Humana

Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a Provider Education & Outreach Representative who is responsible for the day-to-day front line relationship management of network providers for Humana’s Healthy Horizons in Indiana, as well as responsible for provider onboarding, training, education, responding to provider inquiries, and resolving issues or complaints. The Provider Education & Outreach Representative will specialize in supporting Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS) providers and/or Physical Health (PH) and Behavioral Health (BH) providers. The Provider Education & Outreach Representatives serve as the primary relationship manager with providers to ensure positive provider experience with Humana Healthy Horizons and promote network retention. Key roles and responsibilities: Meets regularly, both in person and virtually, with assigned providers to conduct trainings and education, including required annual trainings, ensure understanding of Humana policies and procedures, explain Humana systems, etc.Serves as primary relationship manager with LTSS and HCBS providers and/or PH and BH providers to ensure positive provider experience with Humana Healthy Horizons and promote network retention.Supports new assigned providers with onboarding, including orientation session(s).Responds to assigned provider questions or inquires, and if necessary, ensures prompt resolution to provider issues with appropriate enterprise business teams, including those associated with claims payment, prior authorizations, and referrals, as well as appropriate education about participation in Humana’s Indiana Medicaid plan.Convenes Joint Operating Committee meetings with providers, including organizing agendas, materials, and other team members (clinical, provider engagement), to discuss key operational, clinical, and quality related topics. Use your skills to make an impact Required Qualifications Must reside in the state of Indiana.Must be able to travel (up to 50%) in the State of Indiana to provider offices and Humana locations.2+ years of health care or managed care experience working with providers (e.g., provider relations, claims education).Experience working with LTSS and HCBS providers and/or PH and BH providers.Experience working with or in a health care administration setting.Understanding of claims systems, adjudication, submission processes, coding, and/or dispute resolution.Proficiency in analyzing, understanding, and communicating complex issues.Exceptional time management skills and ability to manage multiple priorities in a fast-paced environment.Working knowledge of Microsoft Office applications, such as Word, Excel, Outlook, and PowerPoint.This role is a part of Humana’s Driver Safety program and therefore requires an individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Preferred Qualifications Bachelor’s Degree.Experience with Indiana Medicaid and Medicare Advantage guidelines.Understanding of managed care contracts, including contract language and reimbursement.Comprehensive knowledge of claims systems, adjudication, submission processes, coding, and/or dispute resolution. Work at Home Requirements 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.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. Additional Information: Workstyle: Remote but may vary due to travel and occasional onsite work at the Humana Healthy Horizons office in Indiana.Travel: Up to 50% travel in the state of Indiana to provider offices and Humana locations.Core Workdays & Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST)/Central Standard Time (CST).Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes; 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more..... Interview Format As part of our hiring process, we will be using an exciting interviewing 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. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 Pay 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. $52,500 - $72,300 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Senior Financial Reporting Analyst / Professional prepares and distributes periodic financial statements for users other than those directly employed by the organization. The Senior Finance Reporting Analyst / Professional analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Value Base Provider reconciliations Maintaining data structure and modifying code/queries Leading/assisting with monthly forecasting, financial and ad hoc reporting Collaborate with business partners in developing methods and criteria for measuring/summarizing financial data and preparing valuable analysis in a dynamic environment Work in a consultative role with various departments in creating effective reporting and analyses in order to improve processes, create efficiencies Establish, foster and maintain working relationships with peers and management within all business areas such as: Finance, Network, Health Services, Claims and Actuarial Use your skills to make an impact Required Qualifications Bachelor’s degree Medicare experience Proficiency in experience working with various Business Intelligence tools (dashboarding tools, Power BI, etc) Proficient/ weekly usage of Microsoft Access, SQL and Microsoft Excel Work Hours: 8:00am to 5:00pm EST Preferred Qualifications Data modeling manipulation Build and understand Macros Programming language Strong written and oral communication Forecasting, statistical analysis and reporting Bilingual ​ Additional Information As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. 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 Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/yammer and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. #LI-BB1 #Remote Scheduled Weekly Hours 40 Pay 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. $76,800 - $105,800 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first Humana Healthy Horizons in Florida is seeking a Provider Engagement Professional to join the Florida Medicaid Market Team. In this role, you will develop and grow positive, long-term relationships with physicians, providers, and healthcare systems to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement Professional works within specific guidelines and procedures, applies technical knowledge to solve moderately complex problems, and receives assignments in the form of objectives to determine approach, resources, schedules, and goals. The Provider Engagement Professional serves as the primary relationship manager with providers to ensure positive provider experience with Humana Healthy Horizons and promote network retention. Key roles and responsibilities: Meets regularly, both in person and virtually, with assigned providers to conduct trainings and education, including required annual trainings, ensure understanding of Humana policies and procedures, explain Humana systems, etc.Serves as primary relationship manager with LTSS, Skilled Nursing Facilities, HCBS providers and/or PH and BH providers to ensure positive provider experience with Humana Healthy Horizons and promote network retention.Supports new assigned providers with onboarding, including orientation session(s).Responds to assigned provider questions or inquires, and if necessary, ensures prompt resolution to provider issues with appropriate enterprise business teams, including those associated with claims payment, prior authorizations, and referrals, as well as appropriate education about participation in Humana’s Indiana Medicaid plan.Convenes Joint Operating Committee meetings with providers, including organizing agendas, materials, and other team members (clinical, provider engagement), to discuss key operational, clinical, and quality related topics. Use your skills to make an impact Required Qualifications Must reside in the State of Florida, specifically within the following counties: Palm Beach, Martin, Indian River, St Lucie, or Okeechobee.Must be able to travel (up to 75%) in the State of Florida to provider offices and Humana locations.2+ years of health care or managed care experience working with providers (e.g., provider relations, claims education).Experience working with LTSS, Skilled Nursing Facilities, HCBS providers and/or PH and BH providers.Understanding of claims systems, adjudication, submission processes, coding, and/or dispute resolution.Proficiency in analyzing, understanding, and communicating complex issues.Exceptional time management skills and ability to manage multiple priorities in a fast-paced environment.Working knowledge of Microsoft Office applications, such as Word, Excel, Outlook, and PowerPoint.This role is a part of Humana’s Driver Safety program and therefore requires an individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.This role is considered patient facing and is a 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 Requirements 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.