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Centene jobs in Dover, DE - 62 jobs

  • Care Manager (RN)

    Centene Corporation 4.5company rating

    Centene Corporation job in Dover, DE

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **This position is a hybrid role that requires fieldwork within the state of Delaware.** **Position Purpose:** Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. + Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome + Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs + Identifies problems/barriers to care and provide appropriate care management interventions + Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services + Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs + Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate + Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services + May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources + Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits + Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner + Other duties or responsibilities as assigned by people leader to meet business needs + Performs other duties as assigned. + Complies with all policies and standards. **Education/Experience:** Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 - 4 years of related experience. **License/Certification:** RN - Registered Nurse - State Licensure and/or Compact State Licensure required Pay Range: $55,100.00 - $99,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $55.1k-99k yearly 60d+ ago
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  • Compliance Officer, Delaware

    Centene Corporation 4.5company rating

    Centene Corporation job in Dover, DE

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **Applicants for this role must be able to travel into the Wilmington, Dover or Newark office in Delaware once a week.** **Position Purpose:** Oversee all compliance functions for the Delaware health plan including communication and coordination of policy development. Oversee the accurate and timely submission of over-contact deliverables for all lines of business and service delivery areas. + Oversee the accurate and timely submission of all CMS Medicare SNP requirements. + Serve as senior leadership and single point of contact in all State compliance meetings and interactions. + Manage direct correspondence and daily interaction with all state regulators. + Serve as senior leadership in all Department of Insurance and HHSC audit processes. + Managing all facets of the audit and communications. + Serve as senior leadership in Enterprise Risk Management process working directly with corporate ERM and Executive Management team to ensure current evaluation and documentation of business risks. + Conduct internal compliance audits, write corrective action plans and work with contract and department managers to ensure timely completion and compliance with federal, state and local regulatory requirements. + Accountable for the management and oversight of compliance for all health plan material subcontractors to include directing the performance of annual oversight. + Performs other duties as assigned. + Comply with all policies and standards. **Education/Experience:** + Bachelor's degree in related field or equivalent experience. Master's degree preferred. + 7+ years of compliance program management and contract experience with State Medicaid programs including internal and State audits. + 5-7 years of experience with health care regulatory agencies in development of compliance and fraud programs. + 5+ years' experience with overseeing implementation of contract requirements. Pay Range: $148,000.00 - $274,200.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $83k-107k yearly est. 60d+ ago
  • Warehouse Associate Representative - CuraScript SD - On Site

    Cigna Group 4.6company rating

    Newark, DE job

    The Warehouse Receiving Associate is responsible for performing tasks related to receiving product, stocking and replenishment, and inventory control. This includes safely unloading trucks and unpacking received product, comparing the purchase order to the product received for accuracy, counting quantities of product received and ensuring the quality of the product is at an acceptable level, and removing damaged or non-conforming product using data entry and retrieval devices to record receipt transaction (using scanners and computer input). In addition, this position safely transfers material from receiving area to warehouse or dispensing locations and ensures proper stock rotation-utilizing PDAs to update the inventory system. The Warehouse Assistant also audits shelf counts for accuracy, reviews inventory for short-dated and expired product, and reports discrepancies to the supervisor. A little more about what you'll do: Safely unpack and evaluate incoming product for correct count and condition in comparison to purchase orders Safe operation of material handling equipment and hand tools such as forklifts, pallet jacks (manual and electric), carts, dollies, box cutters, wire cutters, etc.-to unload trucks and stock the warehouse/pharmacy Accurate data entry and retrieval using computers, and scanners (PDA) Bin and shelf inventory maintenance and stock rotation-including shelf counts, short shelf life and expired product audits Communicate discrepancies or issues as they are occur to the appropriate personnel Maintain organization and cleanliness of assigned work stations and areas Other duties as assigned What you need: Minimum six months in a distribution center environment required Ability to accurately compare two sets of data required Basic math, organization, computer, and communication skills required Ability to do repetitive bending, squatting, standing, walking, pushing, pulling, hand motions, and lift 50 lbs required Ability to walk/stand for full shift required Ability to read and differentiate small print required If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an hourly rate of 17.75 - 24 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
    $30k-35k yearly est. Auto-Apply 60d+ ago
  • Pharmacist In-Charge

