The professional will analyze encounter data to identify errors and trends while supporting the submission and reconciliation processes for Medicare and Medicaid. They will also research claims issues and identify opportunities to improve encounter acceptance rates and reduce errors.
The analyst will develop, implement, and value new and existing value-based programs while managing large datasets to drive process improvements. They will also produce monthly activity reports and provide analytical support for payments to value-based specialists.
The Learning Design Lead diagnoses workforce skilling needs and translates technical capability gaps into practical, learner-centered solutions. They partner with subject matter experts and Tech leaders to design, implement, and measure learning experiences that align with business priorities.
The Actuary will develop and maintain Part D pharmacy forecasting models to support financial planning and risk assessment for Medicare Advantage and PDP lines. They will also partner with stakeholders to ensure data integrity and provide actionable insights to senior leadership regarding program financial strategy.
The Senior Designer develops strategic, high-quality creative solutions across multiple channels, with a strong emphasis on organic and paid social media. They partner with cross-functional teams to translate briefs into compelling concepts while ensuring brand consistency and utilizing performance data to refine deliverables.
The role involves identifying and executing process improvement opportunities to enhance operational effectiveness and ensure compliance with healthcare regulations. The professional will partner with stakeholders to map workflows, develop corrective action plans, and provide actionable insights through data analytics.
The Lead Product Owner will define the product vision and roadmap for OpenText migration while leading cross-functional teams in the design and deployment of personalized communications. They are responsible for ensuring regulatory compliance, managing the product backlog, and serving as the primary contact for Agile delivery teams.
The Senior Workforce Management Professional will develop and maintain comprehensive forecasting models to determine staffing requirements and optimize call center efficiency. They will collaborate with cross-functional teams to align call demand with agent supply and provide strategic insights for workforce decision-making.
The Provider Contracting Representative initiates, negotiates, and executes ancillary contracts for health insurance services. They are responsible for communicating contract terms and payment structures while analyzing the financial impact of these agreements.
Define and drive the product vision and roadmap for the Medicare contact center ecosystem, specifically managing Genesys Cloud CX and Salesforce CRM integrations. Act as the primary liaison between business stakeholders and technical teams to ensure operational efficiency and compliance with CMS regulations.
The coordinator manages clinical documentation and verifies member eligibility to support the prior authorization process. They ensure accurate data entry and maintain compliance with company policies regarding clinical requests.
The coordinator manages inbound and outbound provider calls to facilitate utilization management and prepares authorization requests for clinical review. They are responsible for documenting interactions in medical records and maintaining accurate written correspondence.
The Group Sales Representative develops and maintains brokerage relationships to drive sales of ancillary group insurance products. They are responsible for executing strategic sales plans, conducting presentations, and collaborating with internal teams to meet production objectives.
You will lead a team to develop and execute pharmacy clinical programs aimed at optimizing medication use and improving health outcomes. The role involves utilizing managed care and PBM expertise to implement strategies that reduce pharmacy cost trends and enhance the member experience.
The professional gathers and documents business system requirements while influencing design to optimize support and meet objectives. They also coordinate implementation, testing, and operational readiness to ensure a smooth transition to production support teams.
The Senior Quality Compliance Professional monitors and evaluates quality-related processes and documentation to ensure compliance with Louisiana Medicaid and Humana requirements. They also collaborate with cross-functional teams to support audit readiness, corrective action plans, and performance improvement initiatives.
The Scrum Master 2 facilitates Scrum events and supports the team in delivering value through agile methodologies. They act as a servant leader to remove impediments, coach team members, and drive continuous improvement within the organization.
The Senior Compliance Professional develops and implements compliance policies while researching issues to ensure adherence to contract obligations. They also make decisions on complex technical project components and influence departmental strategy.
Design, develop, and maintain scalable omnichannel APIs while enhancing security, performance, and resiliency across enterprise platforms. Collaborate with cross-functional teams to implement AI-assisted engineering practices and provide Tier 3 support for critical production incidents.
