies. This includes reviewing complex clinical scenarios, communicating decisions to internal associates, and collaborating with external physicians.
Evaluates member needs in a telephonic environment to guide families toward appropriate resources for optimal wellness. Monitors patient progress through assessments and active care planning to resolve barriers to effective care.
The Actuary is responsible for setting pricing assumptions, submitting bids, and securing regulatory approval for premium rates. They analyze market financial metrics and collaborate with sales to develop strategies for profitable membership growth.
Responsible for behavioral health care strategy and operations, including making medical determinations on requested services and levels of care. The role involves collaborating with internal teams and external physicians to ensure quality of care and regulatory compliance.
The role focuses on identifying provider documentation gaps and creating tailored education plans to improve coding quality. Responsibilities include analyzing audit data, conducting educational sessions, and collaborating with cross-functional teams to ensure data integrity.
Lead the end-to-end Anaplan solution architecture for Finance and HR domains, focusing on workforce planning and management. Act as a strategic advisor to executives to align technical systems with enterprise architecture and business goals.
Conduct selling activities via inbound calls to assist consumers in selecting appropriate individual health plan products. Use a consultative approach to align customer needs with Humana's portfolio, including Medicare, dental, and vision plans.
The Medical Director reviews clinical cases for Medicare and Medicaid members to determine the medical necessity of healthcare services. They ensure all decisions align with CMS requirements, national guidelines, and organizational policies while identifying operational improvements.
The Behavioral Health Medical Director manages behavioral health care strategies and operations, making clinical determinations on service authorizations. They conduct peer-to-peer discussions with external physicians and ensure compliance with regulatory and clinical guidelines.
Drive lead generation and market growth through grassroots marketing, community outreach, and event execution. Act as a liaison between sales teams and community partners to build relationships and increase brand visibility.
Provide legal guidance on AI initiatives, including the development, governance, and implementation of responsible AI systems. Support AI-related litigation, regulator inquiries, and e-Discovery counseling across the EDRM.
The Group Sales Representative is responsible for developing and maintaining brokerage relationships to drive the sales and retention of Humana's Group benefit products. This includes executing strategic plans, delivering polished presentations, and collaborating with internal partners to maximize revenue and market penetration.
You will build trust and educate individuals on Medicare Advantage plans while driving self-generated sales through community events and in-home visits. You are expected to meet performance goals and expand Humana's market presence by serving as a valued resource in your local community.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans through face-to-face interactions and community events. They are responsible for driving self-generated sales, meeting performance goals, and expanding Humana's presence within the assigned territory.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans through face-to-face interactions and community engagement. They are responsible for driving self-generated sales, meeting performance goals, and expanding Humana's market presence within their assigned territory.
Engage with prospective and existing customers via inbound and outbound calls to promote and sell health plan products. Conduct thorough needs assessments, overcome objections, and document all interactions accurately within CRM tools.
The agent will build trust and educate individuals on Medicare Advantage plans through face-to-face interactions and community engagement. They are responsible for driving self-generated sales and meeting performance goals within their designated local territory.
You will build trust and educate individuals on Medicare Advantage plans while conducting grassroots marketing and in-home visits. Additionally, you are responsible for driving self-generated sales and meeting performance goals within your local community.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans through face-to-face interactions and community engagement. They are responsible for driving self-generated sales, meeting performance goals, and expanding Humana's market presence.
The role involves building trust and educating individuals on Medicare Advantage plans through face-to-face interactions and community events. Agents are responsible for driving self-generated sales and meeting performance goals within their designated territory.
The Medical Director performs clinical reviews and makes authorization determinations based on national guidelines, CMS requirements, and internal policies. They collaborate with healthcare professionals and internal teams to manage care, resolve conflicts, and support regional market priorities.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans and additional offerings through face-to-face interactions. They are responsible for driving self-generated sales, meeting performance goals, and expanding the company's presence in the local community.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans through face-to-face interactions and community engagement. They are responsible for driving self-generated sales, meeting performance goals, and expanding Humana's presence within their designated local territory.
