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Cambia Health Solutions jobs in Boise, ID

- 64 jobs
  • Risk Adjustment Provider Educator

    Cambia Health Solutions 3.9company rating

    Cambia Health Solutions job in Boise, ID

    Provider Educator Work a Hybrid schedule within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team of Provider Educators is living our mission to make health care easier and lives better. As a member of the Risk Adjustment team, our Provider Educators are responsible for developing communications, content and engaging network providers in support of provider education objectives. - all in service of creating a person-focused health care experience. Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: Provider Education Coordinator would have a Bachelor's degree in a related field and at least 5 years of Medicare Advantage or Commercial risk adjustment experience including at least 4 years of experience in a HCC Coding Audit or Network Management role or equivalent combination of education and experience. CPC and/or CRC credentials preferred Skills and Attributes: Strong consulting, communication (written and verbal), influencing, and facilitation skills Proficiency in using Microsoft Office tools and proven ability to display analytical data and research findings for effective presentations and improved decision making. Knowledge of health care industry trends, provider relations, and risk adjustment HCC coding, ICD10 diagnosis coding. Knowledge of health insurance preferred, including medical and dental terminology, procedural and diagnosis coding, reimbursement methodologies and various provider network arrangements. What You Will Do at Cambia: Develops, coordinates, and drives risk adjustment education initiatives with network providers and acts as primary point of contact for assigned key provider engagements across Commercial and Medicare lines of business Coordinate outreach, communication, training, and education for providers that have been identified through various operational reporting channels as a candidate for provider education engagement Works with key leaders within the provider organization to engage with and drive successful performance of the provider engagement. Assists senior leadership with special projects related to advancing Cambia's value based and innovative provider relationships. Participates in definition of project deliverables, providing consultation, recommendations, and solutions, reviewing project mandates and directives to determine overall provider engagement approach Leads, under the direction of management, in design and implementation of initiative related administrative policies and procedures and provides guidance and direction to the work team Work Environment No unusual working conditions. Work primarily performed in an office environment. Some travel may be required The expected hiring range for a Provider Educator is $83,300.00 - $111,600.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $78,000.00 to $128,000.00. #LI-hybrid About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: Work alongside diverse teams building cutting-edge solutions to transform health care. Earn a competitive salary and enjoy generous benefits while doing work that changes lives. Grow your career with a company committed to helping you succeed. Give back to your community by participating in Cambia-supported outreach programs. Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. Annual employer contribution to a health savings account. Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). Award-winning wellness programs that reward you for participation. Employee Assistance Fund for those in need. Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $83.3k-111.6k yearly Auto-Apply 12d ago
  • Administrative Assistant I - IV, DOE

    Cambia Health 3.9company rating

    Cambia Health job in Boise, ID

    Hybrid within Salt Lake City, UT; Medford, OR; Portland, OR; Lewiston, ID; Boise, ID; Burlington, WA; Renton, WA; Spokane, WA; Vancouver, WA Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team of Administrative Assistants are living our mission to make health care easier and lives better. As a member of the HealthPlan Operations team, our Administrative Assistants provide centralized operational support for multiple Vice Presidents and Directors, handling meeting coordination, document preparation, communication management, and expense tracking. This critical role enables senior leadership to focus on strategic initiatives while ensuring standardized administrative processes and operational continuity across the department - all in service of creating a person-focused health care experience. Do you excel at managing multiple priorities while supporting diverse leadership needs in a fast-paced environment? Are you passionate about creating operational efficiency and enabling others to focus on strategic work through exceptional administrative support? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: Administrative Assistant I: * 2 plus years increasingly responsible administrative assistant/secretarial experience Administrative Assistant II: * 2 - 3 plus years increasingly responsible administrative assistant/secretarial experience Administrative Assistant III: * 4 plus years increasingly responsible administrative assistant/secretarial experience Administrative Assistant IV: * 5 plus years increasingly responsible administrative assistant/secretarial experience and executive level support experience Skills and Attributes: * Familiarity with medical terminology, healthcare claims processes, and clinical workflows is a plus * Advanced proficiency in Microsoft Office software, SharePoint administration, and collaboration tools * Experience with AI tools and technologies to enhance productivity and decision-making in professional settings * Demonstrated ability to provide administrative support to multiple senior executives simultaneously, including complex calendar coordination across departments and time zones * Excellent written and oral communication skills with strong organizational abilities and initiative * Experience with license management, regulatory compliance tracking, and vendor relationship management * Event planning, coordination, and newsletter/communication management experience What You Will Do at Cambia: * Provide complex administrative and confidential support including document preparation, proofreading, correspondence management, and screening communications for multiple senior leaders * Schedule and coordinate calendars, appointments, meetings, and travel arrangements across 4 Associate Directors, 2 Directors, and multiple managers * Record, distribute meeting minutes, and manage follow-up actions to ensure accountability and continuity * Maintain expense records, compile reports, and assist with budget preparation and tracking * Compose, initiate, and manage correspondence, memoranda, and reports on behalf of leadership * Lead special projects including conferences, presentations, and data compilation requiring research and coordination * Provide backup support to other administrative staff to ensure seamless departmental operations Work Environment * Duties are performed primarily in an office environment with an expectation of being in the office a minimum of 3 days a week The expected hiring range for the Administrative Assistant I is $17.75 - $24.00/hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full salary range for this role is $17.75 - $31.20/hour. The expected hiring range for the Administrative Assistant II is $19.00 - $26.40/hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full salary range for this role is $19.00 - $34.40/hour. The expected hiring range for the Administrative Assistant III is $21.30 - $26.70/hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full salary range for this role is $21.30 - $34.80/hour. The expected hiring range for the Administrative Assistant IV is $24.00 - $31.90/hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full salary range for this role is $24.00 - $41.50/hour. About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $21.3-26.7 hourly Auto-Apply 18d ago
  • Sr. Program Delivery Professional IWHA-Interoperability