The Senior Care Coach evaluates member needs to maintain optimal wellness by guiding families toward appropriate resources and facilitating care interactions. They also provide leadership support by mentoring team members, monitoring field visits, and ensuring compliance with clinical documentation standards.
The Manager oversees Utilization Management operations for LTSS members, ensuring accurate authorization determinations and compliance with regulatory requirements. They lead a team of supervisors, monitor performance metrics, and collaborate with internal partners to improve clinical outcomes.
The Process Optimization Lead will design, standardize, and optimize operational processes to improve efficiency and stakeholder experience. They will also lead cross-functional initiatives, manage project timelines, and facilitate governance to ensure organizational alignment and operational readiness.
The Lead Enterprise Architect defines enterprise-wide technology strategy and architecture standards across a complex healthcare ecosystem. This role governs digital transformation initiatives and partners with executive leadership to drive modernization, cloud transformation, and operational resiliency.
Engage members via phone to conduct non-clinical health assessments and identify barriers to care. Assist members in scheduling appointments and accessing health resources while documenting information in an auto-dialer environment.
The Strategy Manager will lead high-impact projects focused on Medicare enrollment growth and investment optimization. They will perform complex research and analysis to develop strategic insights and recommendations for senior leadership.
The Growth Strategy Manager will lead high-impact strategy projects, focusing on Medicare enrollment growth and investment optimization. They will deconstruct complex business challenges, perform targeted research, and collaborate with executive leadership to translate analysis into actionable execution.
The Director will lead enterprise-wide quality validation strategies, cross-platform integration assurance, and end-to-end business workflow certification. This role involves driving AI-enabled quality practices, managing release readiness, and fostering a culture of technical excellence within a high-performing team.
Design, build, and deploy LLM-based applications to generate insights from unstructured data and improve business strategy. Collaborate with cross-functional teams to translate complex business problems into production-ready AI solutions.
The Care Coordinator will conduct health risk assessments and coordinate services for newly enrolled Medicaid members to ensure they receive appropriate care. This role involves proactive outreach, resolving barriers to care, and facilitating access to community resources through both telephonic and face-to-face interactions.
The professional performs business and process analysis, documents requirements, and manages letter configuration workflows within the MHK system. They coordinate cross-functional efforts, monitor backlog throughput, and ensure effective communication between stakeholders and offshore configuration teams.
The representative addresses incoming inquiries via phone, digital, or written channels and conducts outbound calling campaigns to assist members. They are responsible for resolving complex benefit questions, documenting interactions, and escalating unresolved grievances.
You will architect goal-setting and decomposition mechanisms for autonomous agents operating in dynamic environments. Additionally, you will develop evaluation frameworks to ensure agent alignment with human intent and operational reliability.
The Consumer Experience Professional 2 coordinates member support and benefit fulfillment activities while resolving service needs and collaborating with internal and external partners. They also analyze operational data to improve workflows and ensure service excellence in benefit administration.
The Associate Director of Quality Improvement leads enterprise-wide clinical quality strategies and manages cross-functional teams to improve member and provider satisfaction. They are responsible for aligning population health strategies, ensuring compliance with NCQA and EQRO standards, and mitigating performance penalties.
The Senior Full Stack Engineer will lead the hands-on design, development, and modernization of applications and platforms for the Wisconsin Medicaid Market. This role involves driving technical architecture, mentoring engineers, and implementing automation and cloud-native patterns across multiple technology stacks.
The Inpatient Medical Coding Auditor extracts clinical information from medical records to assign accurate procedural and medical codes. They review inpatient hospital claims to ensure correct reimbursement and appropriate diagnosis-related group assignments.
The Care Coach assesses member needs and barriers to develop and implement person-centered care plans that promote wellness and independence. They facilitate interaction with community resources, coordinate with care teams, and support members in navigating long-term services and support.
