The Senior Product Owner defines the product vision and roadmap while prioritizing the product backlog for an Agile delivery team. They serve as the primary contact for stakeholders and the development team to ensure the product is delivered within budget and on schedule.
You will develop and optimize real-time personalized journeys using Adobe Experience Platform and Adobe Journey Optimizer to drive business outcomes. This role involves collaborating with cross-functional teams to configure campaigns, validate audience segments, and ensure operational excellence across digital channels.
The Director leads the enterprise provider performance infrastructure, including strategy, reporting, and governance to improve Medicare Stars performance. They partner with cross-functional teams to develop and optimize provider-facing programs and data-driven insights.
The role involves providing non-licensed customer support for Medicare inquiries before transitioning into a licensed sales or customer success position. Responsibilities include handling customer interactions, learning healthcare operations, and eventually managing plan enrollments and service needs.
The Senior Content Designer will drive content strategy and design across digital product areas to create human-centered healthcare experiences. They will partner with cross-functional teams to simplify complex information and ensure consistency across web, mobile, and other digital surfaces.
The Associate Director of Quality Assurance leads the strategy and governance for the Creative and Content team to ensure all marketing collateral is accurate, compliant, and on-brand. This role manages a team of proofreaders and partners with cross-functional leaders to identify risks, reduce rework, and improve overall delivery quality.
The Portfolio Enablement Lead shapes and advances Humana's portfolio operating model and Agile Release Train design across multiple portfolios. This role acts as a trusted advisor to executive leadership to drive alignment, flow, and measurable business outcomes through enterprise transformation.
The Associate Director leads the strategy, planning, and execution of organic social media programs to support brand and business priorities. They partner with cross-functional teams to ensure content is compliant, measurable, and aligned with the company's voice.
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 Portfolio Enablement Lead shapes and advances Humana's portfolio operating model, Agile Release Train design, and Ways of Working across multiple portfolios. This role acts as a trusted advisor to executive leadership to translate enterprise strategy into scalable frameworks that drive value delivery and organizational agility.
The Care Coach evaluates member needs and develops specific care plans to ensure optimal wellness and access to quality services. They conduct home and facility visits to coordinate care, monitor progress, and facilitate interactions between members and healthcare providers.
The Senior Claims Research & Resolution Professional manages claims operations involving investigation and resolution of complex, escalated claims. This role requires collaborating with multiple business areas to analyze data and identify trends to support accurate claims adjustments.
Configure and optimize enterprise insider threat technologies, specifically Microsoft Purview and Proofpoint ITM, to detect and mitigate risks. Partner with HR, Legal, and Security Operations to investigate alerts and ensure the protection of sensitive company assets.
The professional will analyze and measure business processes while overseeing critical incident reporting and mitigation strategies. They will also conduct audits, prepare state reports, and provide training to staff on quality improvement initiatives.
The engineer provides technical expertise for incident response, forensic investigations, and root-cause identification regarding identity-based threats and fraud. They also develop automation and detection capabilities to improve investigative workflows and operational efficiency.
Lead AI-driven initiatives to improve encounter data accuracy and automate reconciliation processes. Monitor model performance and collaborate with technical teams to identify and implement data quality enhancements.
The Associate Vice President provides cross-functional strategic leadership to improve the quality and effectiveness of enterprise-level decisions across Finance, Markets, and Growth Strategy. This role serves as an independent challenge function, ensuring strategic priorities are grounded in market realities and organizational governance standards.
The Lead Solution Architect will drive the architecture strategy, design, and governance for the organization's CIAM/XIAM ecosystem using ForgeRock. They will collaborate with cross-functional teams to translate business requirements into scalable, secure, and compliant identity solutions.
The Project Manager will lead end-to-end delivery of cross-functional projects supporting clinical operations and regulatory compliance. They are responsible for defining project scope, managing risks, and driving alignment across clinical, operational, and technology stakeholders.