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. Preferred Qualifications Bachelor’s Degree.Experience with Florida Medicaid and Medicare Advantage guidelines.Understanding of managed care contracts, including contract language and reimbursement.Comprehensive knowledge of claims systems, adjudication, submission processes, coding, and/or dispute resolution. Additional Information: Workstyle: Remote but must live in the State of Florida with occasional onsite work at the Humana Healthy Horizons office in Florida.Travel: Up to 75% travel in the state of Florida to provider offices and Humana locations.Core Workdays & Hours: Typically, Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more..... Interview Format As part of our hiring process, we will be using an exciting interviewing 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. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 Pay 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. $52,500 - $72,300 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Intern - Unpaid performs duties in field of study or profession. The Intern - Unpaid performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. The Intern - Unpaid acts as an apprentice while completing formal education or immediately following graduation. 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. Use your skills to make an impact Required Qualifications Currently pursuing a PharmDIntern license in residing stateStrong interpersonal, written and oral communication skillsMust not require sponsorship to work in the U.S. now or in the futureMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Have a strong academic history, with a minimum 3.0 cumulative GPA being desiredBe actively involved on-campus and/or in the communityPossess an interest in working in the healthcare industry Additional Information Alert: 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 Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.To 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 recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees 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 employees 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 Scheduled Weekly Hours 40 Pay 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. $31,200 - $85,100 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About us About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first Humana Healthy Horizons in Virginia is seeking a Strategy Advancement Advisor (FIDE SNP) who will provide data-based strategic direction to identify and address business issues and opportunities for Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP). They will provide business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor (FIDE SNP) works on problems of diverse scope and complexity ranging from moderate to substantial. The Strategy Advancement Advisor (FIDE-SNP) will: Support all priority health plan and care delivery integration workstreams for the Virginia Medicaid contract, which is central to the company's strategic priority to deliver better health outcomes for our members and financial growth for our company.Support the Medicaid Virginia market leadership team with specific Medicare operational impacts such as Open Enrollment and Annual Enrollment Strategy, Plan Benefit Development, Plan Filing Strategy, Model of Care, CMS Memos and Assessment of Compliance impacts, STARS strategy including activities driven by care management and Call Center secret shopper, Member Material strategy including AIP Model Docs, Member ID Cards, ANOCs, EOCs and more, and SNP Governance. Promote strategic alignment across leadership, educate Virginia Medicaid market leaders on the strategy and targeted outcomes, and support the Integration team through presentation development, change management, and communication. Manage FIDE SNP program learning agendas.Capacity to learn the Integration strategy quickly and works collaboratively with VA Medicaid market teams and Humana cross-enterprise teams. Lead projects from end-to-end and develops opportunity cases.Participate in the Department of Medical Assistance Services (DMAS) mandated Dual Special Needs Plan (DSNP) collaboratives. This role will have a dotted line reporting relationship into the National Medicaid Integrated Operations Team which will support coordination with all activities in accordance with Humana’s national strategic priorities for dual eligible health plan operations. Use your skills to make an impact Required Qualifications Bachelor's degree and a minimum of five (5) years of progressive experience managing large scale projects OR equivalent work experience with a minimum of eight (8) years of progressive experience managing large scale projects.A minimum of three (3) years of experience with strategy execution from conception to implementation.Experience with Medicare Advantage and Dual Special Needs Plans.Financial and/or operational experience across Senior Primary Care, Medicare Advantage, Medicaid, Pharmacy, or Home. Understands the build, measures, learns and tests frameworks.Strong communication skills, both written and verbal, for completion of team correspondence, meeting minutes, and status reports to varying levels of the organization.Strong collaboration and facilitation skills to lead project teams and meetings throughout the project lifecycle.Strong time management that allows for working independently.Strong analytical and reasoning skills to lead project teams to solutions and alternatives.Demonstrated ability to affect change in a highly matrixed organization, leveraging data and facts to influence decision-makers.Must be able to travel to the Glen Allen, VA office and DMAS periodically for meetings (see "Additional Information" section for details). Preferred Qualifications A minimum of five (5) years of experience working within a health plan or a care delivery organization.Progressive experience managing portfolios of similar projects.Experience conducting industry, market, competitor, and financial analysis and identify insights. Additional Information Workstyle: This is a remote position that will require you to travel.Travel: Up to10% of the time to Humana Healthy Horizons office in Glen Allen, VA for collaboration and face to face meetings as well as to DMAS for regulatory meetings. Typical Workdays and Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST). Work at Home (WAH) Internet Statement To 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 recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Employees 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 employees 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. Interview Format As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Scheduled Weekly Hours 40 Pay 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. $112,400 - $154,900 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first It’s that time of year!! Humana is looking for several extraordinary individuals to join our ever-growing team to support us during the Annual Enrollment Period (AEP). We are looking for goal-oriented individuals that take pride in helping others and have a customer focus mindset. These seasonal / limited-term assignment opportunities are 100% work at home roles. Training will begin in August and the assignments may last up to six months. Over the years these exciting opportunities have been an ideal step for many to join Humana and start their career with a growing Fortune 100 company and leader in the healthcare industry. This year, Humana is offering a variety of different assignments to support our members during AEP. Each assignment is focused on supporting our members with their enrollment needs. Below are more details about each different assignment, if you would like the opportunity to join Humana and potential to get your new career started, take a look and apply now!! Use your skills to make an impact Where you come in: Enrollment Representative: We need your assistance processing applications from members, enrolling them on company platforms, and transmitting enrollment information to Center for Medicare and Medicaid Services (CMS). You would perform basic administrative/clerical/operational/customer support/computational tasks while providing excellent service to our members. We also need your assistance with reviewing reports and making adjustments, additions, and deletions based on CMS regulations within a results-oriented production environment. You would also resolve issues, inquiries, and concerns from members while demonstrating empathy and compassion for individual needs. Inbound Contact Representative: We need your assistance in taking 20-30 inbound calls a day from potential members, agents and providers to answer questions and resolve any enrollment issues. You will provide excellent support during each call as well as work to update or correct information to ensure that the application can roll into the system. You also work with agents on applications that are missing information or that were completed incorrectly. By resolving these areas, you support and ensure that the members have no access to care issues on their effective dates. Consumer Services Representative (Underwriting): We need your assistance in ensuring that the Medicare Supplement consumer has a positive member experience.  Your assistance in preparing and scrubbing applications assists the Underwriter in completing the work timely. You will primarily take inbound calls as well as make outbound calls related to Medicare Supplement plans.  You will take 20-30 inbound calls from members, agents and other teams within Billing and Enrollment. You will prepare and scrub applications for underwriting review which includes reviewing enrollment applications and ensuring all questions are complete on the Medicare Supplement Application.  