    Humana 4.8company rating

    Boise, ID job

    **Become a part of our caring community and help us put health first** The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery 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 Program Delivery Professional - IHWA Interoperability plays a key role in driving seamless data integration and collaboration within the In-Home Health and Wellbeing Assessment (IHWA) team and across interoperability initiatives. Serving as a business subject matter expert (SME), this individual partners closely with internal and external stakeholders, as well as the Interoperability team, to advance program objectives. Key responsibilities include collaborating with leaders on implementation planning, reviewing and communicating program results, and contributing to the ongoing improvement of processes and automation. The role also begins to influence departmental strategy and requires independent decision-making on moderately complex to complex technical matters related to project components. Work is performed without direct supervision, with considerable latitude in determining objectives and approaches to assignments. The ideal candidate demonstrates a collaborative approach, a strong interest in technology solutions, and a commitment to continuous process improvement. **Use your skills to make an impact** **Required Qualifications** + Minimum three, (3) years of IT project management or business process automation, experience in technology solutions. + Excellent communication skills, both oral and written + Proven experience in interoperability or data integration within a healthcare or technology setting. + Strong problem-solving skills with demonstrated success in process improvement initiatives and process automation. + Familiarity with various technology solutions and interest in exploring new innovations. + Excellent collaboration, and stakeholder management abilities. + Experience with managing and monitoring successful and impactful projects. + Self-starter with the ability to work independently and as part of a team. + Futuristic and broad thinker with attention to detail and downstream impacts. **Preferred Qualifications** + Bachelor's degree in Information Technology, Computer Science, Information Systems, or a related field. + Experience with EHR integration or usage. + Experience with AI integration. + Experience automating business processes. + PMP certification a plus + Knowledge and experience in health care environment/managed care + Strong analytical skills **Workstyle** : Open for Hybrid or Remote Work at Home **Location:** U.S. **Schedule:** 8:00 AM - 5:00 PM Eastern Time Monday through Friday **Travel:** occasional onsite as business needs require. **Work at Home 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 required; 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. **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 ******************** with instructions on how to add the information into your official application on Humana's secure website. **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. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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. $86,300 - $118,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-08-2026 **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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $86.3k-118.7k yearly Easy Apply 4d ago
  • Associate Actuary, SPA-Rx

    Humana 4.8company rating

    Boise, ID job

    **Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. _This a remote nationwide position_ The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. 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 + Associate of Society of Actuaries (ASA) designation + MAAA + Strong communication skills + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Prior Part D experience + Strong SAS skills + Prior Databricks experience **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 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 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. **Alert:** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. **_Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful._** \#LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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. $106,900 - $147,000 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. Application Deadline: 01-29-2026 **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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $106.9k-147k yearly Easy Apply 6d ago
  • National Dental Contracting Professional - Medicaid - VSP

    Humana 4.8company rating

    Boise, ID job

    **Become a part of our caring community and help us put health first** The National Dental Contracting Professional - Medicaid is responsible for identifying, engaging, and contracting with qualified dentists to join the insurance carrier's Medicaid dental network. This role ensures the network meets accessibility, quality, and compliance standards as required by Medicaid regulations and company policies. The recruiter develops relationships with dental providers, manages the contracting process, and supports provider onboarding to enhance member access to dental care. Responsibilities of the National Dental Contracting Professional - Medicaid: + Proactively source and identify dentists and dental practices for participation in the Medicaid dental network. + Develop and implement outreach strategies to attract qualified dental providers, including cold calling, networking, and attending industry events. + Present the benefits of participating in the insurance carrier's Medicaid network and address questions or concerns from providers. + Facilitate the contracting process, including negotiating terms, collecting required documentation, and ensuring compliance with state and federal Medicaid guidelines. + Collaborate with internal teams (legal, credentialing, provider relations) to support a smooth onboarding experience for new providers. + Maintain accurate records of recruitment activities, contract status, and provider information in accordance with company and regulatory standards. + Monitor market trends and provider feedback to optimize recruitment efforts and network adequacy. + Participate in ongoing training related to Medicaid dental program requirements and provider network management. + Responsible for developing, coordinating, and delivering educational programs to dental providers participating in Medicaid. + Ensures providers understand Medicaid policies, compliance requirements, best practices, and program updates, thereby improving quality of care and adherence to regulatory standards. **This role is Variable Staffing Pool( VSP), Variable Staffing Pool Humana associates work specific hours to meet business needs on a limited term basis.** **Use your skills to make an impact** **Required Qualifications** + Minimum of 4 years of experience in dental provider Medicaid recruitment, provider service and retention. + Knowledge of Medicaid dental programs, provider contracting, fee negotiations, and regulatory compliance is highly desirable. + Excellent communication, public speaking and relationship-building skills. + Strong organizational and project management abilities. + Proficiency with Microsoft Office and salesforce platform. **Preferred Qualifications** + Bachelor's degree in business, healthcare administration, or related field preferred. **Additional Information** + 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 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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. $65,000 - $88,600 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. Application Deadline: 01-09-2026 **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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $65k-88.6k yearly 11d ago
  • Medical Director - OP Claims Mgmt

    Humana 4.8company rating

    Boise, ID job

    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized at the Initial and Appeals/Disputes level. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicaid, and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from outpatient, inpatient or post-acute care environments. Has discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, disputes processes, and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. **Use your skills to make an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines. **Required Qualifications** + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient/outpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required. + No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent verbal and written communication skills . + Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists + Advanced degree such as an MBA, MHA, MPH + Exposure to Public Health, Population Health, analytics, and use of business metrics. + Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health. + The curiosity to learn, the flexibility to adapt and the courage to innovate + Ability to obtain additional medical licenses **Additional Information** Typically reports to Lead depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also engage in disputes and appeals reviews. May participate on project teams or organizational committees. \#physiciancareers Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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. $223,800 - $313,100 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. Application Deadline: 01-31-2026 **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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $223.8k-313.1k yearly 35d ago
  • Content Designer

    Humana 4.8company rating

    Boise, ID job

    **Become a part of our caring community and help us put health first** Humana is committed to innovative digital experiences that improve our members' quality of life and the interactions they have with us. We are looking for a content designer who is passionate about digital content and the critical role it plays in customer experience. As a member of Humana's Consumer Digital team, you will be responsible for defining and creating content that ensures people get the information they need to successfully choose and use their plans. By partnering with leaders from business, research, design, technology, marketing and legal and compliance, you will ensure we get the right information, in the right ways, at the right times to audiences that include consumers, members, providers, employers and agents. As the Content Designer, you will: + Create content strategies and direct information hierarchy, content types, voice and tone to ensure content is aligned to established audience and business objectives, research insights, brand standards, legal and compliance requirements, accessibility best practices and digital standards + Collaborate with other UX experts on content organization, navigation, site maps and information architecture + Seek simplicity, distilling complex concepts into clear, concise and contextual content and taxonomies + Create and manage copy for all steps of the digital experience, including headlines, product summaries and comparison, alt text, microcopy, buttons, navigation and error messaging + Develop tools such as content matrices and editorial calendars to track and manage content updates + Regularly audit and inventory online content to identify gaps in quality, compliance, standards and branding + Continuously improve digital content, including partnering to identify research needs, mining user data and insights and conducting competitive assessments + Maintain Humana digital content guidelines, standards, tools and processes **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree in English, Journalism or similar field + At least 3+ years of content strategy and UX writing experience + E-commerce experience + Experience writing and optimizing content for a variety of content types, digital channels and secure portals + Well-organized and detail-oriented, capable of handling multiple projects simultaneously, and able to move between strategic and tactical work + Familiar with working in a regulatory environment that requires legal and compliance oversight + Excellent verbal, written, and presentation skills + Experience with collaboration and agile technology, such as Jira Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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. $65,000 - $88,600 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. Application Deadline: 01-01-2026 **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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $65k-88.6k yearly 12d ago
  • Consulting Research Associate I or II