The Behavioral Health Medical Director is responsible for behavioral health care strategy, operations, and making clinical determinations regarding service authorizations. They also collaborate with external physicians and community groups to support regional market priorities and value-based care initiatives.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans through face-to-face interactions and community events. They are responsible for driving self-generated sales and meeting performance goals to expand Humana's market presence.
The actuary will analyze and forecast financial and economic data to support strategic decision-making and business intelligence initiatives. They will collaborate with stakeholders to identify medical claims trends and provide strategic guidance to executives while ensuring data integrity.
The Utilization Management Registered Nurse interprets and supports the coordination, documentation, and communication of medical services and benefit determinations. They manage post-acute care services to ensure members receive the appropriate level of care in the most suitable setting.
The role involves educating individuals on Medicare Advantage plans and building trust through face-to-face interactions and community engagement. You will be responsible for driving self-generated sales and meeting performance goals within the designated territory.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans through face-to-face interactions and community events. They are responsible for driving self-generated sales and expanding Humana's market presence within their designated local territory.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans and additional offerings through face-to-face interactions. They are responsible for driving self-generated sales, meeting performance goals, and expanding Humana's presence within the local community.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans through face-to-face interactions and community events. They are responsible for driving self-generated sales, meeting performance goals, and expanding the company's presence within their assigned local territory.
The Medical Director performs expert clinical review of inpatient medical records, assessing medical necessity based on national guidelines, CMS regulations, and company policies. This role involves analyzing complex hospital-based cases, delivering utilization management determinations, and communicating outcomes with external providers via phone.
The agent will be responsible for building trust and educating individuals on Humana's Medicare Advantage plans and other offerings through face-to-face connections, community events, and in-home visits. Key activities include driving self-generated sales, meeting performance goals, and expanding market presence by becoming a valued community resource.
The role involves managing a book of business of over 100 Specialty Only clients, developing strategies to achieve membership retention and growth targets, and acting as a strategic business partner to various internal and external stakeholders. Responsibilities also include coordinating complex renewal processes, managing contractual obligations, and leveraging client reporting for cross-selling opportunities.
The agent will build trust by educating individuals on Humana's Medicare Advantage plans and related offerings through face-to-face connections, community events, and in-home visits. Responsibilities also include driving self-generated sales, meeting performance goals, and expanding market presence by becoming a valued community resource.
The role involves building trust and educating individuals on Humana's Medicare Advantage plans through face-to-face interactions. Agents will also engage in grassroots marketing and community events to expand Humana's presence in the market.
The role involves building trust and educating individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. Agents will drive self-generated sales and expand Humanaβs presence in the market.
The Medicare Sales Field Agent will build trust and educate individuals on Humana's Medicare Advantage plans while creating meaningful connections through community engagement. The role involves self-generating sales and expanding Humana's presence in the market.
The role involves building trust and educating individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. Agents will drive self-generated sales and expand Humanaβs presence in the market.
The role involves building trust and educating individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. Agents will drive self-generated sales and expand Humanaβs presence in the market.
The role involves building trust and educating individuals on Humana's Medicare Advantage plans while creating meaningful connections through community engagement. Agents are expected to self-generate sales and meet performance goals to expand Humana's market presence.
Build trust and educate individuals on Humana's Medicare Advantage plans while creating meaningful connections through community engagement. Self-generate sales and meet performance goals to expand Humana's presence in the market.
The Medicare Sales Field Agent will build trust and educate individuals on Humana's Medicare Advantage plans while creating meaningful connections through community engagement. The role involves self-generating sales and expanding Humana's presence in the market.
The Medicare Sales Field Agent will build trust and educate individuals on Humana's Medicare Advantage plans while creating meaningful connections through community events and in-home visits. The role involves self-generated sales and expanding Humana's presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humana's Medicare Advantage plans while creating meaningful connections through community engagement. You will also be responsible for self-generating sales and expanding Humana's presence in the market.
The Medicare Sales Field Agent will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. The role involves driving self-generated sales and expanding Humanaβs presence in the market.