The Care Manager assesses and evaluates member needs to facilitate appropriate resources and develop care plans to achieve optimal wellness. They employ various strategies to manage physical and psycho-social health issues while monitoring patient progress toward desired outcomes.
The Strategy & Operations Lead identifies and operationalizes innovations to improve the effectiveness and efficiency of care management services for Medicare and Special Needs populations. They lead cross-functional teams to analyze complex problems and translate strategic recommendations into actionable execution plans.
The Lead Software Engineer will design and own the end-to-end architecture of AI systems, including LLM-powered clinical tools and agent-based workflows. They will also collaborate with cross-functional teams to translate care delivery workflows into high-impact AI features while ensuring HIPAA compliance.
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 Medicare Sales Field Agent will educate individuals on Medicare Advantage plans and build trust 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 manager will provide leadership, mentoring, and support to care management staff to ensure compliance with the Family Care program. They are responsible for assessing staff performance, facilitating training, and collaborating across departments to maintain high-quality member services.
The Lead Solutions & AI Enablement Architect provides architecture leadership for CenterWell programs, shaping conceptual architectures and governing solution designs. They collaborate with product, engineering, and security teams to align delivery with cloud and data strategies while ensuring compliance with regulatory requirements.
The Senior Portfolio Enablement Lead acts as a strategic advisor to senior executives to shape portfolio operations, Agile Release Train design, and organizational transformation. The role drives continuous improvement and Lean adoption across business and technology teams to optimize value delivery and operational excellence.
Develop and maintain Salesforce Health Cloud solutions using Apex, Flows, and OmniStudio to support primary care business operations. Collaborate with cross-functional teams including product owners and stakeholders to translate business requirements into technical solutions within an Agile environment.
The Software Engineer 2 codes applications based on business requirements and standardizes quality assurance procedures. They oversee testing, debugging, and resolve complex software issues while aligning with organizational strategy.
The engineer will maintain and modernize a mature enterprise application by performing hands-on development across backend, frontend, and database layers. They will also collaborate with offshore teams to conduct code reviews, troubleshoot issues, and implement performance improvements.
Design and deliver end-to-end user experiences for medical benefits products while collaborating with cross-functional teams to drive meaningful member outcomes. Advocate for accessibility and inclusivity while utilizing research and analytics to inform design decisions and improve the member journey.
The Senior Quality Improvement Professional will lead initiatives to improve Kentucky Medicaid clinical quality performance measures and develop sustainable process improvements. They will collaborate with internal and external partners to manage QI documentation, PIPs, and performance metric analysis.
Develop and maintain Salesforce Health Cloud solutions using Apex, Flows, and OmniStudio to support primary care business operations. Collaborate with cross-functional teams to design, test, and deploy technical solutions while following Agile delivery practices.
The Associate Actuary is responsible for setting pricing assumptions for Medicare Part D bids and developing projections for drug utilization trends. They collaborate with cross-functional teams to analyze historical claims and market dynamics to support strategic decision-making.
The Consultative Pharmacy Technician acts as an intake point for patients and providers to resolve medication access barriers and manage prior authorizations. They also conduct patient outreach, manage referrals, and support clinical pharmacists with medication list reviews and formulary needs.
Coordinate end-to-end program and product delivery across cross-functional teams including Product, Marketing, Data, and Technology. Manage project milestones, dependencies, and risks while facilitating alignment and clear communication across the organization.
The Chief Medical Officer, Utilization Management, will lead the clinical strategy and operations for Humana's UM organization across Medicaid and Medicare. This role is responsible for integrating clinical teams, driving trend savings, improving Star Ratings, and ensuring consistent, high-quality clinical practices.
The AVP will lead the end-to-end lifecycle of clinical programs and products, from strategy and design to implementation and scaling. They will drive cross-functional collaboration across the enterprise to improve health outcomes, member experience, and financial performance.
The Float Case Manager will assess member health and safety needs to develop comprehensive care plans and coordinate services across the SW region of Wisconsin. This role involves conducting regular in-person and phone assessments while maintaining accurate documentation and ensuring cost-effective service delivery.