    Cambia Health 3.9company rating

    Cambia Health job in Boise, ID

    Work a Hybrid schedule within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team of Consulting Research Associates is living our mission to make health care easier and lives better. As a member of the Actuarial team, our Consulting Research Associates provide consultation on the design, testing and enhancement of corporate programs. Achieves actionable insights and solutions using analytical and statistical methods, project management and business knowledge. Researches and evaluates programs and outcomes to determine performance against stated objectives. Documents and communicates recommendations and solutions to business partners - all in service of creating a person-focused health care experience. Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: Consulting Research Associate I would have a BA/BS degree in social science, public health, economics, statistics, actuarial science or equivalent related field with less than 3 years of related work experience or equivalent combination of education and experience. Master's degree preferred. Consulting Research Associate II would have a BA/BS degree in social science, public health, economics, statistics, actuarial science or equivalent related field and a minimum of 3 years of related work experience or equivalent combination of education and experience. Master's degree preferred. Skills and Attributes: * Perform complex analyses on programs and initiatives and creates visual representations and summary reports of findings. Develops meaningful dashboards and presentations that use information to inform and influence business activities and strategies. * Applies knowledge of state and federal regulatory policies and procedures to program analysis and recommended actions. * Extract, sort, cleanse, aggregate and process data from multiple sources, developing queries and reports based on business requirements. * Work both independently and as part of a larger team supporting various internal customer groups on identifying business challenges and evaluating solutions to achieve objectives. * Collaborate with cross-functional teams to develop business cases, identify business problems and understand desired business outcomes. * Completes analysis and applies judgment to derive recommendations for complex challenges and initiatives. * Ensures the appropriate identification of root causes through effective use of data analysis tools and techniques. * Prepares and presents standard and ad-hoc analysis to business partners that help guide decisions and support results. * Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired What You Will Do at Cambia: * Experience with analytical / statistical programming tools for data extraction and summarization, statistics, visualization and analysis (Alteryx, SAS, SQL, R, Tableau, etc.). Ability to develop and modify queries to extract large amounts of data for standard and ad-hoc data requests. * Experience with pre-processing of data, such as cleansing, aggregating, sorting, and combining data. Ability to combine multiple sources of data. * Experience or coursework in advanced analytics such as analytic discovery, descriptive statistics, forecasting, experimental design, statistical inference, or predictive models. * Ability to analyze and interpret complex quantitative and qualitative data, independently or as part of a team. Ability to synthesize analytic insights with business questions, literature, judgment, and policy knowledge to develop options, action plans, and solutions for internal business partners. * Excellent oral, written, and presentation skills to effectively interface and communicate with customers. * Demonstrated ability to facilitate or coordinate activities or projects, including the ability to identify business requirements, resolve issues, and build consensus among groups of diverse stakeholders. Work Environment * Work primarily performed in corporate and home office environment. * Travel may be required, locally or out of state. * May be required to work outside of normal hours. The expected hiring range for a Consulting Research Associate I is $62,100.00 - $82,800.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $57,000.00 to $95,000.00. The expected hiring range for a Consulting Research Associate II is $75,700.00 - $102,350.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $71,000.00 to $116,000.00. About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $71k-116k yearly Auto-Apply 16d ago
  • Senior Accountant - Tax Accounting

    Humana 4.8company rating

    Boise, ID job

    **Become a part of our caring community and help us put health first** The Senior Tax Accountant analyzes and interprets tax laws, regulations, GAAP, and Statutory tax accounting principles, and prepare technical reports on how they impact the organization's operations. The Senior Tax Accountant 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 Tax Accountant focuses on Federal and State Income, GAAP and Statutory Tax Accounting, Sales and Use, Property and Premium taxes. Maintains tax information and records, prepares tax returns and other required reports, and pay tax declarations so that compliance obligations are submitted accurately and on time. Prepares correspondence with external tax agencies (for example, auditors). 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: in accounting/finance + 4+ years of relevant tax experience + Experience with predicting liabilities for Federal and/or State tax + Excellent written and verbal communication skills + Strong organization skills - able to manage tax processes, develop work plans, meet deadlines and coordinate with others + Experience with computerized tax software and research programs + Knowledge of federal and state tax law and current developments + Strong Excel proficiency **Preferred Qualifications** + Certified Public Accountant + Master's Degree in Business Administration or a related field + GAAP ASC 740 tax accounting experience or knowledge + Statutory SSAP 101 tax accounting experience or knowledge + Good working knowledge of OneSource Tax Provision software **Additional Informa** **tion** Preferred location is Louisville office/hybrid but would consider remote depending on skills/quals in Eastern or Central time zones. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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. $86,300 - $118,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-08-2026 **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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $86.3k-118.7k yearly 60d ago
  • Actuarial Principal - Financial Planning and Analysis

    Humana 4.8company rating

    Boise, ID job

    **Become a part of our caring community and help us put health first** Join Humana's Financial Planning & Analysis team, part of the CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial strategy and analysis, with connections to enterprise-wide and total Insurance perspectives. The Actuarial Analytics/Forecasting Principal role offers flexibility in responsibilities, significant exposure to senior leadership, and strong potential for upward mobility. We seek candidates who are willing to think creatively, challenge assumptions, voice opinions on key drivers and ranges, and contribute to a culture of continuous improvement and healthy debate. The Actuarial Analytics/Forecasting Principal analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium, and long-term financial and competitive position. The Actuarial Analytics/Forecasting Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. The Actuarial Analytics/Forecasting Principal ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost-effective resolutions for data anomalies. Works with senior executives to develop and drive segment or enterprise-wide functional strategies. Advises one or more areas, programs, or functions and provides recommendations to senior executives on matters of significance, and as an advanced subject matter expert competent to work at very high levels in multiple knowledge and functional areas across the enterprise. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree, in some instances a Master's or Doctorate's degree + 10 or more years of technical experience + 2-5 years of project/people leadership + FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations + MAAA + Strong communication skills + Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending) + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Medicare Advantage pricing and forecasting experience + Experience working with aggregate financials across insurance products or enterprise-level financial planning + Demonstrated ability to challenge existing assumptions and propose creative solutions **Additional Information** Humana is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, or veteran status. For more information on Humana careers, please visit Humana Careers (******************************* . Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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. $156,600 - $215,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-30-2026 **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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $73k-93k yearly est. 14d ago
  • Registered Nurse - Field Assessor