The Portfolio Management Lead is responsible for operationalizing enterprise technology portfolio management practices to drive strategic alignment and value-based decision-making. This role facilitates quarterly prioritization processes, mentors portfolio teams, and ensures technology investments align with enterprise strategic goals.
Lead the development and execution of Humana's Wellness Rewards and Loyalty Strategy to drive member engagement and health outcomes. Align cross-functional teams to design innovative reward ecosystems and scalable structures that deliver measurable business value.
The Senior Hospital Contracting Strategist initiates, negotiates, and executes complex provider contracts and agreements for a health insurance organization. They partner with internal departments like Finance and Legal to ensure contracts are financially sound and operationally executable.
The Lead Digital Product Manager will define the product vision and roadmap for digital experiences while leading cross-functional teams through discovery and delivery. They are responsible for translating customer insights into measurable outcomes and ensuring the development of scalable, reusable platform capabilities.
The Care Coaching Assistant coordinates services and resources to support members' wellness and transitions. They perform administrative and operational tasks to assist with care coordination and member needs assessment.
The lead will identify and manage strategic initiatives to improve Health Outcomes Survey (HOS) performance across the Medicare Advantage segment. They will collaborate with cross-functional teams to develop project plans, monitor KPIs, and ensure strategic alignment across the enterprise.
The Care Management Support Assistant provides non-clinical administrative support to care management teams by managing shared mailboxes, entering data, and facilitating member access to resources. They interpret department policies to complete assignments while ensuring quality standards and member wellness goals are met.
Lead the response to complex production incidents and collaborate with cross-functional teams to ensure system stability. Maintain, integrate, and analyze software applications while driving improvements through operational excellence.
The role leads enterprise-wide procurement systems, digital transformation, and AI-driven initiatives to drive operational efficiency and scalable automation. It serves as a bridge between business stakeholders and technology teams to design, implement, and govern innovative procurement solutions.
The Director of Market Leadership manages TRICARE contract operations within an assigned geography to ensure high-quality integrated healthcare delivery. They oversee network operations, provider relationships, and strategic initiatives to optimize Military Treatment Facilities and support the Military Health System.
The Care Manager will assess, plan, and coordinate care for TRICARE beneficiaries over the phone to maximize self-care and clinical outcomes. They serve as the primary point of contact, collaborating with military treatment facilities and providers to ensure integrated care plans.
The VP of API Technologies is responsible for the end-to-end strategy, product management, and governance of Humana's enterprise API ecosystem. This role leads the modernization of integration technologies, ensures secure external partner exposure, and embeds AI-native capabilities into API design and operations.
The Senior Medical Coding Outpatient Auditor identifies billing anomalies and validates coding accuracy to ensure compliance with reimbursement guidelines. They conduct detailed record reviews, provide recommendations for recovery or education, and collaborate with clinical and analytics teams.
The role manages the end-to-end delivery, orchestration, and operational readiness of acquisition and retention campaigns across multiple business lines. It coordinates cross-functional teams to ensure campaigns are compliant, market-ready, and executed seamlessly across various member touchpoints.
The Supervisor manages encounter data submissions to Medicaid/Medicare, ensuring compliance and process efficiency through data analysis. They also provide leadership and guidance to a team of support and technical associates to ensure operational consistency.
The Lead defines sales product strategy and drives mail order pharmacy utilization through retention initiatives and lifecycle management. They collaborate with cross-functional teams to optimize member touchpoints and improve refill rates, auto-refill adoption, and overall prescription growth.
The Pharmacy Stars Improvement Lead develops and implements clinical program strategies to improve Medicare member medication adherence and safety. The role involves analyzing complex data to identify care gaps and collaborating across departments to enhance performance metrics.
The Associate Director leads the strategy, execution, and performance optimization of mail order pharmacy enrollment, retention, and utilization initiatives. They serve as the primary business leader for acquisition and retention, leveraging data-driven insights to drive sales program effectiveness and market share growth.
