Centene jobs in Lansing, MI

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. **Attend community events, build relationships with community based organizations, and track outcomes of activities.** ***** Must live in SW Michigan - (Counties: Van Buren, Kalamazoo, Calhoun, Berrien, Cass, and St. Joseph, Branch)** **Position Purpose:** Work with Marketing & Community Relations Manager to develop and implement community outreach plan for the Health Plan. + Participate as a member of the Marketing team in developing and implementing strategies to support the department and company + Contribute to the attainment of member growth goals + Maintain thorough knowledge of Healthcare programs and associated regulatory marketing guidelines + Identify and develop relationships with new community contacts and organizations to pursue outreach engagements + Develop and implement promotional plan for new outreach opportunities + Identify and coordinate outreach activities and necessary materials at community and health events + Attend community and health events to distribute Health Plan information + Support manager with scheduling and delivery of health education presentations + Organize Health Plan staff and other resources in the participation and the support of select community events and activities + Distribute written material to customers who call in and request + Support Health Plan sponsored programs in schools + Performs other duties as assigned + Complies with all policies and standards ***** Must live in SW Michigan - (Counties: Van Buren, Kalamazoo, Calhoun, Berrien, Cass, and St. Joseph, Branch)** **Highly Preferred** **Background in Public Relations, Community Service, Social Work, or related experience.** ** 50% of Local Travel and 50% Office/Hub.** **Education/Experience:** High school diploma or equivalent and 3+ years of community outreach experience or Bachelor's degree in Communications, Marketing, or related field. Bachelor's degree preferred. 2+ years of community outreach experience. Experience in working with government-sponsored population, especially Medicare, Medicaid and SCHIP. Experience in public speaking. **License/Certification:** Valid driver's license. **For Coordinated Care only:** Education/Experience: High school diploma and 3+ years of community outreach experience or Bachelor's degree in Communications, Marketing, or related field. Bachelor's degree preferred. 2+ years of community outreach experience or equivalent combination of skills, experience, and education that provides the applicant with the knowledge, skills, and ability required to perform the job. Experience in working with government-sponsored population, especially Medicare, Medicaid and SCHIP. Experience in public speaking. Physical Requirements: Ability to lift up to forty pounds required. **For MHS Indiana only:** MHS only: Ability to lift up to forty pounds required. Community Health Worker Certification required. Bi-lingual in Spanish preferred. Ability to travel the entire state. MHS values diversity in its workplace and provides health plan benefits to culturally diverse individuals. As such, MHS employees are expected to understand, communicate with, and effectively interact with people across cultures. Experience working with low income and/or multi-cultural and multilingual populations is preferred. **For Oklahoma Complete Health:** Ability to lift up to forty pounds required. Ability to travel the entire state required. Bi-lingual in Spanish preferred. Pay Range: $22.79 - $38.84 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

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. **Position Purpose:** Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. + Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting + Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources + Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management + Develop reports and deliverables and make recommendations to management + Model data using MS Excel, Access, SQL, and/or other data ware house analytical tools + Assist management in driving business decisions based on data + Ensure compliance with federal and state deliverable reporting requirements by performing data quality audits and analysis + Assist with training and mentoring other Data Analysts + Assist with determining work load and related activities for other Data Analysts + Performs other duties as assigned + Complies with all policies and standards **Education/Experience:** Bachelor's degree in business, economics, statistics, mathematics, actuarial science, public health, health informatics, healthcare administration, finance or related field or equivalent experience. Master's degree preferred. 5+ years of experience working with large databases, data verification, and data management or 3+ years IT experience. Healthcare analytics experience preferred. Experience with table creation and indexing, query optimization, and utilization of stored procedures. Working knowledge of SQL/querying languages. Experience with table creation and indexing, query optimization, and utilization of stored procedures. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical, or data mining techniques including basic data modeling, trend analysis, and root-cause analysis preferred. Preferred knowledge of modern business intelligence and visualization tools. Experience in emerging trend analysis, financial modeling, claims pricing, contract/network analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired. Pay Range: $86,000.00 - $154,700.00 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