Any missing information will be properly documented. What you get from your great work! - Benefits and Perks of This Opportunity Competitive compensation with strong hourly rate The ability to cut your daily commute to less than a minute!! Yes 100% work at homeExtensive 100% virtual training program for the first 4-6 weeks, setting you up for immediate and future success 401k Retirement Savings option Employee Assistance Program and Work Life Services Great Deals on both national and local discounts on everything from computers and vacations to phones and retail shopping Cross training available for further skills development and potential Full-time opportunities What you need for success! - Required Qualifications Prior customer service or operations work experiencePrior experience utilizing multiple computer applications simultaneously as well as performing multiple tasks simultaneously within a production-based environmentDemonstrated skills in attention to detail Work at home (WAH) requirements include a minimum internet connection speed of 25m x 10m, and a dedicated secure home workspace for interview or work purposes. What you need to STAND OUT from the crowd! Preferred Qualifications Prior experience handling high numbers of calls providing excellent customer serviceMilitary, healthcare/managed care, banking or related industry experience handling confidential and personal information Experience working with the senior population. Additional Information  Schedules shifts will fall during the hours of 6am-6pm EST and may include weekend days Opportunities for overtime hours Seasonal Humana associates may work any number of hours, depending on the business needs, for a limited period of time (usually 60 to 180 days) Please note as part of our CMS government regulations, our Enrollment Representative must have established credit history according to Experian records. As an associate, you will need to access our Medicare eligibility check software systems. This type of inquiry doesn’t affect your credit score.  For additional questions, please refer to the CMS government website: https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Coordination-of-Benefits-and-Recovery-Overview/Downloads/Remote-Identity-Proofing-Multifactor-Authentication-on-the-MSPRP-FAQ.pdf This is a remote position #LI-Remote Scheduled Weekly Hours 40 Pay 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. $34,500 - $47,400 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first We are seeking a compassionate, organized, and experienced case manager to join our amazing team! The Case Manager will serve members in the Wisconsin Family Care (FC) program. In this role, you will be responsible for partnering with your fellow colleagues to provide top quality care to our members. They are looking to you in providing assistance when it comes to living their daily lives. The Case Manager provides comprehensive social service care management for frail elders and adults with intellectual, developmental or physical disabilities who qualify for Wisconsin’s FC program. Learn what is important to the member and support them in achieving it.Partner with a Health and Wellness Coordinator (RN) and collaborate on an ongoing basis regarding the member and their plan.Perform face-to-face social-related assessments for members upon enrollment and at least every 6 months thereafter in the member's setting.Coordinate, perform, and track quarterly face-to-face visits and monthly phone contacts.Participate in the development and ongoing review and coordination of the member's plan of care.Take the lead in areas related to social, community integration, employment, housing, and non-health related issues.Educate on and promote prevention/wellness and mitigate risk when assessed.Document activity and complete paperwork as required.Approximately 40% of this role is traveling to see members in their homes and travel is eligible for mileage reimbursement. Use your skills to make an impact Required Qualifications Four-year bachelor’s degree in the Human Services or related field with one (1) year of experience working with at least one of the Family Care target populations OR a four-year bachelor’s degree in any other field with three (3) years’ related experience working with at least one of the Family Care target populations. ***The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities*** Preferred Qualifications Certification in social work Additional Information Workstyle: This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes.Work Location: Baraboo, Mauston, Wisconsin Dells and surrounding areas.Travel: up to 40% throughout the surrounding areas.Typical Work Days/Hours: Monday – Friday, 8:00 am – 4:30 pm CST Limited Geography Remote - This is a remote position but located within a specific geography. WAH Internet Statement To 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 recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Employees 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 employees 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. Driving This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. TB 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. Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunities Modern Hire As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. SSN Alert 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 Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. Scheduled Weekly Hours 40 Pay 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. $47,700 - $65,600 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, volunteer time off, 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 committed to putting health first – for our teammates, our customers, and our 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Lead Systems Engineer is responsible for design, analysis, configuration and maintenance of complex systems software solutions, based on a thorough knowledge of systems engineering and programming concepts and techniques. Systems software engineering/programming is a specialized area of software engineering/programming focused on software that operates/controls computer hardware and provides a platform for running end user applications. Includes operating systems, device drivers, utilities, and software; development tools (e.g., assemblers, compilers, etc.). The Lead Systems Engineer works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Systems Engineer develops and/or modifies systems software for use internally, conducts requirements gathering and analysis, writes code using lower-level assembly languages and/or higher-level languages (e.g., C) and translates/compiles into machine language for use on specific hardware, and supports software testing, deployment, and maintenance activities by correcting programming errors and coding software enhancements. 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. Use your skills to make an impact Required Qualifications 5+ years experience with Axway SecureTransport, Sentinel and associated products5+ years experience with sFTP and secure MFT transmissions methods5+ years as a Systems Engineer in design, analysis, configuration and maintenance of complex systems software solutions, based on a thorough knowledge of systems engineering and programming concepts and techniquesHighly Experienced in Systems software engineering/programming is a specialized area of software engineering/programming focused on software that operates/controls computer hardware and provides a platform for running end user applicationsMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Experience in Mainframe environments supporting FTP/sFTP Additional Information To 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 recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees 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 employees 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 Scheduled Weekly Hours 40 Pay 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. $115,300 - $158,600 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The Market Development Advisor – Practice Transformation provides support to assigned health plan and/or specialty companies relative to Medicaid Group product implementation, operations, contract compliance, and federal contract application submissions. The Market Development Advisor works on problems of diverse scope and complexity ranging from moderate to substantial. The Market Development Advisor-Practice Transformation is responsible for driving provider performance programs, goals and improvement metrics for network providers to include a focus on Behavioral Health providers and partnerships. The Practice Transformation Advisor is an integral part of a cross-functional, collaborative organization which includes Provider Service Experience, Network Optimization, Clinical Services, Value-Based contracting, HEDIS and Risk Adjustment. Reporting to the Director, Provider Experience and Practice Transformation, this individual ensures the effective management of provider performance and quality improvement programs for Humana Healthy Horizons in Ohio. The Market Development Advisor serves as the primary resource on regulations for all assigned health plans. Ensures that assigned health plans are meeting or exceeding corporate Medicare/Medicaid/TRICARE/Employer Group performance benchmarks. Maintains relationships with regulators within a region. 