    Unitedhealth Group Inc. 4.6company rating

    Aston, PA job

    Explore opportunities with CPS, part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind Caring. Connecting. Growing together. The Pharmacist-in-Charge will have the opportunity to apply your clinical expertise by evaluating and interpreting medication orders, compounding, and dispensing prescriptions in accordance with legal and professional standards. You will play a critical role in identifying, preventing, and resolving medication-related issues to ensure safe, effective, and individualized patient care. Through the application of evidence-based protocols, you will promote clinically sound and cost-effective drug therapy, contributing to improved patient outcomes and advancing the standard of pharmaceutical care. Pharmacy Location: Located at the new WellSpan Aston Hospital in Aston, PA Schedule: Monday through Friday, 8AM to 4PM About the Facility: WellSpan Aston Hospital is a neighborhood hospital created in partnership with Emerus, the nation's leader in small-format hospitals. This innovative model delivers high-quality, patient-focused care close to home, offering services such as Lab, Imaging, Emergency Care, Wellness, and Primary Care. Together, WellSpan and Emerus bring convenient, compassionate care to the Carlisle community. Primary Responsibilities: * Evaluate and interpret medication orders to ensure accuracy and appropriateness * Dispense prescriptions in compliance with legal and professional standards * Identify, prevent, and resolve medication-related issues to promote patient safety * Apply evidence-based protocols to support clinically sound and cost-effective drug therapy * Collaborate with healthcare providers to optimize individualized patient care plans * Maintain regulatory compliance and uphold pharmacy operational standards 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: * ACPE-accredited pharmacy degree (PharmD preferred) * Active Pennsylvania state pharmacist license in good standing Preferred Qualifications: * Some supervision experience * Some hospital experience 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 $44.09 to $78.70 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.
    $44.1-78.7 hourly 3d ago
  • Associate Actuary, SPA-Rx

    Humana 4.8company rating

    Dover, DE 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 20d ago
  • Associate Patient Care Coordinator

    Unitedhealth Group Inc. 4.6company rating

    Vineland, NJ job

    Opportunities with Optum in the Tri-State region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind Caring. Connecting. Growing together. Optum Urgent Care has an immediate opening for a friendly, patient focused and detailed oriented Associate Patient Care Coordinator to join our team. The Associate Patient Care Coordinator is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical and service goals. Working Hours: Office is open seven days a week. This role would consist of a 36- hour work week, consisting of 3 - 12-hour shifts between the hours of 7:45 am to 8:00 pm or last patient. The schedule will be determined by the supervisor upon hire. Rotating schedule including Holidays. May be asked to float to other clinics as needed Location: * 3403 S. Delsea Drive, Vineland, NJ 08360 * 301 South Main Road, Vineland NJ 08360 Primary Responsibilities: * Obtain accurate and updated patient information, such as name, address, insurance information * Perform insurance verification on the date of service * Obtain patient signatures for required documents * Upload a valid Government issued state ID of patient and patient insurance cards * Accurate and complete occupational medicine registration workflow * File and maintain medical records * Consistently correct registration work queue errors * Confirms and schedule appointments * Answer telephone calls promptly and courteously * Perform referral documentation promptly * Working daily in the claims edit work queue and referrals work queue to correct registration errors for submission to insurance companies * Performs certain follow-up services for patients in a prompt and courteous manner, such as scheduling specialist appointments, scheduling follow-up appointments and obtaining copies lab results or specialist reports * Adhere to the standards identified via Sparq regarding Optum Employee Policies * Work cohesively with fellow employees to achieve specific team goals * Keep abreast on current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPAA and OSHA requirements * Comfortable working in high pace environment * Participate in planning, coordinating, and implementing care in conjunction with the multidisciplinary team in accordance with the Plan of Care * Assure the continuity of care through scheduling and tracking systems * Provide effective communication to patient / family team members and other health care professionals as evidenced by documentation, case conferences, communication notes, and evaluations * Notify clinical staff of schedule changes as they occur * Comply with administrative policies to ensure quality of care * Demonstrate precision and efficiency in scanning documents and monitoring the fax server, retrieving and / or scanning documents and assigning to the appropriate electronic chart * Participate in orientation (scheduling segment) of new field employees and distribute updates and changes as needed * Perform other related duties and assignments as required * Organize and maintains medical records * All employees are expected to keep abreast on current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPAA and OSHA requirements * Complete new clinical competencies rolled out by the Educational Committee * Work Independently, and Assist with Clinical duties on a limited basis * Crosstrain and help in other locations if needed * Performs 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: * High School Diploma/GED (or higher) * 1+ years of computer proficiency experience including MS Word, Excel and Outlook, and being able to use multiple web applications * 1+ years of customer service or healthcare related experience * Ability to travel to both offices interchangeable depending on business needs * 3403 S. Delsea Drive, Vineland, NJ 08360 * 301 South Main Road, Vineland NJ 08360 Preferred Qualifications: * 1+ years of customer service experience * 1+ years of experience working in medical office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays, and maintaining medical records * Knowledge of Epic EMR software Soft Skills: * Ability to work independently and maintain good judgment and accountability * Demonstrated ability to work well with health care providers * Strong organizational and time management skills * Ability to multi-task and prioritize tasks to meet all deadlines * Ability to work well under pressure in a fast-paced environment * Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others 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 41d ago
  • Medical Assistant - Urgent Care