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. **Position Purpose:** Establishes and fosters a healthy working relationship between community physician and small provider practices and WellCare. Educates providers and supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS. + Under general guidance form Senior Quality Practice Advisors and management, educates community physician and small provider practices in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements. + Collects, summarizes and trends provider performance data to identify and strategize opportunities for provider improvement. + Collaborates with Provider Relations to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters). + Assists in delivering provider specific metrics and coaches providers on gap closing opportunities. + Assists in identifying specific practice needs where WellCare can provide support. + Partners with physicians/physician staff to find ways to encourage member clinical participation in wellness and education. + Provides resources and educational opportunities to provider and staff. + Captures concerns and issues in action plans as agreed upon with provider. + Documents action plans and details of visits and outcomes. + Reports critical incidents and information regarding quality of care issues. + Communicates with external data sources as needed to gather data necessary to measure identified outcomes. + Provides communication such as newsletter articles, member education, outreach interventions and provider education. + Supports quality improvement HEDIS and program studies as needed, requesting records from providers, maintaining databases, and researching to identify members' provider encounter history. + Ensures that documentation produced and/or processed complies with state regulations and/or accrediting body requirements. + Ensures assigned contract/regulatory report content is accurate and that submission adheres to deadline. + Enter documentation of findings in identified databases and ensure accuracy in medical records for data collection, DE and reporting. + Performs other duties as assigned. + Performs other duties as assigned + Complies with all policies and standards **The ideal candidate will be based in** **Kent, Ottawa, or Muskegon County, Michigan** **, and possess strong** **quality experience** **. This role requires** **up to 50% travel in those counties.** **Education/Experience:** **Required A Bachelor's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field or equivalent work experience within a managed care environment related to HEDIS record review, quality improvement, medical coding or transferable skill sets that demonstrates the ability to perform the role. Preferred:** A Master's Degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field. Candidate Experience: Required: 1+ year of experience in related HEDIS medical record review or quality improvement with experience in data and chart reviews to provide consultation and education to providers and provider staff OR 2 years medical coding or other transferable experience and skill set combination that demonstrates the ability to learn and perform the level of the position. **A license in one of the following is preferred:** Certified Coding Specialist (CCS), Licensed Practical Nurse (LPN), Licensed Master Social Work (LMSW), Licensed Vocational Nurse (LVN), Licensed Mental Health Counselor (LMHC), Licensed Marital and Family Therapist (LMFT), Licensed Certified Social Worker (LCSW), Licensed Registered Nurse (RN), Acute Care Nurse Practitioner (APRN) (ACNP-BC), Other Foreign trained physician/MD, Health Care Quality and Management (HCQM), Certified Healthcare Professional (CHP), Certified Professional in Healthcare Quality (CPHQ). Pay Range: $26.50 - $47.59 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

**Become a part of our caring community and help us put health first** Join Humana's In Home Well-being Assessment (IHWA) team and take ownership of critical claims operations that ensure compliance and accuracy for Medicare members. As a Senior Program Delivery Professional, you'll manage vendor claims processes, monitor compliance, and drive quality improvements. **Key Responsibilities:** + Oversee setup, management, and monitoring of IHWA and Stars vendor claims. + Ensure accurate claims submissions and payments per contract fee schedules. + Partner with internal teams and vendors to resolve issues and maintain compliance with CMS and Medicare Risk Adjustment requirements. + Support auditing processes for corrected claims, deletes, and no-show visit workflows. + Utilize CAS, eHub, CIS, Coding, RGI rules, and claims auditing tools to maintain accuracy and efficiency. + Operate independently, manage multiple tasks/projects, and make decisions in ambiguous situations. + Proactively identify issues, communicate findings, and influence process improvements. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree or equivalent years of experience + 5 or more years of claims experience + Strong knowledge of Microsoft Office XP products (Word, Excel, Access0 + Excellent communication skills, both oral and written + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Master's Degree in Business Administration or a related field + PMP certification a plus + Knowledge and experience in health care environment/managed care + Strong analytical skills **Additional Information** 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 + Recognition pay + 401(k) retirement savings plan with employer match + Tuition assistance + Scholarships for eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership. + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $86,300 - $118,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-11-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Quality Improvement Professional 1 implements quality improvement programs for all lines of business including annual program description, work plan, and annual evaluation. The Quality Improvement Professional 1 work assignments are often straightforward and of moderate complexity. The Quality Improvement Professional supports quality improvement programs for all lines of business by gathering and analyzing data related to critical incidents including report generation and submission as required. **Role Overview** + Work assignments are often straightforward and of moderate complexity. + Monitors quality investigations and compliance processes. + Partners with external entities in the market, Internal and Enterprise departments. + May manage quality management system, department SharePoint, and department reporting. + Audits processes as needed for compliance. + Understands own work area professional concepts/standards, regulations, strategies and operating standards. + Makes decisions regarding own work approach/priorities and follows direction. + Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + Prior experience in a fast-paced insurance or health care setting + 2+ years' experience in provider relations and education + Understanding of healthcare quality measures STARS, HEDIS, etc. + Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint + Proven analytical skills + Excellent communication skills, both oral and written + Strong relationship building skills + Must reside and perform work in the State of Michigan + May travel to the Market office for meetings and/or training. May occasionally meet with Members or providers on an ad hoc basis. **Preferred Qualifications** + Knowledge of Humana's internal policies, procedures and systems + RN/LPN Nurse with quality experience **Additional Information** **WAH Internet Statement** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required. + 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. **Additional Information** **Interview Format** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **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. 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. $53,700 - $72,600 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or 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 ***************************************************************************

**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. 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. **In addition, the Associate Actuary will:** + Support long term projects aimed at advancing technical maturity, process efficiency, and forecasting accuracy. We are looking for creativity, curiosity, and a desire to explore and influence uncharted territory. + Conduct independent research, collaborate across many teams/departments, and require strong communication skills to be successful in the job. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + Associate of Society of Actuaries (ASA) designation + Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP) + MAAA + Strong communication skills + Demonstrated ability to communicate technical information with audiences not in the actuarial space + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + 3+ years health industry experience with ASA, or 1+ years health industry experience with FSA + 2+ years SQL experience, or equivalent skillset **Preferred Qualifications** + Medicare Advantage background + Creative, high degree of self-accountability + Experience in Python, PowerApps, and PowerBI 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: 12-30-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, level of care, and/or site of service should be authorized. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert decisioning on the requested services. They will have regular discussions with external providers by phone to gather additional clinical information and discuss determinations. Medical directors are expected to understand Humana processes with a focus on collaborative professional relationships. The ideal candidate will have a high degree of integrity, professionalism, resourcefulness, and enjoy working in a team-based environment. Medical Directors support Humana value throughout all activities. **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are concordant with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. After completion of structured and mentored training, daily work is performed with minimal direction, but with ready support from other team members. The ideal candidate enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines. + Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services + Maintain accountability for productivity, quality, and compliance metrics + Communicate determinations clearly both verbally and in writing + Participate in rotational weekend work and occasional holiday responsibilities + Demonstrate adaptability and willingness to learn evolving workflows, tools, and utilization management practices **Work Schedule Monday - Friday w/standard weekends (about 5 per year on average) Eastern Time Zone hours** **Use your skills to make an impact** **Use your skills to make an impact** **Required Qualifications** + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required. + No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent verbal and written communication