    Unitedhealth Group Inc. 4.6company rating

    Boise, ID job

    Explore opportunities with Long Term Solutions, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Registered Nurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources. Primary Responsibilities: * Provide high-quality clinical services within scope of practice and infection control standards * Coordinate care with other members of the patient/client's care team from admission to discharge * Complete clinical nursing assessments per federal/state program requirements and payer needs * Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy * Develop and revise individualized plans of care/service plans with other community providers * Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current and unrestricted RN licensure in the state of practice * Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation. * Current CPR certification * Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client Preferred Qualifications: * 1+ years of RN experience * Able to work independently * Good communication, writing, and organizational skills $64,100 - $141,500 annual total cash target pay $36.98 - $81.63 per visit point $30.82 - $68.03 hourly rate Annual total cash compensation for this role assumes full-time employment (40 weekly hours) at full productivity and generally follows the range above. Total cash compensation includes earnings from per visit point pay and hourly pay and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. This role receives two types of compensation depending on the work being performed. When conducting visits, you will be paid per visit point rate compensation. Your per visit pay will be calculated by multiplying your per visit point rate by the productivity points you accrue for various types of visits. Each type of visit is assigned a certain number of productivity points that is inclusive of "direct" and "indirect" patient care activities. Visits are assigned based on patient and business needs. The number of visits performed each week will vary based on individual productivity targets and the productivity points assigned to the visits performed. You will be paid your hourly rate for certain non-visit activities such as orientation. We comply with all minimum wage laws as applicable. In addition to your pay, we offer benefits such as, a comprehensive benefits package, recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $64.1k-141.5k yearly 6d ago
  • AI Scientist I (Healthcare)

    Cambia Health 3.9company rating

    Cambia Health job in Boise, ID

    Hybrid (Office 3 days/wk - Onsite-Flex) within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's Applied AI Team is living our mission to make health care easier and lives better. AI Scientists work with various stakeholders to design, develop, and implement data-driven solutions. This position applies expertise in advanced analytical tools such as generative AI, machine learning, deep learning, optimization, and statistical modeling to solve business problems in the healthcare payer domain. AI Scientists work may focus on a particular area of the business such as clinical care delivery, customer experience, or payment integrity, or they may work across several areas spanning the organization. In addition to expertise in generative AI, machine learning, deep learning and analytics this role requires knowledge of data systems, basic software development best practices, and algorithm design. AI Scientists work closely with AI team members in the Product and Engineering tracks to collaboratively develop and deliver models and data-driven products. AI Scientists also collaborate and communicate with business partners to design and develop data-driven solutions to business problems and interpret and communicate results to technical and non-technical audiences - all in service of making our members' health journeys easier. If you're a motivated and experienced AI Scientist looking to make a difference in the healthcare industry, apply for this exciting opportunity today! What You Bring to Cambia: Qualifications and Certifications: * Bachelor's degree (masters or PhD preferred) in a strongly quantitative field such as Computer Science, Statistics, Applied Mathematics, Physics, Operations Research, Bioinformatics, or Econometrics * 0-3 years of related work experience * Equivalent combination of education and experience Skills and Attributes (Not limited to): For all levels: * Demonstrated knowledge of generative AI, machine learning and data science. * Ability to use well-understood techniques and existing patterns to build, analyze, deploy, and maintain models. * Effective in time and task management. * Able to develop productive working relationships with colleagues and business partners. * Strong interest in the healthcare industry. Core Knowledge: * Generative AI:Understanding of foundation models, transformer architectures, and techniques for working with large language models (LLMs). Experience with prompt engineering, fine-tuning approaches, and evaluation methods for generative models. * Machine Learning:Strong mathematical foundation and theoretical grasp of the concepts underlying machine learning, optimization, etc. (see below). Demonstrated understanding of how to structure simple machine learning pipelines (e.g, has prepared datasets, trained and tested models end-to-end). * Data:Strong foundation in data analysis. * Programming:Strong python programming skills. Familiarity with standard data science packages. Familiarity with standard software development best practices. Strong SQL skills a plus. * Algorithms:Understanding of standard algorithms and data structures (ex. search and sort) and their analysis. * Core Knowledge Details and Examples (meant to be representative, not exhaustive; entry level roles are expected to have hands-on experience training and testing AI models, solid mathematical understanding and computer science fundamentals) Generative AI * Large Language Models (LLMs) and their capabilities (e.g, in-context learning, few-shot learning, zero-shot learning) * Prompt engineering techniques and best practices * Fine-tuning approaches (e.g, full fine-tuning, parameter-efficient methods like LoRA, QLoRA) * Retrieval-Augmented Generation (RAG) and knowledge integration * Evaluation methods for generative models (e.g, perplexity, BLEU, ROUGE, human evaluation) * Alignment techniques (e.g, RLHF, constitutional AI, red-teaming) * Multimodal generative models (text-to-image, text-to-video, multimodal understanding) * Responsible AI considerations specific to generative models (e.g, bias, hallucinations, safety) * Familiarity with Gen AI frameworks and tools (e.g, Hugging Face and LangChain) Machine Learning * Classic ML algorithms (e.g, linear and logistic regression, decision and boosted trees, SVM, collaborative filtering, ranking) * Approaches (e.g, supervised, semi-supervised, unsupervised, reinforcement learning, regression, classification, time series modeling, transfer learning) * Foundational ML concepts such as objective functions, regularization and over fitting * Data partitions (train/dev/test) and model development * Hyperparameter tuning and grid search * Evaluation concepts (metrics, feature importance, etc.) * Familiarity with standard python packages (scikit-learn, XGBoost, TensorFlow, PyTorch, etc.) * Familiarity with structure of machine learning pipelines * Deep Learning (basic understanding expected at all levels) * Activation functions * Optimization/Gradient Decent * Common architectures (CNN, RNN, LSTM, GAN, etc.) * Embeddings * Familiarity with specializations (sequence modeling/NLP/computer vision) Math * Linear Algebra * Discrete math * Probability and Statistics * Calculus Data * Research and experiment design * Visualization with data * Answering questions with data What You Will Do at Cambia (Not limited to): Note that these responsibilities are representative but not exhaustive. Higher-level roles involve successively stronger degrees of initiative taking and innovation beyond the core responsibilities listed here. * Researches, designs, develops, and implements data-driven models and algorithms using generative AI, machine learning, deep learning, statistical, and other statistical modeling techniques. * Trains and tests models, and develops algorithms to solve business problems. * Adheres to standard best-practices and establishes principled experimental frameworks for developing data-driven models. * Develops models and performs experiments and analyses that are replicable by others. * Uses open-source packages and managed services when appropriate to facilitate model development * Identifies, measures, analyzes, and visualizes drivers to explain model performance (e.g, feature importance, interpretability, bias and error analysis), both offline (in the development phase) and online (in production). * Uses appropriate metrics and quantified outcomes to drive AI model and algorithm improvements. The expected hiring range for The AI Scientist I is $135k-$145k, depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15%. The current full salary range for this position is $104k Low/ $169k MRP About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $135k-145k yearly Auto-Apply 18d ago
  • Risk Management BSA I, II, III