    Unitedhealth Group Inc. 4.6company rating

    Vineland, NJ job

    $1,000 Sign on Bonus for External Candidates Opportunities with Optum in the Tri-State region (formerly CareMount Medical, ProHEALTH New York and Riverside Medical Group). Come make a difference in the lives of people who turn to us for care at one of our hundreds of locations across New York, New Jersey and Connecticut. Work with state-of-the-art technology and brilliant co-workers who share your passion for helping people feel their best. Join a dynamic health care organization and discover the meaning behind Caring. Connecting. Growing together. As a National Committee for Quality Assurance "Level III- Patient Centered Medical Home," Optum is able to provide patient-focused precision medical care to the entire family and is committed to providing patients with the highest quality medical care. In addition to providing the highest quality of care, Optum offers its patients the best hours of operation of any private practice in the country. Patients have around-the-clock access to a health-care team and have the benefit of same day and walk in appointments. As an advocate for prenatal health and education, Optum offers prenatal classes every weekend free of charge. We believe in giving back to the community and the patients through health fairs, charitable giving/foundation, and free medical education. Optum is seeking a Certified Medical Assistant Senior to join our growing team in New Jersey. At Optum, we are transforming healthcare nationally while providing physician-led care locally. Working Hours: Office is open 7 days a week. This role will consist of a 36 hour work week, consisting of 3, 12 hour shifts between the hours of 7:45am-8pm or last patient. The schedule will be determined by the supervisor upon hire. Rotating schedule including holidays. May be asked to float to other clinics as needed. Location: Ability to travel to both offices interchangeable depending on business needs * 3403 South Delsea Drive, Vineland, NJ 08360 * 301 South Main Road, Vineland, NJ 08360 Primary Responsibilities: * Prepare the patient for the Medical Provider's examination by obtaining vital signs and patient history * Prepare and maintains the examination and treatment areas * Prepare the patient for and assisting with the examination * Prepare the patient for and assisting with procedures and treatments * Maintain medication and immunization records * Perform sterilization techniques * Performing all Occupational services to all patients and ensuring follow-up to clients providing all necessary documentation * Perform an inventory of supplies and equipment * Accurate completion of daily, weekly, and monthly checklist * Accurate completion and documentation of all quality control testing * Understand proper function and care of special equipment * Perform routine maintenance and calibration of administrative and clinical equipment * Organize and maintains medical records * Cooperate with other RMG employees to achieve specific team goals * To the extent requested by the Medical Provider, RMG Medical Assistants are also responsible for certain follow-up with patients, such as ensuring specialist appointments are scheduled and referrals are prepared * All RMG employees are expected to keep abreast on current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPAA and OSHA requirements * Complete all new-hire clinical competencies within 90 days of start-date. Complete new clinical competencies rolled out by the Educational Committee * Maintain and provide proof of valid CMA license to United Health Group on an annual basis * Perform sterilization techniques, EKG, Nebulizer, Splinting, and other support tasks requested by Provider * Administer injections and collect specimens * Document patient care using electronic medical record software * Schedule appointments, complete prior authorizations, process medication refills, handle referrals, answer calls and complete paperwork as needed * Greet all patients upon entering the Urgent Care Center * Obtain accurate and updated patient information, such as name, address, insurance information * Perform insurance verification on the date of service * Obtain patient signatures for required documents * Upload a valid Government issued state ID of patient and patient insurance cards * Accurate and complete occupational medicine registration workflow * File and maintain medical records * Consistently correct registration work queue errors * Confirms and schedule appointments * Answer telephone calls promptly and courteously * Collects co-pays or outstanding balances on the date of service * Perform referral documentation promptly * Performs certain follow-up services for patients in a prompt and courteous manner, such as scheduling specialist appointments, scheduling follow-up appointments and obtaining copies lab results or specialist reports * Adhere to the standards identified via Sparq regarding Employee Policies * Work cohesively with fellow RMG employees to achieve specific team goals * Keep abreast on current medical requirements relevant to their position, which includes maintaining patient confidentiality and abiding by all HIPAA and OSHA requirements * Comfortable working in high pace environment 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: * High School or GED * Nationally recognized Medical Assistant certification * Active American Heart Association BLS certification or ability to obtain within 30 days of hire * 1+ years of computer proficiency experience including MS Word, Excel and Outlook with the ability to use multiple web applications * Ability to travel to both offices interchangeable depending on business needs * 3403 S. Delsea Drive, Vineland, NJ 08360 * 301 South Main Road, Vineland NJ 08360 Preferred Qualifications: * 1+ years of back office Medical Assistant experience * Experience with Epic EMR * Demonstrated ability to work independently and maintain good judgment and accountability * Demonstrated ability to work well with health care providers * Demonstrated ability to multi-task and prioritize tasks to meet all deadlines * Demonstrated ability to work well under pressure in a fast-paced environment * Proven solid organizational and time management skills * Proven excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others 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.
    $16-27.7 hourly 7d ago
  • Field Property Claims Adjuster

