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Cambia Health Solutions jobs in Portland, OR - 118 jobs

  • Business Ops II

    Cambia Health Solutions 3.9company rating

    Cambia Health Solutions job in Portland, OR

    Business Operations Specialist I or II 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 Business Operations Specialists is living our mission to make health care easier and lives better. As a member of the Actuarial Risk Adjustment team, you will contribute to the achievement of organizational goals at the team, department, or function level through the management of multiple (often changing) objectives that span multiple domain areas (ex., project management, program management, data analysis, process improvement, business process analysis, communications & change management, etc.). Business Operations Analysts are “utility players” with responsibilities that are not better described by a more focused job family (ex. Project Manager, Data Analyst, Business Analyst, Program Manager, etc.) - 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: Business Operations Specialist would have a Bachelor's degree in Business Administration, Operations Research, Computer Science or related field and 3+ years of experience in business operations, data analysis, or a related field or equivalent combination of education and experience. Business Operations Specialist II would have a Bachelor's degree in Business Administration, Operations Research, Computer Science or related field and 5+ years of experience in business operations, data analysis, or a related field or equivalent combination of education and experience. Skills and Attributes: Business Ops Specialist I Advance analytical and problem-solving skills. Proficiency in Microsoft Office, particularly Excel. Demonstrated ability to effectively organize, plan, prioritize, and complete deliverables. Broad organizational knowledge and business sense, and knowledge and understanding of health care operations and administration Ability to communicate and present information effectively, verbally and in writing, with all levels. Demonstrated ability to think critically and articulate complex ideas. 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 Ability to collaborate with team members and stakeholders to define, develop, and deliver analytics that meet the needs of the business to manage routine operations, identify tactical decisions, and inform strategic direction. Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired Additional Minimum Requirements for Business Ops Specialist II Highly advance analytical and problem-solving skills. Proficiency in data analysis tools, such as Excel, SQL, and Tableau. Strong leadership and mentoring skills. Ability to represent the division visibly in internal meetings as a leadership presence. Well-developed business sense (finance, accounting, economics, risk management). Proven ability to perform and manage difficult tasks and deliver results with short deadlines without management assistance. Demonstrated curiosity to tackle hard business problems using data and analytics to develop meaningful, practical solutions. Ability to analyze and measure the effectiveness of existing business processes and develop sustainable, repeatable and quantifiable improvements. Proven ability to lead and manage cross-functional teams to ensure project objectives are obtained and delivered. Ability to communicate and present complex data, analysis or findings to all levels, in a way that is clear and understandable and supports the overall business decisions and goals. Strong facilitation and presentation skills, including the ability to resolve issues and build consensus among groups of diverse stakeholders. Ability to work independently and plan, prioritize and manage multiple projects with varying deliverable timelines and time constraints. Ability to negotiate and resolve project and team issues with diplomacy and persuasiveness. What You Will Do at Cambia: Specific functions and outcomes will vary based on organizational priorities, but in general, are expected to focus on the following in their roles: Business Ops Specialist I Analyze data to identify trends, opportunities, and challenges. Develop and maintain dashboards, reports, and metrics to track key performance indicators (KPIs). Collaborate with cross-functional teams to identify areas for process improvement and develop solutions. Manage small-scale projects and operational initiatives. Develop and maintain documentation of business processes and procedures. Applies knowledge of how various departments within the corporation work together to make the company run effectively. Documents business requirements and methods used to generate work output. Be able to adapt quickly and successfully project manage ad hoc special assignments and initiatives as they may develop. Additional General Functions and Outcomes for Business Ops Specialist II Lead data analysis and reporting to identify trends, opportunities, and challenges. Manage medium-scale projects and operational initiatives. Mentor and guide junior analysts in their professional development. Perform complex analyses on programs and initiatives and create visual representations and summary reports of findings. Develops meaningful dashboards and presentations that use information to inform and influence business activities and strategies. 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 Assist leadership with problem identification and resolution, and program development by researching, assessing, and analyzing issues, and providing recommendations. Partners closely with the IT group to ensure there is a business and technical alignment of the strategic roadmap and projects. Explains complex processes and status updates in a manner that ensures understanding at all leadership levels within the organization. Identifies critical project risks and issues and drives issue resolution; appropriately escalates issues to senior leadership or key stakeholders. Raises awareness regarding critical project dependencies and ensures that all requirements are communicated to relevant work streams and business partners. Work Environment Work primarily performed in an office environment. May be required to work outside of normal hours The expected hiring range for a Business Operations Specialist I 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 Business Operations Specialist II 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 10%. 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 18d ago
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  • Risk Management BSA I, II, III

    Cambia Health Solutions 3.9company rating

    Cambia Health Solutions job in Portland, OR

    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 42d ago
  • Sales, Account Executive, Philips ECG Solutions (Northwest -Portland, OR)