    Cambia Health 3.9company rating

    Cambia Health job in Boise, ID

    Risk Management - Business System Analyst I, II or III Work a Hybrid work schedule within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team of Business System Analysts (BSA) is living our mission to make health care easier and lives better. As a member of the Risk Management team, our BSAs are responsible for complying with CMS mandates to submit Enrollment, Medical Claim and Pharmacy Claims data for Reinsurance Reimbursement, Member Risk Assessment and Risk Corridor calculations - all in service of making our members' health journeys easier. you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: The Risk Management BSA I: Bachelor's degree in Business, Data Analysis or other related field plus 2 years' experience with data analysis, process modeling or equivalent combination of education and experience. The Risk Management BSA II: Bachelor's degree in Business, Data Analysis or other related field plus 2 - 4 years' experience with data analysis, process modeling or equivalent combination of education and experience. The Risk Management BSA III: Bachelor's degree in Business, Data Analysis or other related field plus 5 - 7 years' experience with data analysis, process modeling or equivalent combination of education and experience. Skills and Attributes: * Experience aggregating, reviewing and extracting data from various sources to create larger, more complex data sets. * Good research and problem solving skills including the ability to determine action steps and remediation actions to resolve issues. * Ability to accurately complete activities within established deadlines. Ability to work under pressure and partner with others. * Good written and verbal communication skills including the ability to work with internal and external partners. * Proficiency with Microsoft Office software programs and general experience database query tools. * Ability to update process documentation to ensure activities and outputs align with CMS guidelines. * General knowledge of medical terminology and procedure coding. * Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired. Additional Requirements for BSA II: * Ability to identify problems, develop solutions and implement actions with minimal supervision. * Ability to develop and modify data queries for use in the CMS data submission process. Works with internal partners to test and validate the effectiveness of new or modified queries. Additional Functions and Outcomes for BSA III: * Tracks and monitors CMS data submission guidelines. Reviews and verifies updates made to process documentation align with data submission guidelines. Acts as a resources to others on the Risk Management team. * Updates business partner groups (enrollment, medical claims, pharmacy claims, etc.) on annual changes to CMS submission requirement. What You Will Do at Cambia: * Extracts required information from the source systems into a staging area and performs validation checks based on CMS Edge Server Business Rules. * Submits data to the Edge Server via an established translation process. * Reviews data validation reports that are received back from CMS and any errors are investigated and corrected prior to data being resubmitted. * Communicates with internal/external customers to resolve any errors within the source systems for any of the above areas. * Encourages ongoing innovation and looks for opportunities to enhance the quality and efficiency of departmental processes. * Assists in the training and communicating system changes for end-users and other affected staff. * Schedules, organizes and prioritizes work to ensure timely completion of all assigned activities. * Maintins process documentation and ensures data submission and validation activities align with CMS guidelines. Additional Functions and Outcomes for BSA II: * Partners with Risk Management leadership to prioritize data submission activities and resolve issues in a timely manner. * Creates new data queries for the data submission process. Additional Functions and Outcomes for BSA III: * Communicates to the enrollment, medical claims, pharmacy claims, and supplemental condition code business partners as to what the requirements are for CMS submission. * Completes technical peer review of process improvements and ad hoc departmental projects. Work Environment * Work performed in office environment or can be remote. * Travel rarely required, locally or out of state. * May be required to work outside normal hours. The expected hiring range for a Risk Management BSA I is $62,100.00 - $82,800.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 5%. The current full salary range for this role is $57,000.00 to $95,000.00. The expected hiring range for a Risk Management BSA II is $68,900.00 - $93,150.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $64,000.00 to $106,000.00. The expected hiring range for a Risk Management BSA III is $75,700.00 - $102,350.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $71,000.00 to $116,000.00. #LI-hybrid About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $75.7k-102.4k yearly Auto-Apply 34d ago
  • Lead Citrix Systems Engineer - Network/Virtualization