The analyst will administer and maintain the Configuration Management Database (CMDB) to ensure accurate tracking of IT assets and system components throughout their lifecycle. They will also perform audits, contribute to incident management, and generate reports to support operational excellence and compliance.
The representative will support pharmacists and patients by managing medication therapy programs and conducting comprehensive medication reviews. They will also handle inbound and outbound calls to confirm patient medication adherence and provide health education.
The Business Intelligence Analyst designs, develops, and maintains data solutions while supporting Service Fund operations through reporting and analytics. They also optimize ETL pipelines and collaborate with cross-functional teams to streamline data processes and ensure data integrity.
The Senior Network Resource Group Professional supports the operations, governance, and enterprise alignment of Humana’s Network Resource Groups to drive inclusion and associate engagement. This role manages complex initiatives, analyzes data to provide actionable insights, and partners with stakeholders to translate strategy into practical actions.
The Quality Compliance Professional will conduct medical record reviews and ensure adherence to regulatory requirements for clinical and non-clinical projects. They will also guide NCQA accreditation efforts and analyze data to implement necessary corrective actions.
The Telephonic Care Manager provides holistic case management interventions to prevent hospital readmissions and coordinate care for special populations. They serve as the primary point of contact for beneficiaries, collaborating with providers and military treatment facilities to ensure integrated care plans.
The role involves developing and maintaining data solutions, including Python scripts, SQL queries, and Power BI dashboards to ensure data integrity. You will also perform root cause analysis on data issues and present actionable insights to internal and external partners.
The Associate supports the development, activation, and adoption of Humana's brand strategy by translating market and customer insights into actionable recommendations. They partner with cross-functional teams to ensure brand priorities are consistently applied across all customer touchpoints and business initiatives.
This role partners with clinical teams to standardize and improve operational processes within the National Medicaid Operations Utilization Management team. The professional is responsible for developing sustainable workflows, maintaining SOPs, and ensuring compliance with governing and NCQA requirements.
The role involves supporting network optimization through data analysis, reporting, and process improvement. You will integrate data from multiple sources to generate insights and maintain reporting solutions for business partners.
The Senior User Interface Design Engineer will own end-to-end design for clinical product verticals, from discovery to pixel-perfect delivery. They will also contribute to design systems and collaborate with cross-functional teams to solve complex healthcare workflows.
Design and lead the development of core backend services, APIs, and service-to-service integrations for the AI product stack. Establish security patterns, ensure HIPAA compliance, and define engineering standards for the platform.
Develop and maintain LLM-powered features, including RAG systems and intelligent workflow automation for clinical settings. Build backend services and infrastructure while ensuring all systems comply with HIPAA standards for sensitive health data.
The Medical Director is responsible for Medicaid care strategy and operations, including performing clinical reviews to determine medical necessity and appropriateness of care. They also conduct peer-to-peer discussions with external physicians and collaborate with regional stakeholders to support value-based care initiatives.
The role involves leading the development and execution of marketing strategies for Humana's insurance brokerage business to drive engagement and growth. You will collaborate with cross-functional teams to translate consumer insights into actionable marketing plans and ensure strategic alignment across all initiatives.
The RN Care Manager Lead provides lead care management services and mentors nurses and care coaches within the Family Care Partnership program. They collaborate with the Interdisciplinary Team to assess member needs and coordinate comprehensive medical, social, and behavioral health services.
The Director leads Humana's state advocacy and government engagement strategy across Illinois and a regional group of states. This role advances policy priorities, manages relationships with key stakeholders, and coordinates legislative and regulatory activities to support business growth.
The Medicaid Provider Materials Lead is responsible for creating and updating core provider educational materials, manuals, and training resources to ensure compliance with state contracts. This role involves collaborating across business segments to align provider learning needs with operational changes and state requirements.
The Associate Actuary provides actuarial support for the Illinois Medicaid market, including capitation rate reviews and financial forecasting. They also advise executives on functional strategies and perform complex business analytics under the supervision of an FSA Actuary.