    Liberty Mutual 4.5company rating

    Newark, DE job

    Join us as a Field Property Claims Adjuster where you'll be responsible for helping our customers navigate the claims process and get back on their feet following damage to the homeowner's property. This is a role where people who love every day to be new, different and exciting, can thrive - you'll be traveling on the road to meet customers in person, providing hands-on assessment of damage and empathetic support. The Field Property Claims Adjuster will be traveling locally to insured homes within Newark, DE (19711) and surrounding areas. To be successful within the role, candidates should live within or near this area. Sign-On Bonus Available! We're offering a sign-on bonus for experienced and actively licensed new hires. What you'll do Investigate and evaluate onsite to resolve complex coverage and damage issues to include preparing complete estimates of repair for the covered damages. This may include accessing roofs by ladder, inspecting attics, crawl spaces and basements in search of damage. Handle moderate to complex claims independently while managing your workload, from first notice of loss to final closure. Be expected to work in a vehicle in the field daily while occasionally handling assignments from the desk. Explain coverage of loss, assist policyholders with itemization of damages, emergency repairs and additional living arrangements. Work with and coordinate a few vendor services such as contractors, emergency repair, cleaning services and various replacement services. May be called upon for catastrophe duty. Position details Territory-based work: Most workdays will be spent in the field within your assigned local territory, giving you the opportunity to work directly with customers and gain hands-on experience. Training & support: To set you up for success, you'll participate in a comprehensive 5-month training program, which includes: Primarily virtual and on-the-job learning. Two short in-person training sessions (Weeks 4 and 7) at our Lewisville, TX office. Limited overnight travel for training and team meetings (typically less than 10%). Mileage Reimbursement: This role offers mileage reimbursement. You may qualify for a company-provided vehicle once mileage requirements are met. Additional details will be provided if you advance in the selection process. Qualifications Working knowledge of claims handling procedures and operations. Proven ability to provide exceptional customer service. Effective negotiation skills. Ability to effectively and independently manage workload while exhibiting good judgment. Strong written/oral communication and interpersonal skills. Computer skills with the ability to work with multi-faceted systems. The capabilities, skills and knowledge required through a bachelor's degree or equivalent experience and at least 1 year of directly related experience. Ability to obtain proper licensing as required. The ability to handle multiple competing priorities and organize your day. Strong time management and organizational skills. Demonstrated understanding of building construction principles. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.
    $47k-58k yearly est. Auto-Apply 6d ago
  • Inpatient Medical Coding Auditor