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. Responsibilities Leading and managing the Provider Performance team for Ohio Medicaid and engaging with providers and internal stakeholders to drive high performance in quality and cost efficiency.Designing and implementing programs to maintain positive relationships between the health plan, physician, providers and practice managers.In conjunction with the Director of Behavioral Health, and the Director of Provider Engagement and Practice Transformation, responsible for strategy implementation for Behavioral Health providers and associations.Supporting Stars, HEDIS & Risk Adjustment initiatives and Ohio Department of Health quality initiatives for PRAF, Diabetes and other targeted campaigns.Monitor all feedback from individual providers to inform improvements to Humana processes.Develop provider training/orientation materials and timely communications of changes to the Ohio Department of Medicaid program.Acting as provider performance knowledge leader, lead external and internal training for providers and associates related to Ohio Department of Health value-based programs to include Episodes of Care, Comprehensive Maternal Care, CICIP and other initiatives. Monitor provider’s performance against key performance indicators and contractual commitments and requirements. Work with health plan leadership to improve performance, develop and implement quality improvement initiatives.Supporting in the onboarding and training of new provider engagement and provider transformation team members on performance programs and initiatives.Collaborates with internal stakeholders on development and implementation of value-based programs and alternative payment models.Acts as a supporting function of the broader Provider Experience team. Use your skills to make an impact Required Qualifications Bachelor's degree or 5 years of Market Development Advisor experience.5+ years of experience with Medicaid/Medicare/Duals Employer Group operations3 or more years of progressive experience in managed care operations including practice performance, provider engagement, value-based program implementationTravel required as neededSuccess in developing working relationships within a highly matrixed business environmentAbility to analyze data and make informed recommendationsAbility to lead a team of associate and collaborate with cross functional teamsMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Master's degreeExperience responding to state and/or federal government solicitationsExperience developing relationships with key stakeholders to understand and improve the market Additional Information Alert: 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 Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. Interview Format: HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. WAH Home Statement: To 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 recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees 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 employees 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 #LI-BL1 Scheduled Weekly Hours 40 Pay 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. $93,000 - $128,000 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Medical Records Retrieval Representative (Risk Adjustment Representative 2) travels to provider offices within the region (Santa Fe and surrounding areas) and scans medical records into a secure system. The records are reviewed by Humana's Coding staff. Travel up to 50% of the time and will consist of driving to locations within Sante Fe county and surrounding areas, as well as driving to locations that require overnight travel for up to a week at a time Use a laptop computer and a portable scanner to retrieve medical records which will be uploaded into a database Schedule appointments and visits to physician offices in a timely, efficient manner to meet all deadlines Use your skills to make an impact Required Qualifications 1+ years of experience with Medical Records or Electronic Medical Records Must have reliable transportation Ability to travel locally up to 50% of the time (Santa Fe, NM and surrounding areas) Ability to travel overnight occasionally This role is part of Humana’s Driver safety program and therefore requires an individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100/300/100 limits Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems Demonstrated organizational skills Excellent communication skills, both verbal and written Preferred Qualifications Previous healthcare or health insurance experience preferred Familiarity with medical terminology Additional Information As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Work At Home / Internet Guidance: To 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 recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees 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 employees 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 Alert: 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 Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. Scheduled Weekly Hours 40 Pay 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. $37,200 - $51,200 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Senior Project Manager is an individual with Project Management skills who is a servant leader ready to support projects and products in support of Humana Government Business (HGB). The Senior Project Manager will manage assignments that involve all aspects of Program Delivery including but not limited to Risk Management, Project Management Office, and Records Management. The Senior Project Manager will identify, develop, and gather the resources to complete the project. Communicates with other operational areas in the organization to communicate the status of the project. Sets priorities and allocates tasks to meet project targets and milestones. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Develop and maintain positive relationships and work closely with business segment leaders and key associates to meet the goals of Humana Government Business. KEY ACCOUNTABILITIES 50% Project Execution: Conducts meetings and prepare reports to communicate the status of the project. Sets priorities and allocates tasks to meet project targets and milestones. monitors progress and performance against the project plan. Effectively manages the project by creating and maintaining Project Plan, RAID log and other required project documents. 20% Project Planning and Management: Coordinating and leading team deliverables utilizing Project Management fundamentals, setting priorities, and coordinating project team to meet project targets and milestones. 20% Resources and Communication: Work with functional area leaders to identify, develop and gather the resources to complete the project. Communicates with other areas in the organization to secure specialized resources and contributions for the project. Develops and manages the communication plan based on the needs of the organization and the project/program. 10% Drives Results and Maintains Momentum: Effectively leverages resources to create exceptional outcomes. Anticipates and constructively resolves barriers and constraints. Report on project success criteria results, metrics, status reporting regarding project milestones, deliverable, dependencies, risks and issues, communicating across leadership. This role description in no way states or implies that the key accountabilities above are the only ones being performed by the individual(s) with this role description. The individual(s) may be called upon and required to follow other instructions or perform other duties and tasks requested by his or her supervisor, consistent with the purpose of the position, department and/or company objectives. Use your skills to make an impact Required Qualifications 3 or more years of Project Management experience Expertise and experience in program management, problem solving and issues mitigation Excellent communication and presentation skills to include the ability to communicate and present technical/financial/project details to senior level leadership and/or senior level internal and external partners/leaders Strong experience ideally working within a large matrixed organization Critical thinker who can anticipate team needs and take initiative to present ideas, ask the right questions and deliver the highest quality work Ability to manage multiple tasks/assignments simultaneously and adapt and shift to changing needs Experience with Microsoft Office products for business presentations including; Word, Excel, PowerPoint, Visio and/or Project Our Department of Defense Contract requires U.S. citizenship for this position 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 Preferred Qualifications Bachelor’s degree PMP or equivalent certification 5 or more years of Project Management Information Systems experience – ie. Project Online, Teams, Smartsheets, Jira, etc Federal government contract experience 5 or more years’ experience in the fields of operations, organizational development or customer service Lean; Six Sigma Certification Additional Information Work Style: Remote HireVue Statement: As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. WAH Statement: 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 This is a remote position #LI-Remote Scheduled Weekly Hours 40 Pay 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. $84,600 - $116,300 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The National Sales Executive sells products/services to large group segment brokers and employers and group of strategic/key accounts critical to the organization in terms of sales volume or market share growth. The National Sales Executive works on problems of diverse scope and complexity ranging from moderate to substantial. The National Sales Executive - Group Medicare acts as single point of contact for assigned customers. Focuses on driving revenue and client retention by building consultative relationships. Understands customer industry and business needs to offer unique and innovative solutions. Works with client to establish a strategic account planning process and agree upon performance objectives. Coordinates internal resources to meet and exceed performance objectives and customer expectations. Typical sales cycles may be long and can be complex. 