The role leads the strategy, execution, and optimization of acquisition and retention dialer campaigns to maximize contact rates and conversion performance. It serves as the primary business owner for campaign performance, partnering with cross-functional teams to drive operational excellence and member engagement.
The Lead Data Scientist develops and maintains complex data sets to create analytic solutions, reports, and models that support business strategy. They also advise executives on functional strategies and partner with cross-functional teams to drive operational consistency and compliance.
The Care Coach evaluates member needs to guide them toward optimal wellness and facilitates access to appropriate care resources. They ensure a positive prenatal and postpartum experience by monitoring patient progress and resolving barriers to effective care.
The Technical Product Leader will define and lead the technical product vision, strategy, and roadmap while serving as a vital link between business, architecture, and development teams. They are responsible for managing backlogs, prioritizing initiatives, and ensuring solutions meet security, scalability, and performance requirements.
The Manager of Care Management leads a team of healthcare professionals to ensure effective care coordination and compliance with state performance metrics. They are responsible for identifying members for case management, monitoring clinical trends, and mentoring staff to achieve operational efficiency.
The Broker Relationship Manager will develop and maintain relationships with local brokers and agencies to drive membership growth in the Arkansas market. They are responsible for providing training, coaching, and strategic support to ensure consistent broker performance and market expansion.
The Senior Cybersecurity Engineer develops, tests, and deploys information security tools and system solutions to safeguard sensitive data. They oversee engineering tests, perform risk assessments, and contribute to the research and development of data protection security solutions.
The Senior Financial Analytics Professional develops and maintains complex revenue projection models to support business decisions and financial accrual processes. They are responsible for analyzing financial trends, explaining variances, and translating operational drivers into actionable insights for the Medicare Advantage business.
The RN, Quality Assurance Professional serves as a clinical subject matter expert within Internal Audit to evaluate the effectiveness of healthcare operations and compliance. They partner with audit professionals to identify risks, review clinical documentation, and recommend process improvements to enhance quality and performance.
The VP of FP&A Enterprise Growth will lead a large finance team to provide strategic financial leadership and drive enterprise value for Humana's growth initiatives. Responsibilities include managing a $5B budget, overseeing financial planning and forecasting, and partnering with business leaders to optimize marketing and distribution investments.
The Float Case Manager assesses member health and safety needs to develop comprehensive care plans and coordinates services to support members in the least restrictive environment. They conduct regular face-to-face assessments and maintain accurate documentation while ensuring cost-effective service delivery.
The professional initiates, negotiates, and executes behavioral health provider contracts for South Carolina Medicaid while analyzing financial impacts. They are responsible for recruiting providers, maintaining contract documentation, and communicating payment structures to stakeholders.
The auditor reviews inpatient medical records and claims to ensure accurate coding, reimbursement, and appropriate DRG assignments. They also investigate provider disputes and collaborate with teams to improve payment accuracy and documentation integrity.
The Senior Care Coordinator provides mentorship, coaching, and field support to team members while ensuring compliance and quality in case management plans. They conduct home visits for Medicaid members and coordinate care across interdisciplinary teams to ensure patients meet their health goals.
The Manager of Care Management leads a team of healthcare professionals to ensure effective care coordination, transitions of care, and compliance with state performance metrics. They are responsible for hiring, mentoring, and evaluating staff while identifying trends and implementing actions to improve clinical performance.
The Associate Actuary analyzes and forecasts financial data to support strategic decision-making and business intelligence. They are responsible for designing and implementing value-based care initiatives while ensuring data integrity through robust controls.
The Senior Data Engineer designs, builds, and maintains scalable data pipelines and workflows to transform structured and unstructured data into actionable insights. They collaborate with cross-functional teams to integrate data solutions while ensuring high standards of reliability, performance, and security.