    Humana 4.8company rating

    Boise, ID job

    **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 in a virtual environment, 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 Virtualization Engineer is responsible for architecting, implementing, and maintaining enterprise-grade virtual environments that support the organization's critical applications and services. This role requires broad expertise in virtualization technologies, including but not limited to desktop and application virtualization, server virtualization, cloud-based virtual infrastructure, and remote access solutions. The Lead Engineer will guide technical teams, ensure optimal performance, security, and scalability of all virtualized resources. **Key Responsibilities:** + Design, deploy, and manage complex virtual environments using industry-leading platforms (e.g., VMware, Hyper-V, Citrix, Microsoft Azure Virtual Desktop, and others). + Oversee the lifecycle management of virtual systems, including provisioning, patching, upgrading, and decommissioning. + Develop and maintain technical standards, procedures, and best practices for virtual infrastructure and remote access solutions. + Collaborate with cross-functional teams to assess business requirements and deliver scalable, secure, and resilient virtual solutions. + Lead troubleshooting and incident resolution efforts for virtual platforms, ensuring minimal disruption to business operations. + Conduct capacity planning, performance analysis, and optimization of virtual resources. + Mentor junior engineers and serve as a subject matter expert on virtualization technologies. + Ensure compliance with relevant security policies, regulatory requirements, and audit controls. + Research emerging trends and recommend adoption of new technologies to improve operational efficiency. **Use your skills to make an impact** **Required Qualifications** + **Our Department of Defense contract requires U.S. citizenship for this position.** + **Successfully receive approval for government security clearance (eQIP - electronic questionnaire for investigation processing). Employment with Humana Government Business is contingent upon your having access to government information and systems** + 7+ years of hands-on experience in virtualization engineering and infrastructure management. + Strong expertise in enterprise virtualization technologies (e.g., VMware vSphere/ESXi, Microsoft Hyper-V, Citrix Virtual Apps and Desktops, cloud virtualization platforms). + Solid understanding of networking, storage, and security concepts in virtual environments. + Excellent problem-solving, communication, and documentation skills. + Experience with Citrix NetScaler in the Gateway configuration and load balancing. **Preferred Qualifications:** + Bachelor's degree in Computer Science, Information Technology, or related field; + Relevant certifications such as VCP, CCA, MCSE, or equivalent. + Experience with hybrid cloud or multi-cloud virtual infrastructure. + Familiarity with DevOps practices and Infrastructure as Code (IaC). + Proficiency with scripting and automation tools (e.g., PowerShell, Python, or similar). **Additional Information** This role will also provide support for Humana Government Business and will require a clear background investigation performed by the Defense Counterintelligence and Security Agency. Location/Work Style: Remote US. Must be able to work Eastern Standard Time (EST) hours beginning at 9:00 A.M. EST. **Why Humana** 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 1 + Paid time off, holidays, volunteer time and jury duty pay + 401(k) retirement savings plan with employer match once eligible + Tuition assistance + Scholarships for eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Work-At-Home 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. + 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. **Social Security Task** 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 ******************** with instructions on how to add the information into your official application on Humana's secure website. **_*This is a remote position._** **_**Must be able to work EST hours._** \#LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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. $117,600 - $161,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-25-2026 **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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $117.6k-161.7k yearly Easy Apply 12d ago
  • Assistant Director Claims Production

    Cambia Health 3.9company rating

    Cambia Health job in Boise, ID

    Oregon, Washington, Idaho or Utah- Hybrid (in office 3 days a week) Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team is living our mission to make health care easier and lives better. As a member of the Payment Integrity team, our Assistant Director Claims Production provides leadership for Claims production processing activities in the commercial claims service organization and is responsible for strengthening the organization's effectiveness in claims processing by achieving satisfaction through fast and accurate claims processing - all in service of creating a person-focused health care experience. As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us. Are you a proven health plan operations leader? Do you pride yourself in developing and mentoring high performance teams? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: * Bachelor's degree in business management, health care administration or another related field. * 5 years management/supervisory experience with at least 3 years in claims processing, customer service or membership/enrollment or an equivalent combination of education and job-related work experience. Skills and Attributes: * Expertise regarding health plan legislation and regulations. * Successful experience leading health plan operations such as membership, claims customer service and analytics & reporting. * Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired. * Ability to create, execute and evaluate short- and long-term operating plans. * Business acumen including financial/budget management, data analysis and decision making. * Demonstrated ability to manage managers and lead high performing teams. Ability to effectively delegate, evaluate performance, and to motivate and develop others across multiple functions. * Proven competency in developing and maintaining effective relationships at all levels inside and outside of the organization. * Excellent verbal and written communication skills including ability to effectively convey complex or sensitive issues or regulations. What You Will Do at Cambia: * Works cooperatively with executives and management teams throughout Cambia to accomplish goals. Maintains a leadership team approach to resolve problems or issues of overall importance. Matters that cross functional lines directly involve the position's input and may require frequent, direct contact and close communications with all levels across Cambia. * Drives the effectiveness of the Claims organization through appropriate organizational structure, an effective work environment, regular employee communication, recognition and development. * Continually strives toward increased customer satisfaction while increasing operational efficiency. This is accomplished through motivating all claims staff toward increased productivity, increased accuracy and focus on customer satisfaction. * Responsible for fiscal management, including budget preparation, expenditure control, and record keeping. * Strengthens the organization's effectiveness in achieving customer satisfaction by ensuring fast and accurate claims processing. * Coordinates with the directors from all Regence Plans to continuously improve the cost, quality and effectiveness of Operations functions. * Oversees the selection, training, organization and proper compensation of Cambia claims employees. * Creates and manages appropriate employee incentives and recognition. * Partners with the Business Workforce Optimization teams to successfully implement new procedures and enhancements to claims systems that benefit our members. * Directs the development of Cambia claims processing functions to contribute to improved productivity and accuracy in benefit application and reduced operating costs. * As a member of our strong leadership community, you will provide direction to your team, engage them towards common goals and create a positive experience that helps people flourish. The expected hiring range for a Assistant Director Claims Production is $134,300-181,700 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%. The current full salary range for this role is $126,000-206,000. About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $134.3k-181.7k yearly Auto-Apply 14d ago
  • Senior Manager, MarketPoint Sales - Raleigh Durham, NC.

    Humana 4.8company rating

    Boise, ID job

    **Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact your own income potential? If so, we are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate beneficiaries on our services in a field setting. Our teams also sell Life, Annuity, Indemnity, Dental, Vision, Prescription plans, and more. Humana has an inclusive and diverse culture welcoming candidates with multilingual skill sets to service our consumers. **This role is** **field** **based, and you will be out and about in the field in the Raleigh** **Durham, NC.** **area working with your team and meeting members face to face. You must reside in Raleigh** **Durham, NC.** **area or be willing to relocate to the area.** In this **field** position, you will; coach, mentor, educate, motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a solid understanding of the market they serve, how to resolve operational problems and provide creative solutions to increase sales while following CMS guidelines. This role also involves cultivating, maintaining, and building relationships with Humana's customers, both internal and external business partners, along with the community we serve through telephonic, virtual, and face-to-face interactions with individuals and groups. Other responsibilities include developing marketing budgets, and looking for branding opportunities. **Use your skills to make an impact** **Required Qualifications** + **Must reside in the** **Raleigh** **Durham, NC.** **area or be willing to relocate** + **Active Health & Life Insurance Licenses** + 2 or more years of sales leadership experience + 6 or more years of experience working in the insurance industry + Must be able to travel up to 50% of the time + Ability to lead a team of sales associates and train them in successful sales techniques, educational presentation skills, utilizing technology tools as well as building relationships with communities and medical providers + Strong aptitude for technology with proficiency in MS Office products, various CRM platforms, and various iPhone app capabilities + Must be a strong leader, strong producer + Strong organizational, interpersonal, communication and presentation skills + Ability to adapt and overcome when necessary + Community Engagement/Grassroots experience in marketing Medicare plans in the community + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + 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** + Bachelor's Degree + Prior experience working in Medicare and the health solutions industry + Engaged with the community through service, organizations, activities and volunteerism + Project management background or certification a plus + Bilingual with the ability to speak, read and write without limitations or assistance **Humana Perks:** Full time associates enjoy: + Base salary with a competitive commission structure + Medical, Dental, Vision and a variety of other supplemental insurances + Paid time off (PTO) & Paid Holidays + 401(k) retirement savings plan + Tuition reimbursement and/or scholarships for qualifying dependent children. + And much more! **Social Security Task:** Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. **Virtual Pre-Screen:** As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a HireVue interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes. \#MedicareSalesManager \#MedicareSalesReps Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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. $77,000 - $105,100 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. Application Deadline: 01-30-2026 **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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $77k-105.1k yearly Easy Apply 15d ago
  • Medical Social Worker Hospice (Master's Degree)