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. Use your skills to make an impact Required Qualifications Bachelor's Degree or equivalent work experience5+ years of business-to-business sales experienceExcellent verbal and written communication skillsEntrepreneurial and self-sufficientExperience with Group Medicare products or servicesAbility to travel regularly, by land and air 50% of the timeActive health and life insurance licenses (or able to obtain within 60 days of hire)This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits Preferred Qualifications Prior sales experience in the health and wellness solutions industry working with large group segment brokers and employers Additional Information This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance 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 Scheduled Weekly Hours 40 Pay 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. $120,900 - $166,200 per year This job is eligible for a commission 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first Humana Healthy Horizons is seeking a Senior Business Intelligence Engineer who will solve complex business problems and issues using data from internal and external sources to provide insight to decision-makers. The Senior Business Intelligence Engineer’s 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 Business Intelligence Engineer describes the tools, technologies, applications and practices used to collect, integrate, analyze, and present an organization's raw data in order to create insightful and actionable business information. This position will begin to influence the department’s strategy and will make decisions on moderately complex to complex issues regarding technical approach for project components. Work is performed without direction, and they will exercise considerable latitude in determining objectives and approaches to assignments. Responsibilities Include: New market supportRequirements gathering for new clinical operations reporting, compliance metrics, and workflow toolsDevelopment of clinical operations reporting, compliance metrics, and workflow tools based on custom market needsEnhancements and supplemental needs above and beyond requirementsLegacy market supportNew reporting requestsTool and report enhancement requestsAd hoc requestsOngoing market support and guidanceNew organizational capabilities Use your skills to make an impact Required Qualifications Bachelor's degree and 5 or more years of technical experience in data analysis OR Master's degree and 3 or more years of experience in data analysis.Experience in writing SQL.Experience utilizing Microsoft Office Applications including Word, PowerPoint, and Excel including utilizing advanced formulas, v-lookups, and pivot tables.Experience working with large, complex data sets within large organizations.Experience with tools such as Microsoft Power BI and Tableau for creating data visualizations.Proficiency in understanding healthcare related data. Preferred Qualifications Advanced Degree in a quantitative discipline, such as Business Analytics, Statistics, Computer Science, Engineering or related field.Advanced in SQL, SAS and other data systems.Expertise in data mining, forecasting, simulation, and/or predictive modeling.Experience creating analytics solutions for various healthcare sectors.Experience with Snowflake and other cloud environments.Experience working in clinical data analysis. Additional Information: Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs. Typical Work Days/Hours: must be available Monday – Friday, 8:00 am – 5:00 pm EST or CST. WAH Internet Requirements To 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 recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Employees 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 employees 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. Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunities HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Nationwide Remote - This is a remote nationwide position. Scheduled Weekly Hours 40 Pay 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. $78,800 - $108,500 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Senior Informaticist coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Senior Informaticist 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 Informaticist leverages its advanced knowledge of data, modeling, optimization, and tools. Applies disciplined analytics to predict behavior and optimize programs and products to maximize revenue growth. Utilizes advanced or predictive modeling to develop, test and validate cases that improve the outcomes and quality of the programs we offer. Contributes to more innovative approaches to financial models as it builds knowledge of the business context in which it operates. Understands and analyzes complex data, articulates to various units within the company at the appropriate level, impacts the business from mathematical concepts which have a potentially sizeable dollar impact on the business. 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 degree and 5 or more years of data analytics experience OR Master's degree and 3 years of experienceExperience with data mining, predictive modeling techniques and using data to drive business outcomes and decisionsExcellent verbal and written communicationAble to articulate and present findings and insights to senior leadershipStrong attention to detailMust be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Advanced DegreeSix Sigma certificationExpertise in data mining, forecasting, simulation, and/or predictive modelingPreferred technologies such as SAS, SQL, Python, QlikView, Tableau, Hadoop or similar tools Scheduled Weekly Hours 40 Pay 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. $86,600 - $119,200 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first Humana Healthy Horizons in Kentucky is seeking a Quality Compliance Professional 2 who will participate in performance and quality improvement projects by implementing member and provider targeted interventions to improve health outcomes and member and provider experiences. This role contributes to multidisciplinary committees, both external and internal, required by NCQA and the State Contract. The Quality Compliance Professional 2 participates in, with potential to lead, Kentucky market quality improvement activities, and understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. This includes but is not limited to: Member outreach calls.Medical record audits to evaluate provider compliance with clinical practice guidelines, best practices, and regulations in collaboration with internal and external stakeholders. Provider outreach to close care gaps, audit records to identify improvement opportunities, and abstract data from records to close gaps.Quality document updates (example: quality improvement program description, work plans, and evaluation).Quality Improvement Committee meetings.Completing and updating reports (including State Reports and Kentucky Medicaid Quality Improvement Committee reports).Multidisciplinary committees, both internal and external. Qualified candidates will possess: Strong relationship building skills.Excellent written and oral communication skills.Ability to work independently under general supervision, must be self-directed and motivated.Critical thinking skills. Use your skills to make an impact Required Qualifications Bachelor’s degree or equivalent work experience (4 years of work experience in a health care setting).2+ years of experience working with member/patient outreach on quality and performance improvement activities.2+ years of experience in healthcare quality improvement/quality operations.Experience with healthcare quality measures (HEDIS, CAHPS, etc.).Comprehensive knowledge of Microsoft Office Word, PowerPoint, intermediate Excel experience (pivot tables/filtering, charts, formulas). Preferred Qualifications Licensed RN, LPN or Licensed Clinical Social Worker in the state of Kentucky.Bachelor’s degree in business, health care or a related field.Certified Professional in Healthcare Quality (CPHQ).Quality improvement experience with the Medicaid population. Additional Information: Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs. Travel: Twice/year to Kentucky for team meetings.Typical Work Days/Hours: must be available Monday – Friday, 8:00 am – 4:30 pm EST. WAH Internet Requirements To 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 recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Employees 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 employees 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. Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunities HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Scheduled Weekly Hours 40 Pay 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. $69,800 - $96,200 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Learning Design Professional 2 uses instructional design, cognitive psychology and adult learning theory to determine the appropriate solution to a knowledge or performance gap. The Learning Design Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Learning Design Professional 2 analyzes content, organizes content, designs solutions, and writes storyboards, scripts, performance support, policy & procedure documents, job aids and process flow documents. Analyzes learning needs and partners with subject matter experts to provide input for course content. Writes effective learning objectives and coordinates performance assessments to measure training effectiveness. Ensures course materials are current and relevant to training needs. Tracks and analyzes the training programs effectiveness by examining learner's satisfaction levels, proficiency testing, and job performance improvement. Provides instruction and guidance to Facilitators. Plans, organizes, and develops training curriculum, materials, job aid, job performance aids and programs to meet specific training needs. Uses consultative skills to commit projects and conduct needs analysis with clients to determine whether learning solutions are necessary or relevant. 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. Use your skills to make an impact Required Qualifications Bachelor's degree Minimum two (2) years of development experience specifically in training materials, SOPA (Standard Operation Procedure Announcement), process flows, and job aids. Intermediate or Advanced knowledge using Microsoft office Suite and other applications (Excel, Word, PowerPoint, Adobe PDF, Visio,) Intermediate knowledge using Articulate/RISE or similar platforms Minimum Intermediate/Advanced typing and computer navigation skills using multiple systems, platforms) and an ability to troubleshoot and resolve general technical difficulties Progressive business experience with a focus on learning strategies and adult learning theories. Preferred Qualifications Bachelor's degree or higher in one of the following areas: Business Administration; Learning and Performance; Education; Organizational/Instructional Design. Work experience in a Medicaid health care and / or in insurance settings. Six Sigma Certified Cornerstone Learning Management System experience. Experience Building Computer Based Training. Additional Information Workstyle: Remote work at Home Locations: United States Hours: Must be able to work Eastern Time Zone schedule Monday through Friday 8:00 AM - 5:00 PM Eastern 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 Scheduled Weekly Hours 40 Pay 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. $57,700 - $79,500 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first Humana Healthy Horizons in Indiana is seeking a Manager, Quality Improvement who will lead a team to implement quality improvement programs for Indiana Medicaid including annual program description, work plan, and annual evaluation. The Manager, Quality Improvement works within specific guidelines and procedures, applies advanced technical knowledge to solve moderately complex problems, receives assignments in the form of objectives and determines approach, resources, schedules and goals. Leads the Quality Improvement team to oversee timely deliverables.Supports the Quality Improvement Director on operating an NCQA compliant program.Supports the implementation and monitoring of program documents such as program description, work plan, and evaluation.Drives quality improvement (QI) efforts. Provides support to staff and communicates daily QI functions.Monitors and implements activities related to quality improvement and compliance for both behavioral and physical health in partnership with the health equity team.Tracks HEDIS measures with the assistance of the Quality Data Analyst to ensure the plan meets the goals set for the quality withhold measures.Manages department reporting; completes and submits state or federal reports as required. Audits data/processes as needed for compliance.Conducts briefings and area meetings. Keeps committee meetings minutes.Coordinates with interdisciplinary teams (i.e., population health, community engagement, etc.) to integrate quality improvement processes and evidence-based practices.Coordinates with relevant internal/external stakeholders, providers, and other entities to maintain quality operations and improve health outcomes.Requires cross departmental collaboration and conducts briefings and area meetings. Use your skills to make an impact Required Qualifications Bachelor's Degree.2 or more years of experience leading a team of direct reports.3-5 years of quality experience in a health care, health insurance, or public health setting.Experience with relationship building with external partners, i.e. providers, members, community service providers.Understanding of Quality Improvement tools and methodologies (PDSA, root cause analysis, IHI Model for Improvement, etc.).Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint. Preferred Qualifications Understanding of healthcare quality measures STARS, HEDIS, etc.Master of Health Administration, Master of Public Health or CPHQ (Certified Professional in Healthcare Quality) Certification. Additional Information: Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs. Work Location: Indiana resident preferred.Typical Work Days/Hours: Monday – Friday, 8:00 am – 5:00 pm EST.Direct Reports: up to 7 direct reports. WAH Internet Requirements To 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 recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Employees 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 employees 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. Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunities HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. #LI-JP1 Nationwide Remote - This is a remote nationwide position. Scheduled Weekly Hours 40 Pay 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. $76,800 - $105,800 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Organization Effectiveness Professional II optimizes the effectiveness of a company, business unit, or team. Analyze the internal structure of the organization and create strategies to maximize employee work output and effectively utilize employee skills. The Organization Effectiveness Professional II work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Organization Effectiveness Professional II reviews the organizational structure, determines changes to organizational responsibilities, staffing, managerial skills, and the quality of work life. This person ensures policy/program changes affecting employees do not conflict with the organization's objectives. This person may develop change management strategies, design, and implement development programs, and drive talent mobility initiatives. This person understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. This person makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. This person follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Minimum 5 years of facilitation experience in a corporate settingMinimum 3 years of experience with Microsoft toolsExperience utilizing Cornerstone On Demand (CSOD)Experience facilitating Medicare and Medicaid contentStrong understanding and experience utilizing ZoomAbility to navigate presentations using PowerPointAbility to train and support associates utilizing observations tools in a classroom settingStrong understanding of Adult Learning Theory Work-At-Home Requirements 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 information Preferred Qualifications Bachelor's degreeExperience in a healthcare settingExcellent written and verbal communication skills for presenting research findings and recommendations to stakeholders Additional Information As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. This is a remote role - #LI-Remote Scheduled Weekly Hours 40 Pay 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. $57,700 - $79,500 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first Are you passionate about contributing to the well-being of the Medicare population? Would you like to provide support to an active and fast-paced team of sales professionals? If so, the Administrative Sales Support provides effective sales administrative support to assist the team with bringing new members onboard and retaining the customers we serve. In this role you will