    Philips Healthcare 4.7company rating

    Portland, OR job

    Job TitleSales, Account Executive, Philips ECG Solutions (Northwest -Portland, OR) Job Description Sales, Account Executive, Philips ECG Solutions (Northwest-Portland) Philips ECG Solutions enables a new standard of cardiac care across the continuum by connecting care from home to hospital and hospital to home-all so your customers can deliver patient-centered heart care everywhere. Bring your sales talents to this winning Ambulatory Monitoring & Diagnostics (AM&D) division within Philips! Your role: As a Philips ECG Solutions Account Executive, you will primarily be responsible for orchestrating the sales process from lead identification, prospect new business, maintain and grow existing client accounts and ensure sales strategies meet revenue objectives while promoting ECG Solutions products and services. You will be a part of a dynamic sales organization, calling on cardiologists, electrophysiologists, hospital administrators, in both the office and hospital and report to the Regional Sales Leader. You will drive sales revenue and overall market share inside the territory as well as nurturing existing accounts. You will arrange appointments, equipment demonstrations and eventual sales meetings of Philips ECG Solutions products and communicate the company's competitive differentiation and value proposition to enhance sales and convert competitive accounts This is a field based role and will require daily travel in the territory (Northwest - OR, Vancouver, WA, NE WA, and Alaska. You're the right fit if: Minimum 2 years of sales experience reflecting a track record of proven success within the Medical Device and / or Biotechnology arena, preferably in cardiology. Demonstrated track record of consistently meeting or exceeding an annual quota of more than $1M. Your skills include advanced selling capability that showcases commitment to sales and company strategy, customer satisfaction, negotiation and the ability to close. Experience and success in hunting for new business; experience selling in hospitals or IDNs preferred. Strong communication and presentation skills required. You have a Bachelor's degree in Business Administration, Marketing or health related field; or equivalent combination of education and experience. You must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this Sales position. About Philips We are a health technology company. We built our entire company around the belief that every human matters, and we won't stop until everybody everywhere has access to the quality healthcare that we all deserve. Do the work of your life to help improve the lives of others. Learn more about our business. Discover our rich and exciting history. Learn more about our purpose. Learn more about our culture. Philips Transparency Details Total Target Earnings is composed of base salary + target incentive. At 85% to 120% performance achievement, the Target Earning potential is $165,000 to $200,000 annually, plus company fleet/car. Total compensation may be higher or lower dependent upon individual performance. Total Target Earnings is composed of base salary + target incentive, plus company fleet/car, generous PTO, 401k (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement and much more. Details about our benefits can be found here. Additional Information US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work-authorized visa, now or in the future. Company relocation benefits will not be provided for this position. For this position, you must reside in or within commuting distance to Portland, OR. #LI-Remote #LI-Field #ConnectedCare This requisition is expected to stay active for 45 days but may close earlier if a successful candidate is selected or business necessity dictates. Interested candidates are encouraged to apply as soon as possible to ensure consideration. Philips is an Equal Employment and Opportunity Employer including Disability/Vets and maintains a drug-free workplace.
    $165k-200k yearly Auto-Apply 32d ago
  • Sr. Program Delivery Professional IWHA-Interoperability

    Humana 4.8company rating

    Salem, OR 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 9d ago
  • Medical Director - Nat'l IP UM Team

    Humana 4.8company rating

    Salem, OR job

    **Become a part of our caring community and help us put health first** 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, level of care, and/or site of service should be authorized. 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 and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert decisioning on the requested services. They will have regular discussions with external providers by phone to gather additional clinical information and discuss determinations. Medical directors are expected to understand Humana processes with a focus on collaborative professional relationships. The ideal candidate will have a high degree of integrity, professionalism, resourcefulness, and enjoy working in a team-based environment. Medical Directors support Humana value throughout all activities. **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are concordant with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. After completion of structured and mentored training, daily work is performed with minimal direction, but with ready support from other team members. The ideal candidate enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines. + Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services + Maintain accountability for productivity, quality, and compliance metrics + Communicate determinations clearly both verbally and in writing + Participate in rotational weekend work and occasional holiday responsibilities + Demonstrate adaptability and willingness to learn evolving workflows, tools, and utilization management practices **Work Schedule Monday - Friday w/standard weekends (about 5 per year on average) Eastern Time Zone hours** **Use your skills to make an impact** **Use your skills to make an impact** **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 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 working in a team environment + **Work Schedule Monday - Friday w/standard weekends (about 5 per year on average) Eastern Time Zone hours** **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, or other healthcare providers. + 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 + Experience in hospital-based clinical practice, including specialties of Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine, and hospital-based clinical specialists + The curiosity to learn and the flexibility to adapt to changes in order to enhance efficiency, productivity, and organizational goals. + Ability to thrive in a dynamic fast-paced, team-oriented environment. + Commitment to a culture of innovation, including being facile with using technology to improve workflows + Participate in educational activities by attending required conferences and also create content to lead/teach/present for individual subject matter contribution + Passionate about contributing to an organization's focus on consistency in outcomes, consumer experiences and a highly engaged team culture **Additional Information** The medical director reports to a Lead Medical Director. Participation in weekend work on a rotational basis to ensure cases are decisioned in a timely manner 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: 04-30-2026 **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 ***************************************************************************
    $223.8k-313.1k yearly 50d ago
  • Risk Adjustment Provider Educator

    Cambia Health Solutions 3.9company rating

    Cambia Health Solutions job in Portland, OR

    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 18d ago
  • Pharmacy Stars Improvement Lead

