Humana

Become a part of our caring community The Senior Project Manager manages all aspects of a project, from start to finish, to complete it on time and within budget. The Senior Project Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.The Senior Project Manager designs, communicates, and implements an operational plan for completing the project; monitors progress and performance against the project plan; to resolve operational problems and minimize delays. Identify the resources to complete the project. Prepare designs and work specifications; develop project schedules, budgets and forecasts; and select materials, equipment, project staff, and external contractors. Communicate with other operational areas in the organization to secure specialized resources and contributions for the project. Conduct meetings and prepare reports to communicate the status of the project. Set priorities, allocates tasks, and coordinates project staff to meet project targets and milestones. Begin to influence department's strategy. On moderately complex to complex issues regarding technical approach for project components, and perform work without direction. Exercise considerable latitude in determining goals and approaches to assignments. Use your skills to make an impact  Required Qualifications Bachelor's degree or equivalent experience5 or more years of technical experiencePrevious Project Management experienceMust be passionate about contributing to an organization focused on improving consumer experiencesPreferred Qualifications Reside in one of the following states: Indiana, Kentucky, Michigan, Ohio, Illinois Work at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $86,300 - $118,700 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community We are looking for a compassionate, organized, and experienced case manager to join our amazing team! You will serve members in the Wisconsin Family Care (FC) program. Reporting to the Manager of Care Coaching, you will provide comprehensive case management services to frail elders and adults with intellectual, developmental, or physical disabilities. Let's make a difference together! You will support members in Spooner, WI and surrounding areas.Main responsibilities: Assess members health and safety needs to identify their strengths, interests, and preferences to develop a comprehensive Member Care Plan (MCP).Coordinate with a Field Care Nurse to provide services that address members' health and safety needs, ensuring the team provides support in the least restrictive environment following the MCP.Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence.Conduct quarterly in-person visits and maintain monthly contact with members by phone.Arrange support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs.Ensure cost-effective service delivery.Evaluate risk factors and provide education to members.Maintain accurate documentation including case notes, service authorizations, and updates to the MCP.Use your skills to make an impact  Required Qualifications A Bachelor's degree in human services or a related field is required, with at least 1 year of experience serving frail elders or adults with intellectual, developmental, or physical disabilities. Alternatively, a Bachelor's degree in another field with at least 3 years of such experience is also acceptable.Valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limitsPreferred Qualifications Reside within 45 mins or less of the assigned coverage areaCase Management experienceExperience with electronic case note documentationKnowledge of community health and social service agencies and additional community resourcesAdditional Information Work Location: Washburn County WI and surrounding area. Work remotely from home when not conducting member visits in their home.Travel: up to 40%Typical Workdays/Hours: Monday – Friday, 8:00 am – 4:30 pm CSTDriving You will be part of Humana's driver safety program and therefore requires you to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. Mileage reimbursement is provided for work-related travel. Eligible mileage includes: Travel from your home to your first work location of the day.Travel between client or assignment locations during the workday.Travel from your final work location back to your home.TB Screening This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Work at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $53,700 - $72,600 per year  Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community   Where you Come In The Claims Review Representative 3 partners with professional staff on pre-screening review by applying guidance, and making an appropriate decision which may include interpretation of provider information or data. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge. Use your skills to make an impact  Required Qualifications Fully Bilingual in Spanish/English. Must be able to speak, read and write in the Spanish and English language without limitations or assistance. Minimum of 1 year of strong and proven experience with processing and adjudicating medical claims Knowledge with CPT, ICD9, and ICD10 terminology/codes Proficiency in Microsoft Office applications including Word, Excel and Outlook Must reside in Puerto Rico only Preferred Qualifications CAS and/or CCP experience CIS/CIS Pro experience Finance Knowledge Work at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $35,900 - $48,200 per year  Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About Us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community The Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Actuary, Analytics/Forecasting works on problems of diverse scope and complexity ranging from moderate to substantial.The Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action. Shift: Mon-Fri 8am-5pm CST or EST Use your skills to make an impact  Responsibilities Collaborate with stakeholders to understand business needs, identify issues, and develop actionable insights into drivers of medical claims trends. Provide strategic guidance to executives on matters of significance by leveraging