    Humana 4.8company rating

    Dover, DE job

    **Become a part of our caring community and help us put health first** The Inpatient Medical Coding Auditor reviews a variety of medical records and to determine appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT.) The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Inpatient Medical Coding Auditor confirms appropriate diagnosis related group (DRG) assignments upon appeal. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. 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** **WORK STYLE:** Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week-- some flexibility might be possible, once training is complete and depending on business needs. Associates are expected to start each workday between 6AM-9AM EST, regardless of their home time zone. **Required Qualifications** + RHIA, RHIT, or CCS Certification + At least 2 years' experience in acute in-patient coding experience and/or MS-DRG auditing + Recent experience auditing using CMS Manual, LCD, NCD, and Coding Guidelines + Experience reading and interpreting claims + Excellent written and verbal communication skills + Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel + Strong attention to detail + Can work independently and determine appropriate course of action + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Associate's Degree or higher in Health Information Management (HIM) + Experience in Financial Recovery + Experience in a fast paced, metric driven operational setting + Experience in APR DRG coding/auditing **Additional Information** **Work at Home Requirements** - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. 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. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-12-2026 **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 ***************************************************************************
    $71.1k-97.8k yearly 6d ago
  • Data Scientist - Generative AI

    Humana 4.8company rating

    Dover, DE 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 53d ago
  • Actuarial Principal - Financial Planning and Analysis

    Humana 4.8company rating

    Dover, DE job

    **Become a part of our caring community and help us put health first** Join Humana's Financial Planning & Analysis team, part of the CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial strategy and analysis, with connections to enterprise-wide and total Insurance perspectives. The Actuarial Analytics/Forecasting Principal role offers flexibility in responsibilities, significant exposure to senior leadership, and strong potential for upward mobility. We seek candidates who are willing to think creatively, challenge assumptions, voice opinions on key drivers and ranges, and contribute to a culture of continuous improvement and healthy debate. The Actuarial Analytics/Forecasting Principal analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium, and long-term financial and competitive position. The Actuarial Analytics/Forecasting Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. The Actuarial Analytics/Forecasting Principal ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost-effective resolutions for data anomalies. Works with senior executives to develop and drive segment or enterprise-wide functional strategies. Advises one or more areas, programs, or functions and provides recommendations to senior executives on matters of significance, and as an advanced subject matter expert competent to work at very high levels in multiple knowledge and functional areas across the enterprise. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree, in some instances a Master's or Doctorate's degree + 10 or more years of technical experience + 2-5 years of project/people leadership + FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations + MAAA + Strong communication skills + Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending) + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Medicare Advantage pricing and forecasting experience + Experience working with aggregate financials across insurance products or enterprise-level financial planning + Demonstrated ability to challenge existing assumptions and propose creative solutions **Additional Information** Humana is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, or veteran status. For more information on Humana careers, please visit Humana Careers (******************************* . Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $156,600 - $215,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-30-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $156.6k-215.4k yearly 28d ago
  • Benefit Configuration Coordinator

    Centene Corporation 4.5company rating

    Centene Corporation job in Newark, DE

    You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **_Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT._** **Position Purpose:** Maintain client setups, including data entry, auditing, and error reporting. + Maintain client setup and benefit configuration by entering benefit information into PBM system + Track and process various change requests from the benefit enrollment forms and other system queues timely and accurately + Research system issues and update information of commercial accounts and submit deliverables to account management team + Assist with testing and system setup + Process enrollment and termination member eligibility requests + Track and report client information errors as identified by call center representatives **Education/Experience:** High school diploma or equivalent. 4+ years of database management experience in the healthcare environment, preferably in pharmacy benefit management.Pay Range: $19.43 - $32.98 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
    $19.4-33 hourly 3d ago
  • Business Intelligence Lead