    Humana 4.8company rating

    Salem, OR job

    **Become a part of our caring community and help us put health first** The Pharmacy Stars Improvement Lead will be a part of a collaborative Pharmacy Stars team which is accountable for Humana's Stars patient safety measure performance. The Pharmacy Stars Improvement Lead will autonomously develops, implements, and manages clinical program strategies to improve Medicare members' medication adherence and appropriate medication use with specific focus on telehealth and in-home methods of care delivery. The Pharmacy Stars Improvement Lead exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works under minimal supervision, and analyzes variable factors to determine the best course of action. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree in Business, Finance, Health Care or a related field + 2 or more years of project leadership experience + Prior Medicare/Medicaid experience + Strategic thinking and planning capabilities; organized and detail-oriented + Excellent communication skills + Enthusiasm and motivation essential; a confident change-agent; strong presentation skills (oral and written) + Ability to operate under tight deadlines + Successful track record in facilitating and consulting across teams and managing projects + Ability to learn quickly, work under pressure and timeline, work with ambiguity, and make complex decisions as necessary to meet business need + Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data + Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint **Preferred Qualifications** + Master's Degree in Business Administration, Health Administration or a related field + Provider relations experience + Prior managed care experience + Understanding of metrics, trends and the ability to analyze and identify gaps in care + Proven organizational and prioritization skills and ability to collaborate with multiple departments a plus + Understanding of CMS Stars and performance measure knowledge and experience a plus + Background working in quality improvements **Additional Information:** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **Work at home 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 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. 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. $104,000 - $143,000 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: 01-15-2026 **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 ***************************************************************************
    $104k-143k yearly Easy Apply 4d ago
  • Associate Actuary, SPA-Rx

    Humana 4.8company rating

    Salem, OR 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 11d ago
  • Critical Care Nurse - Clinical Solution Specialist (Travel: Pacific Northwest)

    Philips Healthcare 4.7company rating

    Portland, OR job

    Job TitleCritical Care Nurse - Clinical Solution Specialist (Travel: Pacific Northwest) Job Description Clinical Solution Specialist - Patient Monitoring (Travel: Pacific Northwest) Bring your passion for patient care and technology to this role where you'll be responsible for providing clinical customer support as the clinical application knowledge expert. You'll facilitate solutions design, optimization, configuration, and delivery of Philips Hospital Patient Monitoring (HPM) products to ensure a quality customer experience. Your role: Serving as a clinical resource to Philips HPM customers, working closely with the field service, sales, and project management organizations throughout a multiphase implementation and go-live process - establishing and maintaining strong working relationships with key internal partners and customers to enable a successful implementation team. Understanding customer goals and developing plans to support clinical solutions implementation and usage - delivering clinical services to customers that are consultative, advanced, and focused on workflows and optimization. Managing the clinical aspects of an implementation to include assessing workflows, evaluating education needs, creating education plans, determining custom configurations requirements, planning and delivering equipment and application education, supporting first customer use, encouraging ongoing adoption of change, and optimizing use of complex monitoring solutions. Understanding the clinical implications of technical implementations (including networks and clinical informatics systems); applying product and clinical knowledge to troubleshoot and solve problems. Approximately 90% travel across the district is required. The average driving time is 1-4 hours daily. Occasional overnight stays and travel by air/train/bus may be required. Further support across the zone is required, and occasional national travel may be required. You're the right fit if: You've acquired 4+ years of experience as a Registered Nurse in a hospital environment. Prior clinical training and adult education delivery experience is highly preferred. Your skills include experience in an Intensive Care Unit (ICU), Critical Care Unit (CCU), Emergency Room (ER), Operating Room (OR), Neonatal Intensive Care Unit (NICU), and/or Pediatric Intensive Care Unit (PICU) settings. Knowledge of Philips IntelliVue monitoring equipment and applications preferred. You have a Bachelor of Science in Nursing degree or equivalent licensure to practice nursing (Registered Nurse); must be able to provide verification for current/active license. Certified Technical Trainer Plus (CTT+) and/or Virtual Certified Technical Trainer Plus (VCTT+) is preferred. You're passionate about technology and education related to patient care. You have excellent verbal and written communication and presentation skills. You must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this Clinical position. You must be able to: Work in an office/home office and/or remote setting, as well as in a hospital/healthcare environment; adhere to requirements. Work flexible hours (based on business needs). Wear all required personal protective equipment. May be required to comply with vendor credentialing. How we work together We believe that we are better together than apart. For our office-based teams, this means working in-person at least 3 days per week. Onsite roles require full-time presence in the company's facilities. Field roles are most effectively done outside of the company's main facilities, generally at the customers' or suppliers' locations. This is a field role. About Philips We are a health technology company. We built our entire company around the belief that every human matters, and we won't stop until everybody everywhere has access to the quality healthcare that we all deserve. Do the work of your life to help improve the lives of others. Learn more about our business. Discover our rich and exciting history. Learn more about our purpose. Learn more about our culture. Philips Transparency Details The annual pay range for this position in WA is $92,000 to $147,000. The annual pay range for this position in OR is $87,000 to $140,000. This role also includes company fleet/car, training, and advancement opportunities. The actual base pay offered may vary depending on multiple factors including job-related knowledge/skills, experience, business needs, geographical location, and internal equity. In addition, other compensation such as an annual incentive plan, sales commission, or long-term incentives may be offered. Employees are eligible to participate in our comprehensive Philips Total Rewards benefits program, which includes a generous PTO, 401k (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement, and much more. Details about our benefits can be found here. At Philips, it is not typical for an individual to be hired at or near the top end of the range for their role and compensation decisions are dependent upon the facts and circumstances of each case. Additional Information US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work-authorized visa, now or in the future. For this position, you must reside in or within commuting distance to Seattle/Portland areas. This requisition is expected to stay active for 45 days but may close earlier if a successful candidate is selected or business necessity dictates. Interested candidates are encouraged to apply as soon as possible to ensure consideration. Philips is an Equal Employment and Opportunity Employer including Disability/Vets and maintains a drug-free workplace.
    $92k-147k yearly Auto-Apply 17d ago
  • Semantic Architect