strong communication skills to collaborate effectively with stakeholders, present findings to leadership, and document actuarial analyses in accordance with ASOP 41, Actuarial Communications. Exercise independent judgment and make sound decisions on complex actuarial matters while working with minimal supervision and determining appropriate courses of action based on varying factors. Analyze and forecast financial, economic, and business data by applying technical knowledge, industry insights, and actuarial modeling to inform strategic and operational decision-making and assess the organization’s financial and competitive position over the short, medium, and long term. Conduct root cause analyses, establish metrics, and deliver data-driven insights and cost-effective solutions to address data-related issues and support business intelligence initiatives. Required Qualifications Bachelor's Degree FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations. MAAA Strong communication skills Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending) Preferred Qualifications SAS, SQL, Snowflake or other relevant experience Work at Home Guidance To ensure Home or Hybrid Home/Office associates have the self-provided internet service you must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Leadership approves satellite, cellular and microwave connection for use only if they give approval. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet our requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Work at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $129,300 - $177,800 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 08-12-2026About us About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community The Help Desk Support Technician 2 provides support to end users for computer, application, system, device, access and hardware issues. Utilize technical experience and customer service skill to assist end users to resolve incidents and fulfil requests remotely and escalate as needed. Involvement in project planning; installing, configuring, upgrading, and troubleshooting of computer-related hardware and software components, responding to and resolving customer requests; team leadership to ensure customer support expectations are addressed in accordance with policy, meeting service level requirements and providing excellent customer service.The Help Desk Support Technician 2: Identifies, researches, and resolves technical problems of moderate complexity.Responds to telephone, email and online requests for technical support.Documents, tracks, and monitors the problem using applicable systems and tools.Decisions are typically focus on interpretation of area/department policy and methods for completing assignments.Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction.Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.Has excellent problem-solving skills to diagnose, evaluate and resolve complex problem situations, or when appropriate, escalate or route them to appropriate IT staff members.Performs root cause analysis, develops checklists for typical problems and recommends procedures and controls for problem prevention. Diagnoses and resolves unique, nonrecurring problems associated with application software and operating systems. Creates Knowledge Base articles for applications supported and assists with new hire training of new team members. Works with multiple vendors and other Support Groups to resolve hardware and software issues in a timely manner.Use your skills to make an impact  Required Qualifications 2-3 years of technical experience Effective verbal and written communication skills Effective problem-solving skills, multi-tasking, and time management skills Proficient in use of Microsoft Office products Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Associate's or Bachelor's Degree in Computer Science, Information Technology or a related field Understanding of IT systems and functions with preferred previous work experience in the IT field Additional Information Location/Work Style: Remote US Why Humana? At Humana, we know your well-being is important to you, and it’s important to us too.  That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. Just to name a few: Work-Life Balance Generous PTO package Health benefits effective day 1 Annual Incentive Plan 401K - Excellent company match Well-being program  Paid Volunteer Time Off If you share our passion for helping people, we likely have the right place for you at Humana. Work at Home Guidance To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information SSN Alert Statement Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana’s secure website. Work at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $44,900 - $60,200 per year  Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 07-16-2026About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community The Dental Director relies on dental background and reviews dental claims. The Dental Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.The Dental Director provides dental interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Complete all clinical reviews associated with dental fraud, waste and abuse investigations and create a recommendation on the case direction. Stay up to date on all dental industry standards and provide education and guidance to creating new data tools to review provider outliers Coordinates investigation with law enforcement authorities as well as assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports and advises executives to develop functional strategies for dental fraud, waste and abuse case on matters of significance. Use your skills to make an impact  WORK STYLE: Remote/work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS: Typical business hours are Monday-Friday, 8 hours/day, 5 days/week-- some flexibility might be possible, depending on business needs. Very minimal travel might be required for trainings, meetings, and/or conferences (less than 5% travel). What you need for success! - Required Qualifications Doctor of Dental Surgery (DDS) degree or DMD A minimum of five years of experience in a clinical dentist office as a practicing dentist Must hold a clear and active license to practice dentistry (in any US state) Must be comfortable with data analysis/report interpretation Strong computer skills including MS Office desktop applications (Word, Excel, PowerPoint, Visio, Project) Demonstrated competency in written communication skills Solid understanding of process / workflow concepts Must be passionate about contributing to an organization focused on continuously improving consumer experiences Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, utilization management, discharge planning and/or home health or rehab The Dental Director conducts clinical reviews of the care received by members in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews and/or condition committees. Preferred Qualifications 5+ years of investigative or auditing experience of dental related claims Knowledge of Medicare regulations Knowledge of Medicaid regulations Knowledge of Commercial insurance regulations Additional Information - How We Value You   Benefits starting day 1 of employment  Competitive 401k match   Generous Paid Time Off accrual   Tuition Reimbursement  Parental Leave  Work at Home Requirements WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.   Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Interview Format  As part of our hiring process, we will be using on-demand technology provided by Hire Vue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making through on-demand candidate assessments. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in an on-demand assessment with pre-determined questions. You should anticipate the assessment to take approximately 10-15 minutes. Your on-demand assessment will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. SSN Task via Workday Should you be extended a formal employment offer you will receive a request to enter your SSN into our Workday system to scan for duplicate profiles. #ThriveTogether #WorkAtHomeWork at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $203,400 - $279,800 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 07-26-2026About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.The Senior Provider Contracting Professional communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Use your skills to make an impact  Required Qualifications Bachelor's degree5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare companyExperienced in negotiating managed care contracts with large physician groups, ancillary providers and hospital systems.Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.Excellent written and verbal communication skillsAbility to manage multiple priorities in a fast-paced environmentProficiency in MS Office applicationsMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Master's DegreeExperience with ACO/Risk ContractingExperience with Value Based Contracting Additional Information Work at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $78,400 - $107,800 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 07-24-2026About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community Who We Are With relentless consumer-centricity, Humana's Experience Design team, within the Consumer Digital organization, strives to eliminate friction in today's healthcare ecosystem so consumers feel confident, respected, and heard in the decisions affecting their health.As a Senior Voice of Customer Researcher, you will: Work in a multi-disciplinary team to help Humana better understand how customers experience our products and services. Use customer feedback, survey data, sentiment, behavioral signals, and experience KPIs to identify friction, unmet needs, emerging trends, and opportunities to improve the member experience. Translate customer experience data into applicable insights and support end-to-end journey improvements. Apply judgment, analytical rigor, and communication to influence outcomes, ensuring informed decision-making, and support consumer-centered improvement projects across the organization. Provide daily work guidance and subject matter support to CX professionals to ensure delivery of insights and improvement activities. Key Responsibilities Support the execution of Voice of the Customer across Humana's properties, including feedback collection, survey design, sentiment measurement, and experience performance monitoring Use tools such as Qualtrics and analytics platforms to collect, analyze, and interpret customer feedback across channels Analyze structured and unstructured feedback to identify trends, themes, pain points, user needs, and opportunities for product improvement Monitor experience KPIs such as NPS, CSAT, Customer Effort Score, Task Completion, sentiment, and customer behavior trends over time Investigate recurring issues and root causes to understand what is driving friction and how those issues impact the customer experience Translate findings into actionable insights and recommendations that inform product roadmaps, experience strategy, content improvements, and design decisions Create reports, dashboards, and stakeholder-ready presentations that clearly communicate key themes, insights, recommendations, and business implications Track the impact of implemented changes and help teams understand whether improvements are reducing friction, improving satisfaction, or supporting better task completion Partner cross-functionally with Product, Research, Content, Design, Analytics, IT, and business stakeholders to align VOC insights with product strategy and execution Socialize customer feedback and experience insights in a clear, compelling way that helps teams stay connected to member needs and experience performance Support experience improvement projects focused on prioritized end-to-end customer journeys This is a remote role reporting to the Director of Design Research.  