    Humana 4.8company rating

    Dover, DE job

    **Become a part of our caring community and help us put health first** We're seeking a Business Intelligence Lead to join our team. This role is ideal for a strategic thinker and hands-on thought leader who thrives at the intersection of data, business strategy, and cross-functional collaboration. You'll be responsible for transforming raw data into actionable insights that directly influence executive decision-making and drive enterprise-wide initiatives. **What You'll Do:** + **Lead Strategic BI Initiatives:** Design, develop, and deliver business intelligence tools and analyses that support key organizational priorities across sales, operations, and customer experience. + **Partner with Senior Leadership:** Serve as a trusted advisor to executives and business leaders, translating complex data into clear, actionable insights that inform strategic decisions. + **Drive Analytical Excellence:** Perform deep-dive analyses to uncover trends, relationships, and opportunities to inform decision-making. + **Ensure Data Quality and Governance:** Collaborate with data engineering and governance teams to ensure BI solutions are scalable, reliable, and aligned with enterprise standards. **What We're Looking For** + Proven experience in business intelligence, analytics, and/or strategy advancement, ideally in a lead or senior role. + Expertise in BI tools (e.g., Power BI, Tableau, etc), SQL, and modern data platforms (e.g., Snowflake, DataBricks, etc). + Strong business acumen and the ability to communicate complex data concepts to executive leadership and non-technical stakeholders. + Demonstrated success in leading cross-functional projects and influencing strategic outcomes. + A passion for uncovering insights and driving measurable impact through data. **Why Join Us** + Work directly with senior executives on high-visibility initiatives. + Be part of a team that values depth of thought, precision, and innovation. + Help shape the future of data-driven decision-making in a dynamic and evolving organization. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree and 8 or more years of technical experience in business intelligence, analytics, and/or strategy advancement, ideally in a lead or senior role. + Expertise in BI tools (e.g., Power BI, Tableau, etc), SQL, and modern data platforms (e.g., Snowflake, DataBricks, etc). + 2 or more years of project leadership experience + Advanced experience working with big and complex data sets within large organizations + Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction + Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs **Preferred Qualifications** + Advanced Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field + Advanced in SQL, SAS and other data systems + Expertise in data mining, forecasting, simulation, and/or predictive modeling + Experience creating analytics solutions for various healthcare sectors 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: 01-16-2026 **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 2d ago
  • Part Time Pharmacy Technician

    Unitedhealth Group Inc. 4.6company rating

    Newark, DE job

    Explore opportunities with CPS, part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind Caring. Connecting. Growing together. The Pharmacy Technician will assist in various pharmacy activities under the supervision of a licensed pharmacist. Your responsibilities will include preparing, delivering, and restocking medications; performing order entry; procuring drugs; billing. You will carry out your job duties according to written procedures and guidelines based on pharmacy standards and regulatory requirement Schedule: This position will work up to 10 hours per week every Tuesday and every other weekend. About the Facility: Rockford Center is a 138-bed mental health facility located in Newark, DE, providing easy access to a full complement of inpatient and partial behavioral health programs for children and adolescents, adults, and older adults. Rockford is the only child inpatient behavioral health facility in DE, offers an experienced and tenured senior management team, and serves New Castle County and northern Maryland. CPS Solutions LLC has partnered with the hospital to manage the day-to-day operations of this pharmacy. This position is an employee of CPS Solutions, LLC. About the Pharmacy: The pharmacy is open Monday through Friday from 8:00 am-4:00 pm; on Weekends 9:00 am-1:00 pm. 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: * High school diploma or equivalent required * Active applicable state Pharmacy Technician license in good standing * Recent work experience as a Pharmacy Technician, ideally in inpatient setting 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.
    $16-27.7 hourly 20d ago
  • Insurance Product Compliance Lead