    Cambia Health Solutions 3.9company rating

    Cambia Health Solutions job in Portland, OR

    SEMANTIC ARCHITECT (HEALTHCARE) Telecommute (Possible 2026 Return to office) - 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 Data & Analytics Engineering Team is living our mission to make health care easier and lives better. We're seeking a seasoned Data and Analytics Engineer with extensive semantic data architecture experience to design and implement, expand, and enhance our existing semantic layer within our Snowflake data platform to support AI-driven semantic intelligence and BI for our health insurance payer organization. The role will focus on creating a robust, scalable semantic framework that enhances data discoverability, interoperability, and usability for AI tools, enabling advanced analytics, predictive modeling, and actionable insights. - all in service of making our members' health journeys easier. If you're a motivated and experienced Semantic Professional 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 in computer science, Mathematics, Business Administration, Engineering, or a related field 8 years relevant experience in a multi-platform environment, including, but not limited to application development or database development At least 2 years working with Snowflake or similar cloud data platforms Equivalent combination of education and experience What You Will Do at Cambia (Not limited to): Enterprise Semantic Layer: Design, develop, extend, and maintain semantic data models on Snowflake to standardize data definitions, relationships, and ontologies for healthcare data (e.g., claims, member data, provider data). Data Integration: Collaborate with data engineers to integrate structured and unstructured data from internal (e.g., claims systems, EHRs) and external sources into the semantic layer. When necessary, develop and optimize ETL/ELT pipelines to populate the semantic layer, integrating data from diverse sources (e.g., claims, member data, third-party feeds) using Snowflake's capabilities. Analytics and AI Enablement: Ensure the semantic layer supports analytics, BI, and AI use cases, such as predictive analytics for risk stratification, fraud detection, and member engagement. Governance and Standards: Work closely with our Data Governance organization to develop governance policies, metadata standards, and ontologies to ensure consistency, compliance, and interoperability. Stakeholder Collaboration: Work with business analysts, data modelers, data engineers, and business users to translate business requirements into semantic data models that support self-service analytics and enable AI analysis and agents. Performance Optimization: Optimize semantic models for query performance and scalability on Snowflake, taking advantage of Snowflake's current and future features. Documentation and Training: Document semantic models and provide training to end-users and technical teams on leveraging the semantic layer. Skills and Attributes (Not limited to): Preferred: Experience with FHIR, HL7, or other healthcare data standards; familiarity with tools like Collibra or Informatica for metadata management. Expertise in semantic technologies, including Snowflake semantic views, MicroStrategy, AtScale, or Business Objects universes, and familiarity with healthcare ontologies (e.g., SNOMED, LOINC, ICD-10). Strong understanding of analytics workflows and their data requirements. Experience with data governance, metadata management, and compliance in healthcare. Proficiency in dimensional data modeling. Proficiency in SQL and experience with Snowflake-specific features. Experience using code repositories such as GitLab or GitHub and CI/CD-based deployment. Excellent communication skills to bridge technical and business teams. Preferred: Experience with FHIR, HL7, or other healthcare data standards; familiarity with tools like Collibra or Informatica for metadata management. The expected hiring range for The Semantic Architect II is $135k-$145k and Semantic Architect III is $160k-$175k depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for the Architect II is 15% and Architect III is 25%. The current full salary range for the Architect II position is $113k Low/ $142k MRP / $185k High. The Architect III salary range is $138k Low/ $173k MRP / $225k 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.
    $160k-175k yearly Auto-Apply 60d+ ago
  • Program Director Accreditation and Delegation