Use your skills to make an impact  Required Qualifications Bachelor's Degree in Business, Analytics, Marketing, Research, Customer Experience, User Experience, Data Science, Healthcare Administration, or a related field 5+ years of related experience in voice of customer, customer experience, UX research, product research, insights, analytics, or a related role Experience collecting, analyzing, and interpreting customer feedback across channels Experience using Qualtrics or similar voice-of-customer, survey, or experience management platforms Experience developing surveys, managing feedback programs, and measuring customer sentiment Strong analytical skills with the ability to identify trends, themes, pain points, and opportunities from structured and unstructured data Experience creating reports, dashboards, and executive-level presentations that summarize insights and recommendations Experience translating complex data into concise, actionable recommendations for product, design, content, analytics, and business stakeholders Preferred Qualifications Experience analyzing open-text feedback using text analytics, sentiment analysis, or natural language processing tools Familiarity with digital product development, product roadmaps, customer journey mapping, or experience design Experience in healthcare, insurance, digital customer experience, or member/patient experience A portfolio or work samples that demonstrate: Experience using qualitative and quantitative methods to capture and analyze customer feedback, including surveys, sentiment analysis, behavioral analytics, and customer verbatim analysis Ability to identify and summarize customer pain points, friction, emerging trends, and opportunities for experience improvement Examples of translating customer feedback into actionable recommendations that informed product, content, design, or experience strategy Examples of reporting, dashboards, or stakeholder presentations that made insights clear, usable, and decision-ready Evidence of measurable impact, such as improvements in NPS, CSAT, effort score, task completion, engagement, or reduction in recurring customer friction Experience collaborating with cross-functional teams such as Product, Research, Content, Design, Analytics, IT, and business partners Work at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $89,000 - $121,400 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 07-24-2026About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community The Telephonic Care Manager will be part of the Humana Military Case Management team, providing a comprehensive, holistic approach for Behavioral Health Case Management throughout the continuum of care. You will have personal interaction with beneficiaries to address behavioral health needs and conditions identified through direct referrals, predictive analytics, or diagnosis triggers. You will help them to address immediate care needs, treatment plan adherence, and develop coping skills. As a remote care manager you will report to a Manager of Care Management. You will serve as the primary point of contact and coordinator for the beneficiary for all activities within the clinical spectrum. You will coordinate and collaborate with Military Treatment Facilities (MTF), other Care Management programs (such as Disease Management and Utilization Management), physicians, staff, or providers to ensure there is a fully integrated care plan addressing all beneficiary needs and conditions. Use your skills to make an impact  Required Qualifications Our Department of Defense Contract requires U.S. citizenship for this position.Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services)HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.In your state of residency, you must have a current, valid, and unrestricted license as a Mental Health (MH)/Behavioral Health (BH) Professional in at least ONE of the following: Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Mental Health Counselor (LMHC), Licensed Masters Social Worker (LMSW) AND/OR Clinical Psychologist (Ph.D.).3 years of clinical experience, which may include managed care experience.Ability to obtain a Certified Care Manager (CCM) within the first year of hire.Experience in managing mental health crisis intervention.Preferred Qualifications An active designation as a Certified Care Manager (CCM).Experience in Acute inpatient hospital case management.Experience with Medical/Behavioral Health Case Management Programs.Experience with TRICARE policies and/or the military health care delivery system.Additional Information Work Style: Remote Work Schedule: Monday – Friday; must be able to work an 8-hour shift between the hours of 8:00 a.m. – 6 p.m. EST (Eastern Standard Time) Training/Training Hours: Mandatory for the first 4 weeks between the hours 8:00 a.m. – 5:00 p.m. EST (Eastern Standard Time) Work at Home Requirements To ensure Hybrid Office/Home associates' ability to work effectively, the self-provided internet service of Hybrid Office/Home associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipAssociates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA informationWork at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $59,300 - $80,900 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 07-16-2026About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community The Field Care Manager Nurse 2 assesses and evaluates member needs to support optimal health and wellness outcomes. In this role, you will partner with members, families, and care teams to develop and implement individualized care plans, coordinate services, and connect members to resources that address both clinical and social needs. This is a field-based and telephonic position, where in-person versus telephonic engagement is guided by member needs, contractual requirements, and regulatory expectations.The Field Care Manager Nurse 2 performs advanced nursing activities including: Conduct comprehensive assessments to identify member needs, risks, and barriers to care Develop and manage member-centered care plans with measurable goals and outcomes Coordinate care across providers, community support systems Monitor progress and adjusting interventions to ensure outcomes Address social determinants of health, including