skills. + Evidence of analytic and interpretation skills, with prior experience working in a team environment + **Work Schedule Monday - Friday w/standard weekends (about 5 per year on average) Eastern Time Zone hours** **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, or other healthcare providers. + Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual + Experience in hospital-based clinical practice, including specialties of Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine, and hospital-based clinical specialists + The curiosity to learn and the flexibility to adapt to changes in order to enhance efficiency, productivity, and organizational goals. + Ability to thrive in a dynamic fast-paced, team-oriented environment. + Commitment to a culture of innovation, including being facile with using technology to improve workflows + Participate in educational activities by attending required conferences and also create content to lead/teach/present for individual subject matter contribution + Passionate about contributing to an organization's focus on consistency in outcomes, consumer experiences and a highly engaged team culture **Additional Information** The medical director reports to a Lead Medical Director. Participation in weekend work on a rotational basis to ensure cases are decisioned in a timely manner May participate on project teams or organizational committees. \#physiciancareers Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 04-30-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Plan, develop and track process improvement and operational projects related to clinical outcomes for products and ensure integration with delivery systems including service/care coordination + Serve as the primary subject matter expert for clinical health outcomes + Review of all clinical member materials, including service coordination brochures, handbook references, and educational leaflets + Serve as a liaison for all clinical initiatives including, case and disease management, behavioral health and HEDIS outcome measures + Evaluate the analysis and responses on all quality measures including, performance development and reporting, and provide recommendations + Review member survey results from internal as well as external sources for implications to operations and make recommendations for process improvements accordingly + Collaborate with analytics team on identified process improvement reporting and scheduling + Performs other duties as assigned + Complies with all policies and standards **This position is remote with field-based responsibilities, requiring 25-50% travel to both the East and West regions in Michigan.** **Education/Experience:** Bachelor's degree in Healthcare, related field, or equivalent experience. 5+ years of process improvement experience, preferably in a managed care environment. Experience in project coordination preferred. **License/Certificates:** Current state's RN, or LCSW. Drivers license preferred. Pay Range: $68,700.00 - $123,700.00 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

**Become a part of our caring community and help us put health first** The IHWA Follow-up Senior Program Delivery Professional provides daily operational support to programs that impact members' lives by promoting preventive health activities. The IHWA Follow-up Senior Program Delivery Professional works on problems of diverse scope and complexity ranging from moderate to substantial. **Location:** remote or strong preference for hybrid in Waterside Louisville, KY office The IHWA Follow-up Senior Program Delivery Professional provides daily operational support to the rapidly expanding In-home Health Well-being Assessment (IHWA) PCP Follow-up program that ensures members follow-up with a PCP and complete essential preventive activities (e.g. mammogram, flu vaccine, colonoscopy) which directly supports our members' care management. The operational support includes being initial person for vendor feedback/questions, delivering routine program reporting, reviewing outreach calls to members, and working directly with vendors to improve pilot performance. Beyond the IHWA PCP Follow-up program, the IHWA Follow-up Senior Program Delivery Professional, will support IHWA Care Management Referrals as back-up for daily operations responsible for ensuring members' physical, behavioral SDOH, and urgent needs identified during the IHWA are correctly routed to internal resources for Humana follow-up. Primary Responsibilities: + Provide input and operationalize new follow-up programs + Point of contact for vendor initial questions and feedback + Develop and maintain KPI program reports + Work with internal partners to develop detailed reports + Listen and review outreach calls to members **Use your skills to make an impact** **Role Essentials** + Bachelor's degree + 5 or more years of vendor management, program delivery and/or operations experience + Experience analyzing data and reports + Demonstrated ability to articulate ideas effectively in both written and oral forms + Strong relationship building skills + Strong knowledge of Microsoft Office XP products (Word & Excel) **Role Desirables** + Master's Degree in Business Administration or a related field + PMP certification a plus + Stars, Risk Adjustment, or IHWA experience + Knowledge and experience in health care environment/managed care **Additional Information** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for you. Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $86,300 - $118,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-25-2025 **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 ***************************************************************************

**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. The Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor works on problems of diverse scope and complexity ranging from moderate to substantial. **Become a part of our caring community and help us put health first** The Strategy Advisor (Distribution) provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for the Enterprise Growth vertical. The Strategy Advisor's work involves complex assignments performed without direction where the analysis of situations or data requires an in-depth evaluation of variable factors. This work may require leading end-to-end strategy engagements. As part of the Strategy Advancement team, this role will support MarketPoint's investment rationalization and strategic planning efforts. The role requires comfort with ambiguity and creating new solutions in the "white space" where answers are not clear cut or readily available. A successful candidate will be someone who has worked for several years in large matrixed organization (e.g. a publicly traded corporation or large not profit organization) or has several years' experience with stakeholder management (strategy/operations at a top-tier consulting/professional services firm). They will have a demonstrated ability to synthesize large amounts of information into clear and concise outputs (PPT, Excel). This person must be comfortable working collaboratively with senior leaders and subject matter experts alike and should have a high degree of executive presence leading engagements with these stakeholders. This person also will be effective at multitasking and possess keen program and change management skills to balance an evolving set of priorities and deadlines. Healthcare experience is a plus, but not required, though must have a history of mastering an understanding of their prior industry. Other examples of the kind of work required from this role include leading the analysis of complex business problems and issues using data from internal and external sources. The candidate should bring expertise or identify subject matter experts in support of multi-functional efforts to identify, interpret, and produce strategic recommendations and plans. The candidate's work will substantially shape the thinking of distribution org. They will exercise independent judgment and decision making on complex issues to determine the best course of action and work under minimal supervision. **Use your skills to make an impact** About the team: Humana's distribution organization, MarketPoint, plays a key part in driving Humana's long-term vision to achieve leading growth in Medicare and individual products. The MarketPoint strategy team was created to help transform Humana's customer acquisition approach. The team functions with a mandate to think creatively, discover new opportunities and re-envision operations to drive growth and deliver a first-class experience to our members and agents. **Responsibilities:** + Leads multiple short- and long-term work streams sometimes across engagements, including hypothesis development, working sessions, and report-outs with leaders across the company, and documenting key ideas and actions to drive follow-up actions + Partners closely with finance, analytics, and operators to optimize, track, and report out on internal and external compensation strategy and results + Develop high-quality analysis and deliverables that clearly frame organizational objectives, issues/challenges, and articulate compelling, insightful findings, conclusions, and recommendations + Lead multiple cross functional investment sizing workstreams and provide high-level support for senior leaders to make informed decisions + Identify new growth avenues of opportunity through independent analysis and presents actionable findings + Lead key portions of presentations at high-visibility meetings + Assist MarketPoint leadership in communicating value and impact of MarketPoint initiatives to broader Humana organization + Coach junior team members to develop technical and professional skillsets **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + **3+ years** of progressive experience consulting in finance, strategic planning, or related roles. + Proven track record in **building compensation models** and **incentive design frameworks** . + Advanced proficiency in **financial modeling and Excel** + Demonstrated experience **managing large, complex budgets** and guiding senior leadership through **trade-off decisions** . + Strong background in **business case development** , including **value sizing** , ROI analysis, and scenario modeling. + Ability to influence and partner with senior executives to drive strategic decisions. + Exceptional analytical and problem-solving skills with a focus on **data-driven decision-making** . + Strong communication skills to present complex financial concepts clearly to non-financial stakeholders. **Preferred Qualifications** + Healthcare industry experience, preferably in the managed care or provider sector + Experience in **compensation strategy** within large organizations. + Exposure to **enterprise-level budgeting and resource allocation** . **Additional Information** **- Position does have the potential for up to 5% travel.** **- Position will be working Eastern (EST) hours.** **Virtual Pre-Screen** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a HireVue interview. In this interview, you will listen to a set of interview questions over your phone or text and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **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 Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. 