    Unitedhealth Group Inc. 4.6company rating

    Fruitland, ID job

    Explore opportunities with Heart'n Home Hospice and Palliative, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Medical Social Worker, provides medical social services under the direction of a physician and Interdisciplinary Group to assist in the understanding of significant social and emotional factors related to the patient's health status and in development of coping mechanisms. Primary Responsibilities: * Assists the patient, significant others, physician and health care team staff to understand significant personal, emotional, environmental and social factors related to the patient's health status on an as needed basis * Contributes as a health care team member to the development of a comprehensive, integrated Plan of Care for patients on a daily basis * Instructs health care team members on community resources available to assist patients on a as needed basis * Able to function as Bereavement Coordinator and supervise the provision of bereavement services reflective of patient / family if needed. Establishes a Plan of care that addresses bereavement needs with clear delineation of services to be provided You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Master's Degree from a school of Social Work accredited by the Council of Social Work * Current CPR certification * Licensed Social Worker in the state of residence * Current Driver's License, vehicle insurance, and access to a dependable vehicle or public transportation * 1+ years of social work experience in a health care setting Preferred Qualifications: * Bereavement Coordination experience * Experience with establishing a plan of care for bereavement needs Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. #LHCJobs At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $58.8k-105k yearly 6d ago
  • Occupational Therapist

    Unitedhealth Group 4.6company rating

    Meridian, ID job

    Explore opportunities with Idaho Home Health & Hospice, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As the Occupational Therapist in Home Health, you will be responsible for assessment and evaluation of patient care needs related to functional status, activities of daily living, fine motor coordination, home assessments and adaptive equipment, and other occupational therapy needs as defined by medical conditions. **Primary Responsibilities:** + Provides service within the scope of practice as defined by the state laws governing the practice of Occupational Therapy, in accordance with the plan of care, using evidence-based techniques, and in coordination with other members of the health care team + Evaluates the patient's functional status, status of all body systems as required for CMS documentation, and occupational therapy needs. Consults with the physician in the development of the therapy plan of care + Observes, records, and reports to the nurse supervisor and the physician the patient's response to treatment and changes to the patient's condition + Conducts patient assessments evaluating the level of function by applying diagnostic and prognostic functional ability tests You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current Occupational Therapy licensure in state of Idaho + Current CPR certification + Current driver's license and vehicle insurance, access to a dependable vehicle, or public transportation + Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client **Preferred Qualifications:** + Demonstrated ability to manage multiple tasks simultaneously + Demonstrated ability to work independently + Good communication, writing, and organizational skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $34.23 to $61.15 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $34.2-61.2 hourly 18d ago
  • Consulting Analyst or Associate

    Cambia Health 3.9company rating

    Cambia Health job in Boise, ID

    Consulting Research Associate I, II or Consulting Research Analyst Work a Hybrid schedule within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's dedicated team of Consulting Research Associates and Analysts is living our mission to make health care easier and lives better. As a member of the Actuarial team, our Consulting Research Associates and Analysts provide consultation on the design, testing and enhancement of corporate programs. Achieves actionable insights and solutions using analytical and statistical methods, project management and business knowledge. Researches and evaluates programs and outcomes to determine performance against stated objectives. Documents and communicates recommendations and solutions to business partners - all in service of creating a person-focused health care experience. Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: Consulting Research Associate I would have a BA/BS degree in social science, public health, economics, statistics, actuarial science or equivalent related field with less than 3 years of related work experience or equivalent combination of education and experience. Master's degree preferred. Consulting Research Associate II would have a BA/BS degree in social science, public health, economics, statistics, actuarial science or equivalent related field and a minimum of 3 years of related work experience or equivalent combination of education and experience. Master's degree preferred. Consulting Research Analyst would have a BA/BS degree in social science, public health, economics, statistics, actuarial science or equivalent related field and a minimum of 5 years of related work experience or equivalent combination of education and experience. Master's degree or PhD preferred. Skills and Attributes: * Perform complex analyses on programs and initiatives and creates visual representations and summary reports of findings. Develops meaningful dashboards and presentations that use information to inform and influence business activities and strategies. * Applies knowledge of state and federal regulatory policies and procedures to program analysis and recommended actions. * Extract, sort, cleanse, aggregate and process data from multiple sources, developing queries and reports based on business requirements. * Work both independently and as part of a larger team supporting various internal customer groups on identifying business challenges and evaluating solutions to achieve objectives. * Collaborate with cross-functional teams to develop business cases, identify business problems and understand desired business outcomes. * Completes analysis and applies judgment to derive recommendations for complex challenges and initiatives. * Ensures the appropriate identification of root causes through effective use of data analysis tools and techniques. * Prepares and presents standard and ad-hoc analysis to business partners that help guide decisions and support results. * Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired Additional General Functions & Outcomes for Consulting Research Analyst * Perform responsibilities above with an increased degree of independence and self-direction. * Provide higher level consultation on findings and recommendations. * Works and interacts across the organization with a variety of business units. What You Will Do at Cambia: * Experience with analytical / statistical programming tools for data extraction and summarization, statistics, visualization and analysis (Alteryx, SAS, SQL, R, Tableau, etc.). Ability to develop and modify queries to extract large amounts of data for standard and ad-hoc data requests. * Experience with pre-processing of data, such as cleansing, aggregating, sorting, and combining data. Ability to combine multiple sources of data. * Experience or coursework in advanced analytics such as analytic discovery, descriptive statistics, forecasting, experimental design, statistical inference, or predictive models. * Ability to analyze and interpret complex quantitative and qualitative data, independently or as part of a team. Ability to synthesize analytic insights with business questions, literature, judgment, and policy knowledge to develop options, action plans, and solutions for internal business partners. * Excellent oral, written, and presentation skills to effectively interface and communicate with customers. * Demonstrated ability to facilitate or coordinate activities or projects, including the ability to identify business requirements, resolve issues, and build consensus among groups of diverse stakeholders. Additional Minimum Requirements for Consulting Research Analyst * Deeper experience than Consulting Research Analyst Associate in analytical / statistical programming tools and in the ability to extract, summarize, and visualize data for requests. Demonstrated ability to thoroughly and accurately pre-process and combine multiple sources of data. * Demonstrated application of advanced analytic skills in one or more areas including analytic discovery, descriptive statistics, forecasting, multivariate modeling, experimental design, statistical inference, or predictive models. * Ability to provide analysis and data interpretation in support of strategy development, program implementation, and evaluation. Ability to develop and recommend innovative solutions by synthesizing literature, expert opinion, policy, and analytic insights. * Ability to serve as a Cambia resource for current programs and new opportunities by combining business knowledge with program evaluation concepts and methodologies. * Ability to present to and communicate with a broad array of internal and external customers, including leadership. * Ability to coordinate across teams or functions to drive solutions and to resolve issues in a timely and effective manner. Assists with training and staff development activities. * Applies knowledge of healthcare and interventions to improve member experience and achieve cost containment and other corporate objectives. * Designs, develops or oversees acceptance testing of new reports, programs, and models. Reviews reports and other deliverables with end customer in mind to ensure outputs meet expectations prior to being put into production. The expected hiring range for a Consulting Research Associate I is $62,100.00 - $82,800.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $57,000.00 to $95,000.00. The expected hiring range for a Consulting Research Associate II is $75,700.00 - $102,350.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $71,000.00 to $116,000.00. The expected hiring range for a Consulting Res Analyst is $91,800.00 - $123,100.00 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15%. The current full salary range for this role is $86,000.00 to $141,000.00. #LI-hybrid About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $91.8k-123.1k yearly Auto-Apply 16d ago
  • Systems Analyst III (Healthcare)