housing, transportation, and access to care Utilize evidence-based care pathways to guide clinical decision-making Engage members using coaching and motivational interviewing techniques Field-Based Responsibilities: You will require travel to complete in-person visits with members in different environments to support holistic assessment and care coordination. Visits may occur in: Members' homes Group homes or community living settings Hospitals or skilled nursing facilities Homeless shelters or community locations Correctional facilities (e.g., prisons or jails) as part of reentry and transition planning You will also conduct telephonic outreach and follow-up as part of ongoing care management. Important: Field visits—including those in nontraditional settings such as correctional facilities—are an expected and essential function of this role to ensure continuity of care and successful community reintegration. Use your skills to make an impact  Required Qualifications Reside in Eastern Kentucky (strongly preferred) Active Registered Nurse (RN) license Bachelor's degree in nursing or healthcare/human services related field. 2+ years of experience working as a case manager or care manager Experience working with adult populations Knowledge of community health services, social services, and available resources Proficiency in Microsoft Office (Word, Outlook, Excel) and electronic medical records Preferred Qualifications 3+ years of care coordination or community-based experience Managed care experience Experience with health coaching and wellness promotion Case Management Certification (CCM or similar) Motivational Interviewing training Experience working with Pediatric populations and their families Bilingual (English/Spanish) Additional Information · Schedule/Time Zone: Monday through Friday, 8:00 AM – 5:00 PM Central Time Zone. · Work Location: Eastern Kentucky (strongly preferred) · Work Style: Field · Travel Requirements: Up to 25% within a 120-mile radius to complete field visits. TB Statement: This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Driving Statement: This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher. Work at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $71,100 - $97,800 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community The Director, IT Portfolio Management collaborates with the business portfolio team to align the IT portfolio and demand. The Director, IT Portfolio Management requires an in-depth understanding of how organization capabilities interrelate across the function or segment.This role will be a critical partner to our Segment CIOs, and responsible for cross functional leadership, collaboration, communication, and management of the business of running CWHM. To achieve our strategies, we must deliver on our strategic portfolio, improve operations, modernize our technology stack, improve our security posture, advance our operating and organizational maturity, and develop, diversify, and grow our talent base. This role will provide direct oversight of the following services as a shared service across the organization. IT Strategy AdvancementIT Portfolio Management and Lean Business Case Analysis and DevelopmentFinancial ManagementCommunications and Change ManagementOperations Support and MetricsTalent Strategy and Management, including Operating Model and ResourcingAgile CoachingThe Shared Services team, led by the Director, IT Portfolio Management & Shared Services, will support shared services initiatives. These initiatives will be executed across Pharmacy, Primary Care, Home Solutions, the Office of the Chief Medical Officer, and Integrated Health. The Director and team will provide more limited support to Humana Military IT as needed. Key Responsibilities Responsibilities for this role include leadership of a team responsible for the following functions. IT Portfolio Management and Lean Business Case Analysis and Development Lead a team responsible for: Execution of the Portfolio Management function with the appropriate processes, tools, and team to deliver across all represented Segments in the IT Portfolio. Works directly with the Segment CIOs to support the execution of their strategies.Execution of the IT Prioritization process, including creating/modifying initiatives and partnering with business to create proformas and lean business cases.Ensures continuous alignment of project investments and initiatives with business strategy based on changing functional needs, resource capacity constraints, risk exposure, and interdependenciesOrganizes and prioritizes initiatives and programs based on IT Strategy, strategic roadmap, available and prioritized budgets, and allocates the appropriate financial and organizational support to support those goals.Supporting IT leaders and application owners with appropriate information to understand Total Cost of Ownership (TCO), including how prioritized work impacts TCO.Supporting Agile transformation by partnering with segments to implement Agile best practices including Lean Portfolio Management.Financial Management Lead a team responsible for: Overseeing planning, budgeting, and tracking processes, working with IT Finance to ensure we achieve our objectivesPartnering with IT Finance to analyze the trends and performance against plan, while monitoring to identify and remediate the cause of any unexpected variances.Developing and continually improve budgeting, financial projections, and operating forecastAd-hoc segment performance reporting & analysisWorking with IT Finance to present the monthly and quarterly financial reportsIn concert with the SVP/CIO and Segment CIOs, oversees the approval process for all position additions and changes.IT Strategy Advancement Lead a team responsible for: Supporting the development and execution of IT strategy and annual planning processes, ensuring alignment with business objectives.Defining objectives, frameworks, and metrics for the IT strategic planning process and establishes ownership and timelines for key planning stepsPreparing regular updates and reports for leadership reviews and