    Humana 4.8company rating

    Dover, DE job

    **Become a part of our caring community and help us put health first** The Insurance Product Compliance Lead researches, analyzes, assesses risk and consults on rules, regulations and sub-regulatory guidance that apply to Insurance Products (i.e., Medicare Advantage, Part D, Group Specialty, and Individual Specialty), licensure or corporate structure. The Insurance Product Compliance Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Insurance Product Compliance Lead partners with internal stakeholders and serves as Humana liaison while drafting, filing and negotiating approval with state and federal regulators for service area expansions; product-specific documents, contracts, licenses, member communications or marketing materials, all while safeguarding Humana's brand. Supports implementation and maintenance of compliant insurance products in collaboration with responsible business owners. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. **Use your skills to make an impact** **Required Qualifications** + Experience with Medicare Advantage and/or Medicaid + Comprehensive knowledge of Microsoft Office applications: Word, Excel, PowerPoint, Adobe and Visio + Ability to summarize complex information and tailor communication based on audience (i.e., contracts, federal and state regulations) + Ability to work independently while maintaining focus and managing deliverables to meet critical internal and external deadlines + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + Ability to affect change in a highly matrixed organization, leveraging data and facts to influence decision-makers **Preferred Qualifications** + Experience in working with State Agencies + Understanding of State and Federal Regulations + Experience with Medicare Advantage plan and benefit offerings + Experience specific to Dual Eligible members and healthcare plans for MA DSNP product offerings + Knowledge of Humana's internal policies, procedures and systems + Prior project management or product management experience 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. $94,900 - $130,500 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 ***************************************************************************
    $94.9k-130.5k yearly 4d ago
  • Financial Analytics Professional

    Humana 4.8company rating

    Dover, DE job

    **Become a part of our caring community and help us put health first** The Financial Analytics Professional 2 manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Financial Analytics Professional 2 collates, models, interprets and analyzes data in order to identify, explain, influence variances and trends. Explains variances and trends and enhances modeling techniques. May possess financial or actuarial background. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + 5 years technical experience + Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends + Explain variances and trends and enhance modeling techniques + Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues + Possess a working knowledge and understand department, segment and organizational strategy + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Master's Degree + Financial or Actuarial background + Project Management Certification **Additional Information** This role will be primarily responsible for preparing data and summarization for industry-wide Medicaid actuarial analyses. 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. $66,800 - $91,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-30-2026 **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 ***************************************************************************
    $66.8k-91.1k yearly 4d ago
  • Home Infusion Nurse - Accredo - Southern New Jersey

    Cigna 4.6company rating

    Mays Landing, NJ job

    Home Infusion Registered Nurse - Accredo Specialty Pharmacy Join Accredo Specialty Pharmacy, part of Evernorth Health Services, and bring your nursing expertise to patients where they feel most comfortable-their homes. As a Home Infusion Registered Nurse, you'll deliver life-changing care while building meaningful relationships and driving positive health outcomes. Responsibilities: * Provide safe and effective administration of specialty medications (including IV infusion) in patients' homes. * Partner with pharmacists and care teams to ensure holistic patient well-being. * Document assessments, treatments, and progress to maintain accurate patient records. * Serve as the primary point of contact for patient updates and care coordination. * Demonstrate autonomy in clinical decision-making to achieve optimal outcomes. Required Qualifications: * Active RN license in the state of practice. * Minimum 2 years of RN experience. * At least 1 year in critical care, acute care, or home healthcare. * Proficiency in IV insertion and infusion techniques. * Valid driver's license and ability to travel within a large geographic region. * Availability for a 40-hour workweek, including evenings and weekends as needed. Preferred Qualifications: * Bachelor of Science in Nursing (BSN). * Experience with specialty pharmacy or infusion therapy programs. Benefits: * Medical, Dental, Vision, and Life insurance * 401k with strong company match * Mileage reimbursement and/or company car * 26 Paid Days Off (18 days PTO, plus 8 company holidays) * Merit and Bonus eligibility If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 79,200 - 132,000 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
    $68k-85k yearly est. Auto-Apply 5d ago
  • Medical Director - Nat'l UM Team 1wknd/mo

    Humana 4.8company rating

    Dover, DE 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. Weekend work required one weekend per month with compensated days off during the work week 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 + Demonstrate adaptability and willingness to learn evolving workflows, tools, and utilization management practices + **Weekend work required one weekend per month with compensated days off during the work week** **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 **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 60d+ ago
  • Lead Citrix Systems Engineer - Network/Virtualization

    Humana 4.8company rating

    Dover, DE 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 26d ago
  • Senior Manager, MarketPoint Sales - Raleigh Durham, NC.

    Humana 4.8company rating

    Dover, DE 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 29d ago

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