The Manager, Care Management leads multidisciplinary teams to oversee the care management of Medicaid members, ensuring optimal wellness through resource coordination and adherence to departmental procedures. They are responsible for monitoring program performance, driving continuous improvement, and fostering partnerships with community-based organizations to address social determinants of health.
The Performance Enablement Lead manages reporting, KPI measurement, and business intelligence support for Part D risk adjustment programs. They translate business needs into repeatable dashboards and analytic datasets while partnering with IT teams to ensure scalable reporting solutions.
The Associate Actuary analyzes and forecasts financial and economic data to support strategic decision-making and business intelligence. Responsibilities include developing financial models, validating processes, and modeling the financial impact of risk arrangement contracts.
The coordinator provides administrative support for utilization management operations, including reviewing records and processing information. They also coordinate communications with internal and external stakeholders while ensuring accuracy and timeliness in service delivery.
The coordinator provides administrative support for utilization management operations by reviewing records, performing data entry, and maintaining accurate documentation. They also facilitate communication between internal teams and external stakeholders to ensure efficient service delivery.
The assistant will engage members via phone to conduct non-clinical health assessments and identify barriers to care. They will also assist members in scheduling appointments and accessing health-related benefits while documenting all interactions in an auto-dialer system.
Handle over 40 inbound calls daily from members and providers to resolve benefit questions, service issues, and general inquiries. Document all interactions accurately in internal systems while ensuring compliance and high-quality customer experience.
Lead the AI-first transformation of the clinical technology organization by integrating AI-assisted engineering and agentic workflows into enterprise systems. Oversee the delivery of critical healthcare platforms like Epic Tapestry and Compass Rose while partnering with cross-functional leadership to drive interoperability and data platform architecture.
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 unifies product strategy and solution architecture across four core business segments to deliver integrated health solutions. You will own cross-segment product roadmaps, establish architectural standards, and serve as the primary liaison between business leaders and technical teams.
The Senior Enterprise Architect translates business needs into technical systems solutions and architectural roadmaps while aligning business vision with technology strategy. They also mentor other architects and lead modernization initiatives to ensure efficient execution of technology standards.
The Regional CMO provides executive leadership to drive clinical excellence, performance, and patient outcomes across multiple geographies. They partner with the Regional Market President to build high-performance care teams and implement value-based care strategies.
The Care Manager will telephonically assess and evaluate members' needs to facilitate optimal wellness and coordinate appropriate community care and services. They will work within a multi-disciplinary team to manage physical, environmental, and psycho-social health issues while ensuring patients progress toward desired outcomes.
The Lead Solutions Architect translates business needs into integrated technical systems by working with hardware, software, and network interfaces. They also advise executives on functional strategies and exercise independent judgment on complex technical issues.
The RN Care Manager will assess member health needs, develop comprehensive care plans, and coordinate with primary care providers to support members in the Wisconsin Family Care Program. The role involves regular health assessments, member education, and documentation within a remote work environment with 40% travel.
The Utilization Management Nurse coordinates and communicates medical services and benefit determinations using clinical nursing skills. They interpret criteria and policies to ensure members receive the most appropriate treatment and care.
The Lead, Offensive Security will govern red-team tradecraft, set rules of engagement, and lead complex adversary-emulation campaigns. They will also drive the integration of agentic AI into offensive workflows and conduct adversarial testing of production AI systems.
The representative conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes by traveling to provider offices to retrieve and validate documentation. They are responsible for uploading verified records to a centralized database while ensuring strict adherence to HIPAA and internal compliance guidelines.
The RN Care Manager assesses member health and safety needs to develop comprehensive care plans and coordinates with acute and primary care providers. They also provide education on disease processes and lifestyle modifications while maintaining accurate member documentation.
The role involves analyzing provider network performance, auditing contracts, and ensuring quality assurance for network loading. You will also monitor network adequacy data and collaborate with internal departments to manage provider escalations and contracting opportunities.