The Medicare Sales Field Agent will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. They will drive self-generated sales and expand Humanaβs presence in the market.
The role involves building trust and educating individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. Agents will drive self-generated sales and expand Humanaβs presence in the market.
The role involves building trust and educating individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community events and in-home visits. Agents are expected to drive self-generated sales and expand Humanaβs market presence.
The Medicare Sales Field Agent will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community events and in-home visits. The role also involves driving self-generated sales and expanding Humanaβs presence in the market.
The role involves building trust and educating individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. Agents will drive self-generated sales and expand Humanaβs presence in the market.
The Medicare Sales Field Agent will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community events and in-home visits. The role also involves driving self-generated sales and expanding Humanaβs market presence.
The Medicare Sales Field Agent will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. The role involves driving self-generated sales and expanding Humanaβs presence in the market.
The Medicare Sales Field Agent will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. They will drive self-generated sales and expand Humanaβs presence in the market.
The Medicare Sales Field Agent will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. They will also drive self-generated sales and expand Humanaβs market presence.
Bilingual Medicare Sales Field Agent (English - Vietnamese / Chinese) - West / SW Harris and Fort Bend County
Humana
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Full Time
·
6 months ago
Humana
As a Bilingual Medicare Sales Field Agent, you will educate individuals on Humanaβs Medicare Advantage plans and create meaningful connections through community engagement. You will also drive self-generated sales and expand Humanaβs presence in the market.
Medicare Sales Field Agent - SW Harris and Fort Bend County
Humana
·
Full Time
·
6 months ago
Humana
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
Bilingual Medicare Sales Field Agent (English / Spanish) - East / SE Harris County
Humana
·
Full Time
·
6 months ago
Humana
As a Bilingual Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will also drive self-generated sales and expand Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community events and in-home visits. Your role will involve driving self-generated sales and expanding Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community events and in-home visits. Your role will also involve driving self-generated sales and expanding Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
The Senior Stars Improvement, Clinical Professional is responsible for the development, implementation, and management oversight of the company's Medicare/Medicaid Stars Program. This role involves monitoring provider performance in key performance indicators related to preventive care and chronic conditions.
The Quality Assurance, Clinical Professional 2 develops and implements programs to maintain quality standards and conducts quality audits to improve care management services. This role collaborates with various partners on quality, process, and performance improvement initiatives.
The Director of Investment Governance & Portfolio Management will oversee the IT organizationβs investment governance processes, ensuring alignment with strategic objectives. This includes managing the intake, prioritization, and execution of investment initiatives while collaborating with cross-functional stakeholders.
The Associate Director of Care Management will lead teams responsible for care management, overseeing the assessment and evaluation of members' needs. They will guide the development and implementation of care management programs while ensuring effective communication with stakeholders.
The Sales Support Professional 1 provides timely and effective sales administrative support to assist with the acquisition or retention of customers. This role involves supporting the Sales team throughout the sales cycle and collaborating with internal stakeholders.
The Informatics Lead is responsible for leading the development and refinement of EOC volume forecasting models for Humana Clinical Pharmacy Review activities. This position supports operational resource planning and integrates business initiatives while ensuring forecast accuracy.
The Pharmacy Contracting Professional 2 ensures all published materials support the contracting process and may perform analysis regarding pharmacy claims and purchasing data. They draft communications for stakeholder review and coordinate with various departments to publish communications.
As a Bilingual Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
The Senior Pharmacy Contracting Professional conducts all aspects of pharmaceutical contracting and pricing, including development, implementation, and maintenance. They oversee relationships with Humana pharmacy partners and support pharmacies throughout the contracting process.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand Humanaβs presence in the market.
As a Medicare Sales Field Agent, you will build trust and educate individuals on Humanaβs Medicare Advantage plans while creating meaningful connections through community events and in-home visits. Your role will also involve driving self-generated sales and expanding Humanaβs market presence.
The Senior Quality Assurance, Clinical Professional consults and collaborates with clinicians to ensure high accountability of compliance and quality. They conduct case audits, assist with audit preparation, and support quality improvement projects.