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. $115,200 - $158,400 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: 12-28-2025 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** Humana is seeking MBA Interns to join for Summer 2026! Humana's MBA Summer Internship Program offers a unique opportunity for MBA students to contribute to enterprise level initiatives across a range of business functions. Interns will drive strategic projects, gain exposure to executive leadership, and develop the skills and insights needed to launch a successful post-MBA or graduate school career in healthcare. We are looking for talented interns who are innovative, agile learners who have a high degree of emotional intelligence and are excited to tackle the ambiguous world of healthcare. We are looking for talent driven by purpose. Internships are available across multiple domains, and can be in the following areas: + Treasury + Office of Diversity, Equity, and Inclusion + HR Strategy Advancement + Total Rewards **Location:** The summer internship program is remote, and all interns are expected to travel to Louisville, KY for the first week of internship for orientation. Note that if you are extended a full-time offer at the conclusion of the internship to start upon graduation, you could be expected to be based out of or willing to relocate to the following cities: Boston, MA; Chicago, IL; Louisville, KY; Nashville, TN; or Washington, DC. **Use your skills to make an impact** **Required Qualifications:** + Enrolled in a Master of Business (MBA) or other advanced professional degree (e.g. MPH, MD, JD, Ph.D.), with a graduation in Spring or Summer 2027 + Must be available to work full-time, 40 hours per week for 12 weeks from May 18 to August 7, 2026 + Must not require sponsorship to work in the United States either now or in the future + Minimum of three years of work experience prior to beginning graduate school + Demonstrated leadership experience through professional, academic, military, or extracurricular roles, showcasing the ability to lead teams, drive cross-functional initiatives, influence stakeholders, and deliver measurable results in a dynamic environment **Preferred Qualifications:** + Must possess strong interpersonal, written, and oral communication skills + Must be intellectually curious, flexible, as demonstrated through previous jobs, internships, and/or projects + Be actively involved on-campus and/or community activities + Commitment to innovative thought, strategic thinking, and making a difference + Passion and interest in working in the healthcare industry **What to expect during your 12-week internship program** + **Strategic, High-Impact Work:** Lead meaningful projects aligned with critical business initiatives, designed to stretch your skills and deliver real value. + **Executive Access & Networking:** Engage with senior leaders and peers through speaker series, fireside chats, and curated networking events. + **Mentorship & Support:** Receive personalized guidance from mentors, coaches, and buddies to help you thrive professionally and personally. + **Leadership Development:** Participate in hands-on workshops, certifications, and leadership training tailored for future business leaders. + **Culture & Community Immersion:** Experience Humana's values through DEIB initiatives, well-being programs, and community volunteerism. + **Career Growth Opportunities:** Showcase your work, receive structured feedback, and be considered for full-time roles or leadership programs post-internship. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 1 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $37,440 - $96,800 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or 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 ***************************************************************************

**Become a part of our caring community and help us put health first** Join Humana's In Home Well-being Assessment (IHWA) team team and lead the management of key vendor relationships that drive in-home health and well-being assessments for Medicare members. As a Program Delivery Lead, you'll own vendor partnerships, monitor contractual obligations, and ensure compliance with CMS guidelines-all while supporting Humana's Retail bid goals and Medicare Risk Adjustment requirements. This role requires strong task management, project management, independent decision-making, and the ability to operate in times of ambiguity. **Key Responsibilities** + Serve as the primary point of contact for one or more IHWA vendors, building strong, productive partnerships. + Manage and monitor vendor deliverables, contractual obligations, and service-level agreements. + Track, prioritize, and oversee a high volume of vendor activities while supporting internal Humana partners. + Ensure compliance with CMS guidelines and Medicare Risk Adjustment standards. + Collaborate with Stars program teams to manage vendor activities tied to quality and risk adjustment goals. + Operate independently, make decisions in ambiguous situations, and manage multiple projects simultaneously. + Proactively identify issues, communicate findings, and influence process improvements. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree or equivalent experience + 6 or more years of large project implementation or vendor management + 2 or more years of project leadership experience + Strong knowledge of Microsoft Office XP products (Word, Excel, Access) + Excellent communication skills, both oral and written + Strong relationship building skills + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Required Travel:** Quarterly vendor meetings required, plus occasional ad hoc travel. Estimated total travel: **6-7 trips per year** . **Preferred Qualifications** + Master's Degree in Business Administration or a related field + PMP certification a plus + Six Sigma Certification also a plus + Knowledge and experience in health care environment/managed care + Strong analytical skills **Additional Information** 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 + Recognition pay + 401(k) retirement savings plan with employer match + Tuition assistance + Scholarships for eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership. + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. 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. $115,200 - $158,400 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: 12-11-2025 **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 ***************************************************************************

**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. ** As a **Specialty Pharmacy Liaison** you will engage directly with patients to coordinate pharmacy services through the health system's specialty and retail pharmacy. Acting as a bridge between patients, providers, and the pharmacy, this role focuses on improving prescription capture, providing follow-up counseling, and ensuring smooth communication. Key duties include processing prior authorizations, assisting with financial aid, updating clinical data, and supporting administrative tasks. The liaison collaborates closely with the CPS Patient Care Services team and works under the direct supervision of a pharmacist. **Pharmacy location:** Located within Memorial Healthcare Hospital - 826 W King Street, Owosso, MI 48867 **Hours:** Monday-Friday 8:00am to 4:30pm 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 + Active applicable state Pharmacy Technician license in good standing + Work experience as a Pharmacy Technician, ideally in specialty or outpatient settings + Experience supporting clinical pharmacy programs and performing administrative tasks such as prior authorizations and data entry + Solid knowledge of medication regimens, age-specific dosing, and managed care practices + Proficient in pharmacy systems, care management platforms, and Microsoft Office (Outlook, Word, Excel) + Comfortable interacting professionally with patients and providers via phone, in person, or telehealth. 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 $17.74 to $31.63 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._

**Become a part of our caring community and help us put health first** The Lead Interoperability Product Owner is responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog. The Lead Product Owner works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Interoperability Product Owner maximizes value of Interoperability products created by Agile team. Liaises with stakeholders and the development team ensuring the right product is being built, in the right order, within budget and by the deadline. Serves as the Agile team's primary contact for information, work prioritization, and decision-making. 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** **Job Responsibilities Include:** + Lead dedicated Scrum team(s) through all SAFe Agile Ceremonies such as: Daily Stand up, PI Planning, Sprint Planning, Backlog Refinement, Sprint Review, Sprint Retrospective, ART Synch, Scrum of Scrums, PO Synch, System Demo, Solution Demo, etc. + Lead your dedicated scrum team(s) through quarterly **on-site** PI Planning. + Create and refine user stories for the team and maintain a robust backlog ensuring adequate workload for dev team members. + Prioritize and assign work for development team members based on Humana's LPM (Lean Portfolio Management) strategy with a top-down value approach. + Manage technical relationships with external E.H.R. Partners, internal dependent technical partner teams, consuming business owners and own the end-to-end delivery of technical solutions ensuring all parties involved are aligned with the delivery and timelines of the same. + Manage internal communications with Interoperability Principal Product Managers, Lead Product Managers, IT Directors and AVPs, IT Solution Managers, Tech Leads, Solution Architects, Application Architects, Scrum Masters. + Remove blockers and drive delivery of the technical solution for product initiatives. + Lead communications and drive discussions with other Humana teams to achieve product team goals such as Humana's PIRC (Protected Information Review Council) and Internal Business Leaders and stakeholders for consuming business teams such as Stars, MRA, Care Plus, Clinical and many more. + Ensure the alignment of delivery timelines meets our strategic goals for Interop Products and our partners' strategic goals. + Decompose High Level Architecture and apply that understanding to the work breakdown and strategy for development and consumption. + Stay apprised and understand Interoperability regulatory and compliance requirements from CMS distilling those into product technical requirements for development teams to deliver. + Ensure maximum value is delivered to the enterprise through the work of the team(s). + Function and acquire expertise across multiple Interoperability Product Areas, not just one. + Develop subject matter expertise and share your acquired knowledge base with others who need to learn. **Required