The Associate Vice President provides strategic and operational leadership for multidisciplinary care coordination programs serving Indiana Medicaid members. This role oversees integrated care models, complex case management, and regulatory compliance while managing large-scale clinical and non-clinical teams.
The Care Management Support Assistant processes referrals for the Autism Care Demonstration program by coordinating authorizations and managing treatment plans. They also provide support by answering inbound calls and chats from providers and beneficiaries while maintaining accurate documentation in the medical management system.
The Lead Software Engineer will own AI products from concept through production, defining technical approaches and delivering solutions that create value for clinicians and members. They will collaborate with cross-functional teams to build scalable AI features while ensuring compliance with HIPAA and responsible AI standards.
The Senior Clinical Pharmacist will drive collaboration across teams to implement and track clinical program strategies for Medicaid lines of business. They will also participate in program innovation, analyze key performance indicators, and maintain clinical drug lists to ensure program excellence.
The Senior Clinical Pharmacist will drive the implementation of clinical program strategies and collaborate with cross-functional teams to ensure program excellence. They are responsible for tracking key performance indicators, managing drug lists, and fostering relationships with internal and external partners.
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 technical guidance for API lifecycle management.
The Field Care Management Team Lead oversees daily operations, manages case assignments for care coordinators, and ensures performance excellence in alignment with organizational goals. The role also involves conducting onsite quality assurance visits, providing clinical training, and supporting the Interdisciplinary Care Team to address member health needs.
The Community Health Worker serves as a liaison between health services and the community, conducting in-home visits to support case management and address social determinants of health. They assist members in navigating the healthcare system, managing chronic conditions, and coordinating access to essential social services.
The Medical Director reviews complex Medicare drug appeals by analyzing clinical data against regulatory policies and Humana guidelines. They collaborate with clinicians and support staff to ensure members receive optimal value-based care.
The Director of Product Management will lead the vision, strategy, and execution for the enterprise IVR ecosystem, focusing on modernization and conversational automation. This role involves owning the full product lifecycle, managing high-performing teams, and driving measurable improvements in customer outcomes and operational performance.
Lead a team providing Medicaid healthcare trend insights and strategic advisory services to support business decision-making. Translate complex analytical findings into compelling narratives for executive leadership to improve total cost of care performance.
The Credentialing Professional supports clinician compliance by performing primary source verifications and maintaining accurate records of licenses and certifications. They also support internal and external audits while partnering with teams to ensure ongoing regulatory compliance.
The Senior Process Improvement Professional analyzes and measures the effectiveness of business processes to develop sustainable and quantifiable improvements. They oversee the implementation of these changes while partnering with subcontractors to ensure timely and accurate processing of TRICARE claims.
The Pharmacy Stars Improvement Lead develops and implements clinical program strategies to improve Medicare members' medication adherence and appropriate medication use. They exercise independent judgment to manage complex issues and analyze variable factors to optimize patient safety measure performance.
The Associate Director leads a team of Contract Managers to oversee the negotiation, execution, and governance of supplier agreements while driving operational excellence. This role serves as a strategic advisor to senior leadership and partners with cross-functional teams to mitigate risk and maximize business value.
The Senior Analytics Consultant serves as a strategic partner to business leaders, transforming complex operational and pharmacy data into actionable insights. They lead analytical initiatives from discovery through delivery, designing decision-support tools and communicating findings to diverse audiences.
The RN Field Care Manager assesses and evaluates member needs to develop and coordinate individualized care plans in home or community settings. They serve as the primary point of contact for the Interdisciplinary Care Team to ensure members receive appropriate clinical support and social services.
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 self-generating sales, meeting performance goals, and expanding Humana's presence within the designated territory.
Build trust and educate individuals on Medicare Advantage plans and additional health offerings through face-to-face interactions. Drive self-generated sales and expand the company's market presence through community events and relationship building.
The Lead Digital Product Manager oversees the product vision, strategy, and roadmap for digital experiences while managing multiple workstreams from conception to completion. They lead cross-functional teams to deliver mobile-first customer journeys and identify opportunities to convert channel-specific functionality into reusable platform capabilities.