    Cambia Health 3.9company rating

    Cambia Health job in Salem, OR

    Hybrid in Renton, WA or Portland, OR 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 Program Directors are living our mission to make health care easier and lives better. As a member of the Health Care Services team, our Program Director Accreditation and Delegation plans, directs, and manages enterprise-wide quality management and improvement initiatives that drive clinical excellence and operational performance across the organization, while overseeing accreditation, delegation, and quality of care activities. This position provides strategic leadership to ensure operational and procedural compliance with regulatory requirements for Health Care Services. The Program Director serves as a senior leader representing the department in interactions with all levels of management, vendor partners, providers, government officials, accrediting agencies, and external consultants - all in service of making our members' health journey easier. Do you thrive in roles where you influence strategy across an entire organization? Are you looking for a position where your decisions directly impact clinical excellence and member outcomes? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: * Bachelor's degree in healthcare or a related field (Master's is preferred) * 8 years of leadership experience * 7 years of insurance industry experience or an equivalent combination of education and experience. * A Certified Professional in Healthcare Quality (CPHQ) is preferred Skills and Attributes: * In-depth knowledge of managed care principles, health insurance industry trends and technology, with demonstrated application of regulatory and quality standards including Medicare, URAC, NCQA, and other accreditation requirements * Extensive experience applying quality management and improvement methodologies (Lean, Six Sigma, PDSA cycles, evidence-based frameworks) with successful URAC or NCQA accreditation process experience * Advanced competency in pulling, managing, organizing, and analyzing data to surface actionable insights * Ability to write policies and procedures, develop monitoring/auditing tools, and use judgment and knowledge of standards to identify scenarios requiring delegation oversight * Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired * Proven ability to develop and lead teams across multiple locations or remote settings, including hiring, goal setting, coaching, and developing supervisors and employees while managing resources, budgets, and deliverables * Strong verbal and written communication and presentation skills with ability to negotiate and resolve complex, sensitive issues diplomatically and persuasively across diverse internal and external contacts * Strategic thinking capability to independently identify issues, opportunities, gaps, and effective solutions while collaborating cross-functionally to drive innovative initiatives and improve processes and results * Advanced analytical skills to analyze complex situations, learn quickly, synthesize solutions and action plans, and use thorough business understanding to influence initiatives What You Will Do at Cambia: * Leads development and execution of compliance, quality, and delegation policies while designing and implementing division and corporate-level projects related to accreditation and delegation activities * Establishes long-term departmental goals in conjunction with division leadership, maintains quality management frameworks that support continuous improvement culture, and drives best practice adoption across all business functions * Communicates and interprets laws, regulatory procedures, and accreditation standards while ensuring legislative, regulatory, and accreditation changes are promptly identified and implemented across the organization * Develops, maintains, and revises policies, procedures, and audit tools for oversight of delegated functions including credentialing, utilization management, case management, appeals, claims, and network management * Conducts periodic oversight reviews of delegated entities, prepares final reports identifying deficiencies, develops corrective action plans with timelines, and escalates mandatory standard deficiencies while monitoring entity performance * Champions quality improvement best practices by mentoring team members in QI methodologies (Lean, Six Sigma, PDSA cycles), fostering data-driven decision making, and leading projects that drive measurable organizational transformation * Collaborates with leadership and cross-functional teams to identify improvement opportunities, serves as primary quality management subject matter expert providing guidance across departments, and facilitates knowledge sharing and best practice dissemination * Develops and executes quality management strategies aligned with organizational goals, monitors quality trends, analyzes performance data, and recommends corrective actions to senior leadership while ensuring regulatory compliance and driving innovation * Manages financial targets, department budget, and workforce allocation while overseeing project plans to ensure deliverables meet compliance and regulatory standards * Defines business requirements for delegation-related reporting and data systems, manages design and control of delegation reporting systems, and tracks corrective action plans from internal monitoring and external audits FTEs supervised 3-10 #LI-Hybrid The expected hiring range for a Program Director 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 26d ago
  • Data Scientist - Generative AI

    Humana 4.8company rating

    Salem, OR job

    **Become a part of our caring community and help us put health first** The Data Scientist uses mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions. The Data Scientist work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Growth Analytics & AI within Humana is dedicated to transforming members' journeys and Humana's services using technology and analytics. We are looking for a Data Scientist who will be responsible for using mathematics, statistics, NLP, Generative AI, and machine learning to analyze complex data and deliver insights. In this multi-disciplinary team, you will have the opportunity to work closely with various partners, including IT, sales, and strategy partners, to positively identify potential opportunities using high volumes of complex data. This is a unique opportunity for a motivated individual to influence Humana's vision around member growth and experiences. Our goal is to create an impactful AI solution to improve healthcare experience and outcomes for our members. As a Data Scientist, you will develop advanced analytic solutions, engaging with customers, and creating reusable statistical models and generative AI solutions. You will create reports, projections, models, and presentations to support business strategy and objectives, and communicate insights with leaders (technical and non-technical). **Key Responsibilities** + Develop and validate machine learning and statistical analysis using Python, R, SQL, programming languages and packages + Design Generative AI solutions using Python, generative models like LLMs (API and open-source models), and frameworks (i.e., LangChain, LangGraph, Google Agent Development Kit) + Develop, maintain, and collect structured and unstructured data sets for analysis and reporting + Experience in creating reports, projections, models, and presentations to support business + Interpret and communicate analytic results to analytical and non-analytical business partners + Partner with business teams to understand challenges, co-create solutions, and communicate AI capabilities, especially generative AI **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree with at least 4 years of technical experience OR a Master's Degree in Math, Computer Science, Analytics, Quantitative Social Sciences, or related analytical field and 1 year of experience + Proficiency in SQL, Python, and data analysis/data mining tools + Experience with machine learning frameworks like Scikit-Learn, TensorFlow, or PyTorch + Experience with large language models, transformers, and model providers **Preferred Qualifications** + Ph.D. in a quantitative discipline, such as Computer Science, Data Science, Machine Learning, or related field + Prior experience in healthcare + Experience in Big Data environment, specifically PySpark and/or Databricks + Experience in cloud computing, Azure, AWS, or GCP + Clear and concise oral and written communication skills + Ability to communicate statistical concepts to broad audiences + Hands-on experiences deploying Generative AI solutions **Additional Information** + Visa sponsorship is not available for this position. 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. $97,900 - $133,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-15-2026 **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 ***************************************************************************
    $97.9k-133.5k yearly 44d ago
  • Director, IT Portfolio Management & Shared Services