support 4 Senior Managers of Medicare Sales, a Director and Career Medicare Sales Representatives. Decisions require good time management to prioritize requests, the ability to work efficiently, strong organization and the ability to create processes to complete administrative tasks and projects. This role requires an independent thinker who can rely upon their own judgment to meet work deadlines. This role works in collaboration with other teams and departments and will require someone who is reliable and follows through. Some duties include: assisting members as well as agents who call into the office. This assistance could include, but not be limited to customer service needs, answering questions, taking messages, Planning and Promoting on site events, Outbound welcome calls, event RSVPs and filling sales material requests. This role would also handle daily office duties such as receiving and sending mail through the USPS, as well as other delivery services. Handling vendors and technicians who need to be scheduled for routine services for the office as well as scheduling/submitting work orders as issues arise in the office that need dealt with by outside vendors. Further tasks could include compiling and completing standard calculations for reporting statistics; confirming the status of orders and collating marketing materials and preparing information, coordinating refreshments and room setup needed for events and team meetings; and completing general administrative duties as needed. Use your skills to make an impact Required Qualifications 1+ years of administrative experiencePrior experience with technology to include high level use of laptop, proficient use of Microsoft Office suite and an understanding of or comparable knowledge of CRM tools and other sales/marketing resources.Must be able to lift boxes up to 40 lbs. – position requires organizing, loading and unloading products and Medicare materials.This position will work remotely but will require going to office or field locations(30% of time) ​Preferred Qualifications Associates or Bachelor's DegreeHealthcare industry experienceBilingual with the ability to speak, read and write in both English and an additional language without limitations or assistanceAdditional Information Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.Humana Perks:      Full time associates enjoy    Medical, Dental, Vision and a variety of other supplemental insurances   Paid time off (PTO) & Paid Holidays   401(k) retirement savings plan with a competitive match   Tuition reimbursement and/or scholarships for qualifying dependent children And much more!  Scheduled Weekly Hours 40 Pay 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. $43,400 - $59,600 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Telephonic Call Center Care Coach Specialist/ Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. Winter Haven, FL area. Telephonic Call Center Care Coach Specialist/ Care Coach 1: Employs a variety of case management strategies, approaches and techniques to manage a member's case. Identifies through a screening process for potential eligibility for state and federal benefits. Ensures member is progressing towards desired outcomes by continuously monitoring Member’s case through use of assessment, data, and conversations with members, active planning and educating the member on potential resources. Use your skills to make an impact Required Qualifications ​ Live in the Winter Haven, FL area 1 or more years of Telephonic environment experience and/or customer service in an office setting. Microsoft Office Programs Word and Excel. Current valid Driver’s license Travel up to 25% or more at times to include home visits and events Monday-Friday 8:00 AM-5:00 p.m. EST, Overtime based on business needs and hours could include weekends/holidays. During the Medicare Annual Election Period, September to December, must be able to work Monday through Friday between the hours of 8am-7pm EST but also subject to Overtime based on business needs and hours could include weekends/holidays. Preferred Qualifications Associate Degree Microsoft Office PowerPoint Healthcare experience Strong preference for experience in member services and a call center environment specifically but not limited to Medicare & Medicaid recipients Previous experience with electronic case note documentation and experienced with documenting in multiple computer applications/systems Knowledge of community health and social service agencies and additional community resources reviews Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. See Additional Information on testing Healthcare Telephonic environment experience and/or Healthcare customer service in an office setting Additional Information Work Schedule: Monday-Friday 8:00 AM-5:00 p.m. EST, Overtime based on business needs and hours could include weekends/holidays. During the Medicare Annual Election Period, September to December, must be able to work Monday through Friday between the hours of 8am-7pm EST but also subject to Overtime based on business needs and hours could include weekends/holidays. Language Proficiency Testing: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. 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 Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/yammer and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. #LI-BB1 Scheduled Weekly Hours 40 Pay 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. $47,700 - $65,600 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Physical Therapy Assistant 2 provides services that help restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities of patients suffering from injuries or disease. The Physical Therapy Assistant 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. The Physical Therapy Assistant 2 examines patient's medical history, evaluates their physical abilities, determines their potential to respond to therapy, and develops treatment plans. 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. Use your skills to make an impact Required Qualifications TX Physical Therapist Assistant License Preferred Qualifications Home health experienceKnowledge with Wellsky/KinnserBilingual Scheduled Weekly Hours 1 Pay 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. $57,700 - $79,500 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About Us About onehome: onehome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients’ homes. onehome’s patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. onehome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first The Senior Product Owner will work within the Data and Analytics team. This team is focused on data, reporting, and data science supporting Humana’s Service Operations and on converting data to actionable insights for our business partners who can utilize this to reduce administrative cost and improve the customer’s experience. The Senior Product Owner is responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog. The Senior Product Owner work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. What you can expect in a Senior Product Owner role at Humana: Delivers new data products to meet business needs within a specified scope, while aligned to enterprise objectivesWorks closely with the Product Manager as epics and features are created to develop the product backlog and the roadmap Liaises with stakeholders and the development team ensuring the right product is being built, in the right order, within budget and by the deadlineServes as the Agile team's primary contact for information, work prioritization, and decision-makingCollaborates effectively with cross-functional teams to define product requirements and prioritize features, ensuring alignment with business goals and customer needsServes as the primary point of contact between the product team and engineering teams, facilitating communication and ensuring clear understanding of requirementPrioritizes and manages product backlog, working closely with engineering teams to deliver high-quality solutionsUtilizes agile methodologies to drive product development, including sprint planning, backlog grooming, and daily stand-upsGathers and analyzes feedback from stakeholders and end-users, incorporating insights to continuously improve product features and functionalityTracks and reports on key performance metrics to measure product success and inform decision – making Translates the business needs to technical requirementsDefines user stories and acceptance criteriaAccepts stories through post-production validation In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include: Medical BenefitsDental BenefitsVision BenefitsHealth Savings AccountsFlex Spending AccountsLife Insurance401(k)PTO including 8 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being timeAnd more Use your skills to make an impact Required Qualifications 3+ years of experience as a Product OwnerKnowledge of Systems Development Life Cycle, Waterfall, or Agile Development Methodologies2+ years of project leadership experienceComprehensive knowledge of Microsoft Office Programs Word, PowerPoint, and ExcelAbility to communicate effectively and deliver presentations to leadersStrong written and verbal communication skills Preferred Qualifications Bachelor's Degree in Computer Science, Information Technology, Health Information Systems or a related technical fieldSAFe Agile PMPO certificationExperience with Genesys or other consumer experience equivalent platformsWorking knowledge of ADO and Jira AlignKnowledge of the healthcare insurance industryExperience with call centersExperience producing metrics, measurements and trend reportsExperience in problem analysis and processKnowledge of Snowflake or other cloud platforms Additional Information This position will be from 8AM to 5PM EST hours. Work at Home/Remote Requirements Work-At-Home Requirements 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 to support Humana applications, per associate.Wireless, Wired Cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. 