The Inpatient Medical Coding Auditor extracts clinical information from medical records to assign accurate procedural terminology and medical codes. They review inpatient hospital claims to ensure correct reimbursement and appropriate diagnosis related group (DRG) assignments.
The Lead Intelligence Data Architect serves as the subject matter expert for the collection, organization, and usability of cyber threat intelligence across enterprise security teams. This role defines standards for data structure to ensure threat intelligence is effectively consumed by both human analysts and AI-driven automated systems.
The Lead Cloud Architect will provide strategic leadership and engineering oversight for enterprise NoSQL database platforms across cloud environments. This role involves designing, implementing, and modernizing database solutions while ensuring they are secure, scalable, and aligned with enterprise standards.
The Case Manager will assess member health and safety needs to develop and implement comprehensive care plans. They will coordinate services, conduct regular face-to-face assessments, and maintain accurate documentation to ensure effective support for members.
The Care Management Support Professional provides non-clinical support to assess enrollee needs and connects them with community-based resources for housing, transportation, and food security. They also facilitate communication between care managers, providers, and community organizations to ensure integrated care and support treatment adherence.
The Care Manager assesses and evaluates member needs to facilitate access to behavioral health resources and integrated care services. They serve as the primary point of contact, managing care plans and coordinating with interdisciplinary teams to improve health outcomes.
The Lead Software Engineer will architect, build, and deliver modernized claims ecosystem solutions while mentoring a team of software engineers. They are responsible for standardizing quality assurance procedures, conducting code reviews, and providing technical guidance throughout the software development lifecycle.
The Lead Solutions Architect will design and engineer enterprise-level cloud infrastructure and digital application solutions aligned with business needs. They will provide architectural strategies, lead technical roadmaps, and collaborate with cross-functional teams to ensure successful project delivery.
You will shape the end-to-end mobile member experience across Humana's digital channels by designing intuitive and accessible interactions. You will collaborate with cross-functional teams to deliver cohesive omnichannel experiences that improve member engagement and digital adoption.
The professional will use clinical knowledge to support the coordination, documentation, and communication of medical services and benefit administration determinations. They will interpret criteria and policies to facilitate optimal treatment and care for members while working independently in varied assignments.
The Senior Associate will configure, test, and deploy personalized member journeys using Adobe Experience Platform and Adobe Journey Optimizer. They will collaborate with cross-functional teams to refine audience segments and monitor journey performance to drive measurable business outcomes.
The Care Coach assesses member needs, coordinates services, and develops care plans to ensure optimal health outcomes and independence. They act as a liaison between members, providers, and interdisciplinary teams while resolving barriers to care and facilitating access to community resources.
The RN Care Manager assesses member health and safety needs to develop comprehensive care plans and coordinates with primary care providers. They also provide ongoing education to members and manage documentation within required contract timeframes.
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 ongoing education to members regarding disease processes, lifestyle modifications, and health risks while maintaining accurate documentation.
The RN Care Manager will assess member health and safety needs to develop comprehensive care plans and coordinate with primary care providers. They will also provide ongoing education to members regarding disease processes, lifestyle modifications, and health risks while maintaining accurate documentation.
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 ongoing education to members and maintain accurate documentation in compliance with contract requirements.
The Case Manager will assess member health and safety needs to develop and implement comprehensive care plans while coordinating services with field care nurses. They are responsible for conducting regular face-to-face assessments, maintaining accurate documentation, and arranging necessary social and community support services.
The Care Coach evaluates member needs and coordinates services to facilitate optimal wellness and resolve barriers to care. They monitor patient progress through assessments, data analysis, and active care planning to ensure desired health outcomes.
The Associate Vice President provides clinical leadership and strategic direction for STARS and Risk Adjustment initiatives while driving provider engagement. They are responsible for developing KPIs, overseeing clinical quality programs, and ensuring compliance with regulatory standards.