The Associate Director leads a team of actuarial professionals to develop complex models and forecasts for financial and operational decision-making. They ensure data integrity, perform root cause analysis of trends, and partner with stakeholders to solve complex business challenges.
The Network Optimization Lead will drive network performance and compliance for Humana's Illinois Medicaid plan by managing provider contracting and network adequacy. They will collaborate with internal teams to implement value-based care models and ensure operational alignment with state requirements.
Perform expert clinical reviews of inpatient medical records to assess medical necessity based on national guidelines and company policies. Communicate effectively with external providers to obtain clinical information and discuss utilization management determinations.
The Cyber Security Engineer will support the engineering, integration, and operationalization of enterprise security tools across cloud environments and development pipelines. They will also manage security policies, troubleshoot tool issues, and create documentation to improve the organization's overall security posture.
The field agent is responsible for selling Medicare insurance products to prospective clients within the assigned territory. They will manage client relationships and ensure compliance with all insurance regulations.
The Senior Security Architect for AI defines and develops security architecture requirements and secure designs for AI technology solutions across the enterprise. They lead threat modeling, risk assessments, and the development of security patterns to protect Humana's tools, data, and systems.
The field agent is responsible for selling Medicare insurance products to clients within Jefferson County, Missouri. They will manage client relationships and provide professional guidance on insurance coverage options.
The Behavioral Health Medical Director is responsible for developing behavioral health care strategy, operations, and new delivery models while ensuring quality of care and financial goals. They use their medical expertise to make authorization determinations for services and collaborate with external providers to support regional market priorities.
The pharmacist performs medical necessity and comprehensive medication reviews for pre-authorization requests. They also analyze medication care plans and intervene with providers to ensure cost-effective, high-quality patient outcomes.
The Care Coach conducts telephonic outreach to members with chronic conditions to assess needs and develop individualized care plans. They coordinate services, connect members to community resources, and monitor health outcomes while maintaining strict compliance standards.
The Provider Relations Representative manages day-to-day relationships with LTSS and HCBS providers to ensure positive engagement and network retention. They are responsible for conducting provider training, facilitating onboarding, and resolving operational inquiries regarding claims and policies.
The Technology Implementation Lead delivers scalable, governed data solutions for Finance by translating business needs into production-ready assets. They lead the full lifecycle of data foundation projects, including Databricks development, data quality monitoring, and metadata management.
The Senior Insurance Product Compliance Professional performs research and consultation for policy language development and negotiates with regulatory agencies to secure form approvals. They also manage annual On-Exchange submission processes and serve as a subject matter expert for Specialty lines of business.
The AVP of FP&A leads strategic financial planning, forecasting, and value creation for the Primary Care Organization. This role also manages M&A due diligence, payer contracting strategies, and the development of driver-based financial models to support executive decision-making.
You will lead the development of an in-house AI agent platform to automate and enhance offensive security operations, including red teaming and penetration testing. Additionally, you will perform adversarial testing on the company's own AI systems to identify vulnerabilities and ensure robust security guardrails.
Assess and evaluate member needs to develop person-centered care plans while facilitating access to long-term services and community resources. Conduct field visits to member homes or facilities to advocate for care, monitor health outcomes, and ensure service needs are met.
The specialist will create personalized care plans and coordinate long-term services for members to improve health outcomes and independence. They will conduct field visits to assess member needs, advocate for care, and facilitate connections with community resources and interdisciplinary teams.
The Technology Implementation Lead coordinates with HIT vendors to evaluate and implement clinical opportunities for the PBM while driving alignment across cross-functional teams. They are responsible for overseeing contract execution and managing business relationships to ensure seamless operational transitions.
The Utilization Management Behavioral Health Professional coordinates medical services and benefit administration determinations using clinical knowledge and independent critical thinking. They communicate with providers and members to facilitate optimal care while adhering to organizational strategies and established guidelines.