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 Our Hiring Process As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you. If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. #LI-LM1 Scheduled Weekly Hours 40 Pay 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. $93,000 - $128,000 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first Humana is seeking an experienced management professional to lead the Pharmacy Stars team. In this role, the selected candidate will be responsible for the strategy, opportunity evaluation, planning oversight, coordinating the development and monitoring outcomes. This position will work and collaborate with leaders across the Humana enterprise, HPS executive leaders as well as have extensive engagement representing Humana with external partners. This individual will leverage their deep pharmacy background and strong collaboration and communication skills to drive improvement in measures that impacts Stars performance, driving programs and process improvements to improve member health and well-being. This position requires an in-depth understanding of how Stars is impacted by multiple organization capabilities that interrelate across the function and Humana business overall. . Responsibilities Leads positive performance of medication adherence, statin use, polypharmacy, and Medicare Plan Finder measures for Pharmacy by influencing both the strategy and execution of improvement opportunities through collaboration with internal and external partnersServes as primary liaison and representative between Pharmacy and Corporate Stars/Quality Teams, serving as Enterprise Part D/Pharmacy Stars Task Force LeaderResponsible party within Stars team for driving performance in Pharmacy related Star ratings along with collaborating on other measures including HEDIS and CAHPSDefines multi-year Pharmacy Stars strategic plans and influences partners who directly execute member and provider touchpoints; identifies key details necessary to mitigate risks and ensure quality experiencesDevelops strategies for various segments of member population (i.e., members chronically non-compliant, members New to Therapy, segmentation)Gains approval for funding and manage budgets for programs Use your skills to make an impact Required Qualifications Five years of leadership experienceEight years clinical experience in managed care or equivalent experienceRegistered pharmacist with license in good standing; Degree of Doctor of Pharmacy or equivalentDeep business and financial acumenStrong track record of driving solutions that achieved clinical and financial outcomesExperience with effectively coaching, developing and leading direct reports and cross-functional teamsComplex and innovative problem-solving, analytical, critical and strategic thinking capabilities; knows how to create options and then converge on solutionsBrings an organized, attention-to-detail approach (strong tactical execution)Exceptional cross-functional collaboration, relationship management, influencing, and interpersonal skillsImpeccable oral and written communication skills, as well as the polish, poise, and executive presence to effectively interact with and present to external partners and executive and senior-level stakeholdersVery disciplined; has the ability to manage competing priorities and operate effectively within a large and complex organizational structureAbility to engage, educate, influence and guide matrixed teams at all levels on the concepts, opportunities and strategy of managing specialty and traditional medications Preferred Qualifications MBA, pharmacoeconomics or health outcomes trainingExperience in finance and/or business related pharmacy practicePrevious experience with CMS Stars, specific to Pharmacy, Patient Safety, and Drug Pricing Additional Information 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 Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.To 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 recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Employees 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 employees 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 Scheduled Weekly Hours 40 Pay 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. $164,700 - $226,600 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first Humana Healthy Horizons in Indiana is seeking Utilization Management (UM) Administration Professionals who use skills to support the coordination, documentation and communication of long-term supports and services (LTSS) and/or benefit administration determinations. The UM 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 UM Administration Professional responsibilities include (but not limited to): Provides support for the policies and procedures ensuring best and most appropriate treatment, care, or services for members.Communicates across the organization to support members and the team. Conducts presentations, prepares reports, and manages small projects. Makes decisions on moderately complex to complex issues and follows established guidelines and procedures. Use your skills to make an impact Required Qualifications Bachelor’s degree in social work.2+ years of experience working as a Social Worker.Experience working with Medicaid and/or Medicare Plans.Excellent written and verbal communication skills, to include demonstrated presentation skills. Work at Home Requirements 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.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. Preferred Qualifications Preferred residence in the State of Indiana.1+ years of experience working with vulnerable populations and the assessment and provision of LTSS services.Project management experience.MSW or other relevant graduate degree.Managed care health plan experience.Experience with utilization management. Additional Information: Workstyle: Remote but may vary due to occasional onsite work at the Humana Healthy Horizons office in Indiana.Travel: Up to 10% travel in the state of Indiana to Humana locations.Core Workdays & Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more..... Interview Format As part of our hiring process, we will be using an exciting interviewing 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. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 Pay 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. $47,700 - $65,600 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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 and help us put health first Humana Healthy Horizons in Indiana is seeking Utilization Management (UM) Nurses who utilize clinical nursing skills to support the coordination, documentation and communication of long-term supports and services and/or benefit administration determinations. The Utilization Management Nurse work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The UM Nurse responsibilities include (but not limited to): Uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care, or services for members.Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment.Understands department 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 and procedures. Use your skills to make an impact Required Qualifications Licensed Practical Nurse (LPN) in the State of Indiana with no disciplinary action.Previous experience in utilization management.2+ years of clinical experience, preferably in an acute care, skilled, or rehabilitation clinical setting.Previous Medicare/Medicaid Experience.Comprehensive knowledge of Microsoft Word, Outlook, and Excel.Ability to work independently under general instructions and with a team. Work at Home Requirements 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.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. Preferred Qualifications Preferred residence in Indiana.BSN, RN, or bachelor’s degree in a related field.1+ years of experience working with vulnerable populations and the assessment and provision of LTSS services. Additional Information: Workstyle: Remote but may vary due to occasional onsite work at the Humana Healthy Horizons office in Indiana.Travel: Up to 10% travel in the state of Indiana to Humana locations.Core Workdays & Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more..... Interview Format As part of our hiring process, we will be using an exciting interviewing 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. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 Pay 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. $57,700 - $79,500 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large. 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.