    Humana 4.8company rating

    Salem, OR job

    **Become a part of our caring community and help us put health first** The Director, IT Portfolio Management collaborates with the business portfolio team to align the IT portfolio and demand. The Director, IT Portfolio Management requires an in-depth understanding of how organization capabilities interrelate across the function or segment. This role will be a critical partner to our Segment CIOs, and responsible for cross functional leadership, collaboration, communication, and management of the business of running CWHM. To achieve our strategies of delivering on our strategic portfolio, improving operations, modernizing our technology stack, improving our security posture, advancing our operating and organizational maturity, and developing, diversifying, and growing our talent base - this role will provide direct oversight of the following services as a shared service across the organization: + IT Strategy Advancement + IT Portfolio Management and Lean Business Case Analysis and Development + Financial Management + Communications and Change Management + Operations Support and Metrics + Talent Strategy and Management, including Operating Model and Resourcing + Agile Coaching The Shared Services team led by the Director, IT Portfolio Management & Shared Services will support and execute shared services initiatives across Pharmacy, Primary Care, Home Solutions, the Office of the Chief Medical Officer, and Integrated Health. The Director and team will provide more limited support to Humana Military IT as needed. **Key Responsibilities** Responsibilities for this role include leadership of a team responsible for the following functions. **IT Portfolio Management and Lean Business Case Analysis and Development** Lead a team responsible for: + Execution of the Portfolio Management function with the appropriate processes, tools, and team to deliver across all represented Segments in the IT Portfolio. Works directly with the Segment CIOs to support the execution of their strategies. + Execution of the IT Prioritization process, including creating/modifying initiatives and partnering with business to create proformas and lean business cases. + Ensures continuous alignment of project investments and initiatives with business strategy based on changing functional needs, resource capacity constraints, risk exposure, and interdependencies + Organizes and prioritizes initiatives and programs based on IT Strategy, strategic roadmap, available and prioritized budgets, and ensures that the appropriate financial and organizational support is being allocated in support of those goals + Supporting IT leaders and application owners with appropriate information to understand Total Cost of Ownership (TCO), including how prioritized work impacts TCO. + Supporting Agile transformation by partnering with segments to implement Agile best practices including Lean Portfolio Management. **Financial Management** Lead a team responsible for: + Overseeing planning, budgeting, and tracking processes, working with IT Finance to ensure we achieve our objectives + Partnering with IT Finance to analyze the trends and performance against plan, while monitoring to identify and remediate the cause of any unexpected variances. + Developing and continually improve budgeting, financial projections, and operating forecast + Ad-hoc segment performance reporting & analysis + Working with IT Finance to present the monthly and quarterly financial reports + In concert with the SVP/CIO and Segment CIOs, oversees the approval process for all position additions and changes. **IT Strategy Advancement** Lead a team responsible for: + Supporting the development and execution of IT strategy and annual planning processes, ensuring alignment with business objectives. + Defining objectives, frameworks, and metrics for the IT strategic planning process and establishes ownership and timelines for key planning steps + Preparing regular updates and reports for leadership reviews and strategic planning meetings. + Collaborating with IT Leaders and architects on technology roadmaps **Communications and Change Management** Lead a team responsible for: + Developing and executing communications strategy to support IT leaderships team and associates in achieving priorities. + Operating rhythm: Support the SVP/CIO in the management, orchestration, facilitation, and follow-up for all departmental meetings including weekly tactical, monthly strategic, extended leadership, all hands, quarterly offsite and other key operating meetings. + Change enablement: Offer organizational change management guidance and tools to support stakeholders within CWHM as they lead and experience change. **Operations Support and Metrics** Lead a team responsible for: + Driving operational maturity by capturing and sharing key data and insights in operational dashboards that include all key metrics. Create cadence and artifacts needed to support Tech Committee, IT operations reviews, monthly business reviews, etc. + Contribute to the design, rollout, and maintenance of operational dashboards and key performance metrics, providing actionable insights for IT leaders. + Ensure that Segment CIOs are prepared with the information they need to maintain effective operations. **Talent Strategy and Management** The Director, IT Portfolio Management & Shared Services will: + Work with the SVP/CIO, along with Segment CIOs, to create, update and refine operating models. + Advance labor strategy: Ensure that we have consistent models for managing resourcing demand and capacity, in concert with the annual budget and aligning to key measures for internal and external, onshore / offshore, and other ratios across the organization. In addition, the Director will lead a team responsible for: + Overseeing all talent development, recruiting and internship initiatives in partnership with the IT Leadership team and HR. + Enhancing the associate experience that encompasses all aspects of culture - including engagement, well-being, inclusion, and diversity - in partnership with HR and the Diversity, Equity, and Inclusion team. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree in a related field. + 7 or more years of progressive experience in IT, finance, technology strategy, or related areas + 5 or more years of management experience + Excellent communication, collaboration, and interpersonal skills; able to engage and influence stakeholders at various levels. + Ability to work independently with sound judgment and autonomy. + Strong analytical, problem-solving, and financial analysis skills. + Demonstrated leadership skills, marked by poise, positive influence, and the ability to drive change + Champions and demonstrates the ability to empower others + Advanced interpersonal, presentation, and communications skills (written and oral) + Ability to manage multiple priorities with attention to detail in a fast-paced and dynamic environment. + Demonstrated ability to employ judgment and experience to make rapid, complex decisions + Demonstrated commitment to improving consumer experience and advancing organizational culture. + Advanced experience leading special projects and producing metrics, measurements and trend reports + Ability to question and challenge the status quo to foster an open dialog and better outcomes + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Master's Degree in a relevant field + Experience within healthcare IT, including provider, payor, or technology-focused organizations + Experience supporting large-scale transformation initiatives and process improvement efforts within a complex corporate environment + Possess a solid understanding of operations, technology, communications and processes + Strong in consensus-building, organizational leadership, and ensuring optimal technical performance for the organization **Additional Information** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. 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. + Work-at-home location is flexible and remote within the US. Preference will be given to candidates located in Louisville, KY, Washington, DC, or major metropolitan areas. + Requires occasional domestic travel, as business needs dictate. + Scheduled weekly hours: 40 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. $172,200 - $236,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, 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 ***************************************************************************
    $172.2k-236.9k yearly 3d ago
  • Social Worker, SW