The Implementation Professional supports connections for the IntelligentRx Real-Time Benefit tool and MyRx pharmacy pricing service by coordinating with internal and external teams. They are responsible for gathering business requirements, managing system design, and overseeing testing and operational readiness.
The Encounter Data AI & Automation Lead will spearhead initiatives to improve encounter data accuracy through AI-driven reconciliation and automation. This role involves monitoring model performance, identifying process gaps, and collaborating with cross-functional teams to scale automation solutions.
The Senior Storage Engineer is responsible for the architecture, deployment, and management of large-scale enterprise backup, recovery, and data protection solutions. This role serves as a technical leader, driving cyber resilience, platform modernization, and automation initiatives across on-premises and cloud environments.
The Behavioral Health Medical Director is responsible for behavioral health care strategy, operations, and performing clinical reviews to determine service authorizations. They collaborate with internal teams and external providers to support regional market priorities and ensure compliance with regulatory and clinical guidelines.
The Medicare Sales Field Agent will educate individuals on Medicare Advantage plans and additional health offerings through face-to-face interactions and community engagement. They are responsible for driving self-generated sales, meeting performance goals, and building lasting relationships within the local community.
You will build trust and educate individuals on Medicare Advantage plans while conducting grassroots marketing and in-home visits. Additionally, you will drive self-generated sales and meet performance goals to expand the company's presence in the local community.
The Medicare Sales Field Agent will educate individuals on Medicare Advantage plans and build trust through face-to-face interactions and community events. They are responsible for driving self-generated sales and meeting performance goals while expanding the company's market presence.
The 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 within their assigned territory.
The auditor reviews inpatient medical records for DRG and ICD-10 coding accuracy to resolve disputes within the coding team. They collaborate with departments to ensure compliance and professional communication of dispute outcomes to providers.
The Compliance Lead develops and implements pharmacy compliance policies for Medicare programs while overseeing performance monitoring and risk assessments. They collaborate across departments to ensure adherence to regulatory requirements and manage relationships with government agencies and external partners.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans through grassroots marketing and in-home visits. They are responsible for driving self-generated sales and meeting performance goals within their assigned territory.
The Care Manager will provide telephonic support to members with chronic conditions by assessing their health needs and developing individualized care plans. They will collaborate with interdisciplinary teams to coordinate services and monitor patient progress to ensure optimal health outcomes.
The Field Care Manager assesses member needs and develops care plans to optimize physical and psycho-social health outcomes. This role involves extensive travel to conduct face-to-face meetings with members, families, and providers to resolve barriers to effective care.
The Lead Solutions Architect will own the architectural vision for complex, multi-system initiatives and provide leadership for CenterWell Home Health platforms. They will act as a connective force between business strategy and engineering execution while governing solution designs against enterprise standards.
The Senior AI Implementation Lead designs and implements scalable AI solutions, including LLM orchestrations and resilient microservices to meet business objectives. They also lead cross-functional teams and influence strategy while ensuring adherence to responsible AI practices and regulatory compliance.
The Senior Application Architect designs and develops IT architecture solutions that align with enterprise standards and business needs. They are responsible for technical planning, creating architecture artifacts, and making decisions on complex project components.
The Medicare Sales Field Agent will build trust and educate individuals on Humana's Medicare Advantage plans and supplemental offerings through face-to-face interactions. They are responsible for driving self-generated sales, meeting performance goals, and expanding the company's market presence through community engagement.
The Medicare Sales Field Agent will build trust and educate individuals on Medicare Advantage plans through face-to-face interactions, community events, and in-home visits. The role involves self-generating sales, meeting performance goals, and expanding Humana's presence within the designated territory.
The Field Care Manager serves as the primary point of contact for members, providing integrated behavioral health care and coordinating services to improve health outcomes. They lead interdisciplinary care teams, conduct face-to-face assessments, and address health-related social needs to ensure high-quality, person-centered care.