strategic planning meetings.Collaborating with IT Leaders and architects on technology roadmapsCommunications and Change Management Lead a team responsible for: Developing and executing communications strategy to support IT leaderships team and associates in achieving priorities.Operating rhythm: Support the SVP/CIO in the management, orchestration, facilitation, and follow-up for all departmental meetings including weekly tactical, monthly strategic, extended leadership, all hands, quarterly offsite and other key operating meetings.Change enablement: Offer organizational change management guidance and tools to support stakeholders within CWHM as they lead and experience change.Operations Support and Metrics Lead a team responsible for: Driving operational maturity by capturing and sharing key data and insights in operational dashboards that include all key metrics. Create cadence and artifacts needed to support Tech Committee, IT operations reviews, monthly business reviews, etc.Contribute to the design, rollout, and maintenance of operational dashboards and key performance metrics, providing actionable insights for IT leaders.Ensure that Segment CIOs are prepared with the information they need to maintain effective operations.Talent Strategy and Management The Director, IT Portfolio Management & Shared Services will: Work with the SVP/CIO, along with Segment CIOs, to create, update and refine operating models.Advance labor strategy: Ensure that we have consistent models for managing resourcing demand and capacity. These models should be in concert with the annual budget and aligning to key measures. The key measures include internal and external ratios, as well as onshore / offshore ratios, across the organization.In addition, the Director will lead a team responsible for: Overseeing all talent development, recruiting and internship initiatives in partnership with the IT Leadership team and HR.Enhancing the associate experience that encompasses all aspects of culture – including engagement, well-being, inclusion, and diversity – in partnership with HR and the Diversity, Equity, and Inclusion team.Use your skills to make an impact  Required Qualifications Master's Degree8 or more years of technical experience5 or more years of management experienceAbility to manage multiple tasks and deadlines with attention to detailAbility to communicate effectively and deliver presentations to senior leadersAdvanced experience leading special projects and producing metrics, measurements and trend reportsMust be passionate about contributing to an organization focused on continuously improving consumer experiencesPreferred Qualifications MBA or other Advanced DegreePossess a solid understanding of operations, technology, communications and processesSix Sigma certificationPMP certificationDemonstrated ability to run large scale, highly visible programs with responsibility for multiple project teamsAdditional Information Work-At-Home Requirements WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.Satellite and Wireless Internet service is NOT allowed for this role.A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA informationWork at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $172,200 - $236,900 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community The Fraud and Waste Professional conducts investigations of allegations of fraudulent and abusive practices. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The Fraud and Waste Professional coordinates investigation with law enforcement authorities. Assemble evidence and documentation to support successful adjudication. Conduct on-site audits of provider records ensuring appropriateness of billing practices. Prepare complex investigative and audit reports. Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receive guidance where needed. Follow established guidelines/procedures. Use your skills to make an impact  WORK STYLE: Remote/Work at Home (minimal travel,

Become a part of our caring community The Senior Stars Improvement, Clinical Professional This work focuses on areas of clinical emphasis. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Continue to focus efforts and identify opportunities on performance improvement for assigned providers Actively engages provider during virtual visit to facilitate education, HEDIS outcomes, care of members and bi-directional feedback. Attends JOCs with providers and participates in active discussions on HEDIS, member care, and clinical/quality outcomes. Communicate clinical quality initiatives to assigned providers Educate and assist providers in reducing potential preventable events Educate providers and staff about Medicaid Consume Assessment of Healthcare Providers and Systems (CAHPS) survey.Required Qualifications FL RN LicenseMust reside in the state of FloridaBachelor's degree in nursingExperience with Medicare, Medicaid, or dual eligible populationsPrior experience in a fast-paced insurance or health care settingUnderstanding of healthcare quality measures STARS, HEDIS, etc.Experience collaborating with cross-functional teamsComprehensive knowledge of Microsoft Office Word, Excel and PowerPointProven analytical skillsExcellent communication skills, both oral and writtenUse your skills to make an impact  Preferred Qualifications: Medical Coding CertificationKnowledge of Humana's internal policies, procedures, and systemsMedicaid Health Plan ExperienceWork at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $78,400 - $107,800 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community The STARS Improvement Professional 2 develops, implements, and manages oversight of the company's Medicare/Medicaid Stars Program. Directs all Stars quality improvement programs and initiatives. The STARS Improvement Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The STARS Improvement Professional 2 develops programs designed to increase the plan quality. Partners with leaders regarding implementation planning. Reviews and communicates results of programs. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. General Duties/Responsibilities: Review provider/member-specific UM and QI metrics and coach assigned providers (center/group less than 150 members) gaps of care opportunities through virtual/telephone/email. Provide resources and educational opportunities to providers and staff.Promote practice-patients’ participation in clinical programs - providing information on participation, Clinical Program availability/descriptions and facilitating members with program engagement.Identify specific practice needs (e.g. use of most efficient interaction channel) to provide support.Educate providers and staff about Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey.Use your skills to make an impact  Required Qualifications Bachelor's Degree in Business, Finance, Health Care or a related field2+ years of clinical experiencePrior Medicare/Medicaid experienceStrong attention to detail and focus on process and qualityExcellent communication skillsComprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPointPreferred Qualifications Master's Degree in Business Administration, Health Administration or a related fieldProgressive experience in the health solutions industryPrior managed care experienceUnderstanding of metrics, trends and the ability to analyze and identify gaps in careExperience with SQL which includes the ability to create reports from scratch and also run existing reportsProven organizational and prioritization skills and ability to collaborate with multiple departments a plusUnderstanding of CMS Stars, performance measures, HEDIS knowledge and experience a plusBackground working in quality improvementsWork at Home RequirementsTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $71,100 - $97,800 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Become a part of our caring community Humana Healthy Horizons in Indiana is looking for a Senior Data Manager to fulfill the required Data Compliance Manager role, dedicated full-time to the Indiana Medicaid product line, PathWays. You will ensure data quality, report validation, and data exchange with state agencies. The Senior Data Manager will lead efforts to evolve reporting from a manual quality assurance process to a more mature model. This model will include exception-based and self-service reporting. Additionally, the Senior Data Manager will help establish formal change management and our requirements documentation practices. You are comfortable navigating complex, business processes and works with partners across the market to understand requirements, assess impacts, and define appropriate Quality Auditing processes and oversight.Responsibilities: Be the designated Data Compliance Manager for Indiana Medicaid, ensuring data exchanges and data quality meets FSSA and OMPP standards, policies, and contractual obligations.Oversee the end-to-end data lifecycle for state reporting, including data quality, validation, delivery, change management, and audit readiness.Lead manual quality assurance (QA) processes of state-required reports and electronic file exchanges, including detailed reconciliation, defect identification, and coordination of corrections with our teams, vendors, and external partners.Identify recurring data/reporting issues, conduct root cause analysis, and implement corrective and preventative actions in collaboration with departments both within the market and among shared services teams.Refine and promote the change management process, including intake, impact assessment, documentation, prioritization, and tracking.Oversee the process of the creation and review of Our requirements Documents (BRDs) in partnership with report developers, business owners, and operational teams to support report changes and data corrections.Demonstrate a understanding of business processes across all departments and departments to analyze BRDs, anticipate downstream impacts, and design QA plans.Maintain others on data standards, validation rules, reporting controls, and data governance practices for all State-facing submissions.Coordinate with FSSA, OMPP, and internal/external teams to implement new or revised data exchange and reporting requirements or modifications.Represent us in meetings with State partners, IT, vendors, and leaders; communicate data quality and compliance status.Prepare and maintain documentation, standard operating procedures, data definitions, QA methodologies, and change logs.Support readiness activities, compliance reviews, audits, and corrective action plans related to data and reporting.Key Success Factors: Balance hands-on report QA with strategic process improvement.Collaboration and skills across technical and business teams.Demonstrated capability to design data/reporting processes.And connect business processes across multiple operational areas to interpret requirements and design QA solutions.Use your skills to make an impact  Required Qualifications: Must reside in the Indianapolis, IN area and commute to the Indianapolis office three days per week, per contract requirements.Bachelor's degree or equivalent experience.5+ years of experience in data quality, regulatory reporting, or data compliance in the healthcare arena.Experience working with report developers, partners, and external vendors.Proficiency with data extraction and reporting tools (e.g., SQL, Power BI).Experience with business processes that span multiple operational areas.Preferred Qualifications: Knowledge of healthcare data exchange standards regulatory/state data and reporting operations.Master's degree in a quantitative or health-related field.Medicaid, managed care, or government-sponsored healthcare program experience.Experience designing or implementing QA frameworks, exception reporting, or automated data quality controls.Experience with change management, BRD development, and process improvement.Experience working with third-party vendors on reporting or quality solutions.  Scheduled Weekly Hours 40Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.  $97,900 - $133,500 per year  This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About Us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.