    Unitedhealth Group Inc. 4.6company rating

    Portland, OR job

    Explore opportunities with Assured Home Health, 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. 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 12d ago
  • Pharmacy Technician

    Unitedhealth Group Inc. 4.6company rating

    Portland, OR job

    $3,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS "A Day in the Life" video Opportunities with Genoa Healthcare. A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start Caring. Connecting. Growing together. We seek a Pharmacy Technician to support all functions of the Genoa mental health and specialty pharmacy primarily through dispensing medical prescriptions and performing necessary clerical duties while under the direct supervision of a registered pharmacist. Location: 18417 SE Oak St., Suite 117, Portland, OR, 97233 Hours: Monday-Friday 8:00am to 5:00pm PST with lunch from 12:00pm to 1:00pm PST Primary Responsibilities: * Provides exceptional customer service to all consumers and members of the clinic staff * Fills prescription orders and makes them available for verification under direct supervision of the registered pharmacist * Orders, receives and stores incoming pharmacy supplies * Receives and processes wholesaler medication orders * Verifies medication stock and enters data in computer to maintain inventory records * Works with the Pharmacist to assist in the pharmacy functions and keeping the pharmacy in compliance with all federal and state requirements * Performs various clerical duties relating to the department * Communicates with strong professional verbal and written communication skills * Provide assistance to Behavioral Health patients * Other duties as assigned What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: * Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays * Medical Plan options along with participation in a Health Spending Account or a Health Saving account * Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage * 401(k) Savings Plan, Employee Stock Purchase Plan * Education Reimbursement * Employee Discounts * Employee Assistance Program * Employee Referral Bonus Program * Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) * More information can be downloaded at: ************************* 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: * Active and unrestricted Pharmacy Technician license in the state of Oregon * Access to reliable transportation Preferred Qualifications: * Bilingual in Spanish and English * National Pharmacy Technician Certification * Pharmacy and prescription data entry experience PLEASE NOTE The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. 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 $16.00 to $27.69 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. #RPO #RED
    $16-27.7 hourly 11d ago
  • Underwriter I, II, III, or Senior

    Cambia Health Solutions 3.9company rating

    Cambia Health Solutions job in Portland, OR

    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 Underwriters is living our mission to make health care easier and lives better. As a member of the Underwriting team, our Underwriters evaluates each assigned group's risk and attaches the appropriate rate- all in service of creating an economically sustainable health care system]. 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: The Underwriter I would have a Bachelor's degree in business, math, statistics or related discipline or an equivalent combination of education and experience. The Underwriter II would have a Bachelor's degree in business, math, statistics or related discipline and a minimum of 2 years related experience or an equivalent combination of education and experience. The Underwriter III would have a Bachelor's degree in business, math, statistics or related discipline and a minimum of 4 years related experience or an equivalent combination of education and experience. The Underwriter Senior would have a Bachelor's degree in business, math, statistics or related discipline and a minimum of 6 years related experience or an equivalent combination of education and experience. Skills and Attributes: Demonstrated analytical and problem solving skills. Business sense including: finance, accounting, economics, and risk management principles. Effective verbal and written communications. Ability to build and maintain positive internal and external customer interactions. Ability to prioritize tasks and meet deadlines. Demonstrated technology proficiency, including Excel, Word, and applicable software applications. Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired Additional Requirements for Underwriter II: Demonstrated success with managing competing priorities and workload. Additional Requirements for Underwriter III: Demonstrated proficiency working with complex computer software systems and automation. Ability to effectively explain complex mathematical and abstract concepts to a variety of stakeholders, including those with less familiarity and/or understanding. Additional Requirements for Underwriter Senior: Proven understanding of business, including: finance, accounting, economics, and risk management. Demonstrated attainment of a high level of independent, consistent performance. Ability to organize, plan, prioritize and complete complex assignments with little or no supervision. Demonstrated ability to read the marketplace and competitive environment. What You Will Do at Cambia: Approves renewal changes after verifying rates and product selection. Audits both new and renewing groups as necessary. Determines rates for alternative benefit variations. Ensures that group participation requirements are met. Prepare rate filings. Follows underwriting guidelines, policies, procedures and formulas in developing rates for new and renewal groups. Gathers the appropriate data used to determine the status of account refunds. Maintains spreadsheet information on group renewal history. Prepares memos and other correspondence to communicate changes in rates or benefits which have been approved by underwriting management. Processes the appropriate paperwork associated with renewal rate action and proposal closing. Supports internal sales staff regarding underwriting questions and/or resolves issues. Effectively communicates Underwriting decisions to other departments when necessary. Additional Responsibilities for Underwriter II: May determine rates for alternative benefit variations and funding arrangements. Assist in the training process and mentoring of more junior level Underwriters. Prepares contingent premium settlements. Prepares the rate quotations and completes bid specifications. Processes group financial settlement calculations. Reviews and determines whether or not to grant exception requests. Supports management reporting efforts and the development of automated rating and analysis tools. Additional Responsibilities for Underwriter III: May determine rates for alternative benefit variations and more complex funding arrangements. Actively involved in the preparation and maintenance of underwriting guidelines and rating policy. Actively involved with testing new rating, underwriting and front end systems. Answers questions regarding the basic factors used in developing rates, (group size, type of benefits, age/gender composition, large claims, experience provided from the prior carrier, current rates). Answers questions regarding the rate model and how it impacts rates in accordance with particular group demographic changes. Assesses health risk in a group environment (performs large claim analysis for ongoing claim cost). Develops prospective and renewal rates for group accounts in accordance with corporate and underwriting guidelines. Reviews and determines whether or not to grant exceptions to underwriting policy. Ensures the proper administration of underwriting and legislative guidelines for new and renewing groups. Handles large volume production with account specific issues (I.e. reinstatements, eligibility standards, group identification criteria, etc) Maintains a working knowledge of State and Federal regulations affecting group rating. Prepares rate breakouts and hierarchy definitions for group setups. Reviews and directs the preparation of experience reports for fiscal, ERISA and contingent premium settlements. May meet with external customers, brokers or account representatives to review underwriting calculations and provide explanations for rating principles. May prepare written summaries of recommendations and/or conditions of coverage for the group after completion of each analysis. May prepare an explanation of the past rating history, documenting benefit and enrollment changes, and providing a recommendation for benefit and financial options. Additional Responsibilities for Underwriter Senior: Contribute to timely and accurate productivity by assisting the Manager in education to new Underwriters. Attends broker meetings, as well as meetings with sales executives, agents and/or groups to provide explanations of rating principles or rationale of rating positions. Contributes to the development of new rating formulas, methodologies and guidelines. Represent underwriting on Cambia workgroups and strategy sessions and serves as department representative where applicable. The expected hourly hiring range for a Underwriter I is $22.70 - $33.35 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 hourly range for this role is $21.30 to $37.70. The expected hiring range for a Underwriter II is $58,000.00 - $77,050.00 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 $53,000.00 to $88,000.00. The expected hiring range for a Underwriter III 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 Underwriter Sr 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. 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 34d ago
  • Senior Manager, MarketPoint Sales - Raleigh Durham, NC.