The Senior Offensive Security Engineer will build and operate AI-driven agentic tooling to enhance offensive security operations. They will conduct penetration tests, red-team operations, and purple-team exercises while securing the enterprise's internal AI systems.
The Senior Offensive Security Engineer designs and executes activities to simulate threat actors and pressure test security controls. This role involves building agentic offensive tooling and conducting end-to-end penetration tests and red-team operations.
You will lead the penetration testing practice by defining methodologies, standards, and adopting agentic AI offensive tooling. You will also conduct complex security assessments and translate technical findings into business risk for stakeholders.
The Medical Coding Coordinator reviews and educates providers on adjudicated claims involving code editing denials or financial recovery. They are responsible for extracting clinical information from medical records and assigning accurate procedural terminology and medical codes.
The RN Care Manager will assess member health and safety needs to develop comprehensive care plans and provide ongoing education regarding disease processes and lifestyle modifications. They will coordinate care with primary and acute providers while maintaining accurate documentation and conducting regular member visits.
The Medical Director provides clinical determinations and medical interpretations to ensure healthcare services align with national guidelines, CMS requirements, and Humana policies. They collaborate with cross-functional teams to support departmental objectives, quality outcomes, and appropriate utilization management.
The Principal Anaplan Solutions Architect will own the end-to-end architecture for workforce planning and management domains while serving as a strategic advisor to Finance and HR leadership. They are responsible for setting architectural standards, mentoring team members, and ensuring seamless integration between Anaplan and enterprise systems.
The Field Care Manager performs face-to-face and telephonic assessments to provide integrated behavioral health care coordination for members. They manage interdisciplinary care teams, facilitate treatment plans, and address health-related social needs to improve overall health outcomes.
Conduct home and facility visits to assess Medicaid members' needs and develop personalized care plans. Coordinate services and monitor patient progress to ensure optimal well-being and access to community resources.
The Group Sales Representative develops and maintains relationships with brokers and consultants to drive the sale and retention of ancillary group insurance products. They are responsible for executing strategic plans to increase market penetration and delivering polished presentations to employers with 50+ employees.
Responsible for behavioral health care strategies and operations, including making clinical determinations on requested services and levels of care. The role involves reviewing complex clinical scenarios, conducting peer-to-peer discussions with external physicians, and ensuring regulatory compliance.
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 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.
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 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 Humana’s Medicare Advantage plans while creating meaningful connections through community engagement. Agents will drive self-generated sales and expand Humana’s 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 will drive self-generated sales and 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 events and in-home visits. The role involves self-generated 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 engagement. The role involves self-generating sales and expanding Humana's presence in the market.
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 role involves building trust and educating individuals on Humana’s Medicare Advantage plans while creating meaningful connections through community events and in-home visits. Agents are expected to drive self-generated sales and expand Humana’s market presence.
The Medicare Sales Field Agent will build trust and educate individuals on Humana’s Medicare Advantage plans while creating meaningful connections through community engagement. They will drive self-generated sales and expand Humana’s 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 will drive self-generated sales and 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 driving self-generated 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 engagement. They will drive self-generated sales and 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. They will also drive self-generated sales and expand Humana’s market presence.
As a Bilingual Medicare Sales Field Agent, you will educate individuals on Humana’s Medicare Advantage plans and create meaningful connections through community engagement. You will also drive self-generated sales and expand 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 drive self-generated sales and expand Humana’s presence in the market.
As a Bilingual 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 drive self-generated sales and expand 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 events and in-home visits. Your role will also involve driving 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 events and in-home visits. Your role will involve driving 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 drive self-generated sales and expand 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 drive self-generated sales and expand 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 drive self-generated sales and expand 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 drive self-generated sales and expand Humana’s 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 organization’s 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.
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 Humana’s Medicare Advantage plans while creating meaningful connections through community engagement. You will drive self-generated sales and expand 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 events and in-home visits. Your role will also involve driving self-generated sales and expanding Humana’s 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.