The Field Care Manager assesses member needs to develop and implement individualized care plans while facilitating access to appropriate resources. They monitor patient progress through regular assessments and coordinate services across various care settings to ensure optimal wellness.
The Compliance Professional 2 develops and implements compliance policies while researching issues to ensure adherence to contract obligations. They also coordinate site visits for regulators and manage the implementation of corrective action plans.
The professional will conduct annual quality reviews, perform medical record abstractions for Coordination of Care studies, and analyze data to implement corrective actions. They will also support organizational strategy by managing project goals and facilitating care for members.
The Principal Software Engineer will develop AI-powered software solutions, intelligent applications, and reusable frameworks to transform enterprise quality engineering. They will provide technical leadership, mentor engineering teams, and integrate advanced AI capabilities into production-ready enterprise platforms.
The IT integration leader provides strategic guidance for M&A, divestitures, and joint ventures, managing end-to-end IT integration plans and due diligence. This role involves partnering with corporate development and senior leadership to ensure technology alignment, risk mitigation, and synergy realization.
The Senior Learning Design Professional partners with business leaders and SMEs to design and develop scalable learning solutions that strengthen technical AI capabilities. They are responsible for conducting needs analyses, creating multimedia learning assets, and tracking the effectiveness of training programs to drive performance improvements.
The Learning Design Lead designs and advances AI-focused learning pathways by translating capability needs into practical, measurable learning experiences. You will lead the design and development of various learning formats while collaborating with business partners and subject matter experts to ensure quality and consistency.
The Member Services Advisor develops and executes strategies to improve member engagement, retention, and satisfaction while managing key market performance metrics. They lead cross-functional workgroups to identify friction points and implement automation solutions to enhance the overall consumer experience.
The Care Manager will telephonically assess and evaluate members' needs to facilitate appropriate care and wellness resources. They will collaborate with an interdisciplinary team to manage physical, environmental, and psychosocial health issues while monitoring patient progress.
The Care Coach performs member outreach to assess needs, coordinate services, and manage health outcomes through active care planning. They also maintain accurate documentation and collaborate with multi-disciplinary teams to ensure compliance with regulatory standards.
The Field Care Manager assesses and evaluates member needs to create individualized care plans and facilitate access to appropriate physical and behavioral health resources. They coordinate care across the lifespan while monitoring patient progress and collaborating with interdisciplinary teams to ensure optimal health outcomes.
The RN Field Care Manager assesses member needs, develops care plans, and coordinates services to ensure optimal health outcomes in home and community settings. They serve as the primary contact for the Interdisciplinary Care Team and conduct comprehensive clinical assessments to ensure regulatory compliance.
The Care Management Support Assistant provides nonclinical administrative support to the care management team, including evaluating enrollee needs and facilitating access to wellness resources. The role involves performing moderately complex operational tasks and maintaining quality standards while working under minimal direction.
The Case Manager provides care management services including psychosocial assessments, service plan development, and ongoing monitoring for adults with disabilities and the frail elderly. They collaborate with an interdisciplinary team to coordinate medical, social, and rehabilitation services to help members achieve their desired outcomes.
The Fraud and Waste Investigator conducts investigations into allegations of fraudulent and abusive practices within the healthcare industry. They collaborate with law enforcement, assemble evidence for adjudication, and perform on-site audits of provider records.
The Senior Quality Improvement Professional leads clinical quality and provider performance initiatives for the South Carolina Medicaid Plan. They collaborate with internal and external stakeholders to analyze data, implement targeted interventions, and drive measurable improvements in HEDIS and CAHPS performance measures.
The intern will perform varied pharmacy tasks and interpret professional guidelines to determine appropriate courses of action. They will support organizational strategy while working under minimal direction to complete assigned duties.
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.
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.
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 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 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 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.
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 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.
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 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 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 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 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 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 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 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 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 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.
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.
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 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 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 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 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. 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. 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 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 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 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 events and in-home visits. Your role will also involve driving self-generated sales and expanding Humana’s market presence.
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 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.