    Humana 4.8company rating

    Salem, OR 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 20d ago
  • Lead Citrix Systems Engineer - Network/Virtualization

    Humana 4.8company rating

    Salem, OR 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 17d ago
  • Speech Therapist

    Unitedhealth Group Inc. 4.6company rating

    Salem, OR job

    Explore opportunities with [agency name], 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 Speech Therapist in Home Health is responsible for the assessment and evaluation of patient care needs related to treating speech and language disorders, and functional training in communication, swallowing, and cognitive impairments. Based on this assessment and evaluation, the Speech Therapist works to help determine a treatment plan, performs interventions aimed at improving and enhancing the patient's well-being, and evaluates the patient's progress. Primary Responsibilities: * Provides services within the scope of practice as defined by the state laws governing the practice of speech therapy, in accordance with the plan of care, and in coordination with other members of the health care team * Evaluates the patient's level of function by applying diagnostic and prognostic functional ability tests. Assists the physician in the development of the therapy plan of care * Treats patients to communicate effectively by expressing thoughts according to the patient's condition using acceptable standards of practice * Observes, records, and reports to the supervising nurse and/or physician the patient's response to treatment and changes in the patient's condition * Instructs the patient, the family and/or caregiver and other members of the health care team in areas of speech therapy in which they can participate 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: * Licensed in Speech Therapy in the state of Oregon * Current CPR certification * Current driver's license, vehicle insurance, access to a dependable vehicle or public transportation 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 $71,200 to $127,200 annually 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.
    $71.2k-127.2k yearly 17d ago
  • Business Office Manager- Home Health

    Unitedhealth Group Inc. 4.6company rating

    Happy Valley, OR job

    Explore opportunities with Assured Home Health, 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. The Home Health Business Manager is responsible for managing, coordinating, and directing the administrative support and non-clinical operations of the agency, and for ensuring that all duties are performed in a timely manner. The Business Manager is also responsible for ensuring that all administrative support to the Executive Director and/or Clinical Director functions are operating effectively and efficiently. Primary Responsibilities: * Overseeing and maintaining contracts, binders, and HR/medical files for all agency employees and contract staff in accordance with policy and applicable regulations * Reviewing, reconciling, and submitting invoices to Home Office in accordance with LHC Group policy. This also includes ensuring payment is issued timely, following up on concerns, and maintaining a positive relationship with all vendors * Performs and or manages billing audits per policy and follows-up with corrections * Manages clerical staff and manages all non-clinical workflow and process in the office. This includes timely completion of all clerical tasks, as well as providing input into hiring, disciplinary, and separation decisions 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: * Must possess at least one of the following: * 3+ years of healthcare experience * 3+ years of experience in an office administration role * Bachelor's Degree * Computer proficiency, including Microsoft Office suite Preferred Qualifications: * Demonstrated solid organizational, written, verbal communication, and time management skills * Demonstrated computer proficiency, including Microsoft Office suite * Demonstrated ability to work independently * Demonstrated solid process and people leadership abilities * Experience with payroll process, supply management, and basic financial knowledge #LHCJobs 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 $20.00 to $35.72 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.
    $20-35.7 hourly 6d ago

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