    Cambia Health 3.9company rating

    Cambia Health job in Boise, ID

    Hybrid (In office 3 days/week) within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia's Software Engineering Team is living our mission to make health care easier and lives better. The Systems Analyst participates in a team environment for the development, maintenance, and delivery of product/application (s) and data integrations as an integral part of a multi-functional team. This position is generally responsible for business, data and product/application analysis. This position requires business, analytical, design, interpersonal, technical and administrative skills in performing day to day work. - all in service of making our members' health journeys easier. If you're a motivated and experienced Systems Analyst looking to make a difference in the healthcare industry, apply for this exciting opportunity today! What You Bring to Cambia: Preferred Key Experience (MUST HAVE): * Healthcare Experience * Facets Experience * API - Not development Qualifications and Certifications: * Bachelor's degree in Computer Science, Mathematics, Business Administration, or a related field and minimum * 5 years business or system experience developing requirements for projects where computer software is created * The equivalent combination of education and/or experience including experience with methodologies and structured analytical approach Skills and Attributes (Not limited to): * Ability to work with teammates and with business partners to participate in sessions to gather, translate and document and system requirements to support transforming requirements into effective technology solutions. * Ability to create simple story cards and understand simple acceptance criteria enough to verify results; develop simple technical documentation and understand technical documentation and concepts. * Ability to coordinate and facilitate one to one and small groups (3-5) of customers or other analysts for small work efforts. * Ability to develop positive relationships among business partners, teammates and management. * Ability to follow direction, collaborate effectively with peers to provide results, and relay status to management and peers in a timely manner. Additional Minimum Requirements for level II * Understands moderately complex acceptance criteria enough to verify results; develops technical documentation and can understand moderately complex technical documentation. * Ability to facilitate and lead small teams (1-3) for moderate work efforts which includes estimating, coordinating, tracking progress, inspiring others to complete tasks on time, assisting with resolving issues. * Able to participate in requirements sessions/interviews and document clear requirements for moderate work efforts. * Mastering knowledge and skills of common software development methodologies. Additional Minimum Requirements for level III * Ability to lead small teams (3-5) for complex work efforts which includes estimating, coordinating, tracking progress, inspiring others to complete tasks on time, assisting with resolving issues and creating status reports. Ability to present and effectively communicate with leadership. * Ability to participate in the definition of a QA plan. * Ability to use and coach more junior team members and business partners on development methodologies. What You Will Do at Cambia (Not limited to): * Read and create simple structured specifications such as use cases, story cards. * Read and understand design and business models including basic technical understanding. * Writes SQL queries, reads simple data models. * Understands and participates in the creation of deliverables by acting as a liaison between the development team and the end users. * Contributes to deliverables including analysis, development that may include writing SQL/scripting, quality and validation. Additional General Functions and Outcomes for level II * Reads and creates moderately complex and structured specifications such as use cases, story cards and requirements. * Provides support for applications and products during releases and warranty which may include quality and validation. * Actively acquires basic understanding of API concepts as applicable to the products and teams. * Reads most data models and has the ability to participate in logical data model creation. * Writes moderately complex SQL queries. Additional General Functions and Outcomes for level III * Applies in depth knowledge on health insurance terminology and concepts as needed by the product/application (s) the teams support. * Reads and creates complex structured specifications such as use cases, story cards. * Reads complex and creates moderately complex business models. * Writes well designed complex SQL queries and trains the more junior analysts. * Participate/ Actively develop automated validation techniques (QA automation) as applicable to the product and team. * Understands basic API concepts, such as API structures, JSON, collections and how to document in a technical design as applicable to the product and team. * Reads complex data models and creates basic logical data models. * Provide estimates for complex size work efforts increasing accuracy of the estimate as work effort progresses. * Trains and coaches less experienced and peer analysts. * May participate in the research, evaluation and selection of vendor products, methodologies and processes. * Lead medium size groups including multiple departments with a structured approach (i.e. JRP or grooming sessions). * Manages own tasks on moderate size enterprise-wide work efforts. The expected target hiring range for the Systems Analyst III is $92k - $124k is depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15% . The current full salary range for the Product Manager is $86k / $141k. About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: * Work alongside diverse teams building cutting-edge solutions to transform health care. * Earn a competitive salary and enjoy generous benefits while doing work that changes lives. * Grow your career with a company committed to helping you succeed. * Give back to your community by participating in Cambia-supported outreach programs. * Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck - and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: * Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. * Annual employer contribution to a health savings account. * Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. * Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). * Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). * Award-winning wellness programs that reward you for participation. * Employee Assistance Fund for those in need. * Commute and parking benefits. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email ******************************. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
    $92k-124k yearly Auto-Apply 60d ago

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