Qualifications:** + 5+ years' experience in SDLC (software development life cycle) within Healthcare Product solutions, or other equivalent experience + Experience or understanding of Industry Standard HL7 FHIR formatting. + Demonstrated ability to articulate ideas effectively in both written and oral forms, collaboration and team-building skills + Strong organizational skills; capable of handling multiple details simultaneously, with ability to move between strategic and tactical work in a dynamic environment with changing processes and priorities. + Strong intuition about user experience and what makes a product experience great. Ability to unpack complex, ambiguous problems and ship simple and user-friendly solutions. **Preferred Qualifications:** + Bachelor's Degree or higher + Experience in Data Movement solutions such as APIs, SFTPs, and Streaming Services. + Experience in Data Storage environments such as relational, unstructured, no SQL, or graph databases. + Experience in monitoring and logging capabilities to increate transparency of data. + Querying experience in SQL or other analytics software knowledge to view / read data sets. + Experience with Healthcare Interoperability, Electronic Medical Records, and/or Electronic Notifications. + Familiarity with CMS Risk Adjustment and Quality Measure Reporting. + Experience in UAT (User Acceptance Testing) / PPV (Post Production Validation Testing) scenario creation and data gathering. + Progressive strategic and operational experience. + Strong performance orientation for delivering high quality technology products. + SAFe PO/PM certification. + Data Governance and/or Data Stewardship 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. $115,200 - $158,400 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: 12-14-2025 **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 ***************************************************************************

"A Day in the Life" video Opportunities with Genoa Healthcare. A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start Caring. Connecting. Growing together. We seek a Part Time Pharmacy Technician to support all functions of the Genoa mental health and specialty pharmacy primarily through dispensing medical prescriptions and performing necessary clerical duties while under the direct supervision of a registered pharmacist. Pharmacy Hours: Monday - Friday 8am - 5pm (Lunch 12pm - 1pm) Schedule: 24 hours per week. Shifts are flexible based on business needs Location: 2280 E. Grand River Ave, Room 122, Howell, MI, 48843 Primary Responsibilities: * Provides exceptional customer service to all consumers and members of the clinic staff * Fills prescription orders and makes them available for verification under direct supervision of the registered pharmacist * Orders, receives and stores incoming pharmacy supplies * Receives and processes wholesaler medication orders * Verifies medication stock and enters data in computer to maintain inventory records * Works with the Pharmacist to assist in the pharmacy functions and keeping the pharmacy in compliance with all federal and state requirements * Performs various clerical duties relating to the department * Communicates with strong professional verbal and written communication skills * Other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Active and unrestricted Pharmacy Technician license in the state of Michigan * Access to reliable transportation Preferred Qualifications: * National Pharmacy Technician Certification * 6+ months of Pharmacy Technician 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 $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

Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others. Our Impact Today Today, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions. Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions. Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day. 1. Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of Tenet Physician Resources. 2. Adheres to the Tenet HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement. 3. Demonstrates support for the Tenet Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner. 4. Assists in the assessment of patient needs and health plan by taking vital signs, history, medication listing, assessing visual acuity and determining chief complaint. Assesses patients' physical and mental status. 5. Completes all necessary documentation in the patient's medical record in accordance with practice's charting policy. 6. Prepares equipment and assists physicians with medical treatments, exams and medical procedures 7. Administers prescribed oral medications and gives intramuscular and subcutaneous and intradermal injections. Performs venipunctures, CLIA-Waived and non-CLIA Waived lab testing. 8. Maintains a clean, orderly and safe environment for patients and visitors. This includes cleaning, sterilizing, and storing instruments in accordance with practice policies. Stocks rooms in preparation for the daily work schedule. Takes inventory of medical and exam room supplies. 9. Complies with established personal protective equipment requirements necessary for protection against exposure to blood and other potentially infectious body fluids, chemical disinfectants, radiation, and other hazardous substances. 10. Arranges for specialized consultations and appointments for testing as ordered by the physicians. Notifies appropriate insurance personnel to pre-certify surgeries or tests ordered by the physician or other health care provider, which require pre-certification by the insurance company. 11. Answering office phones, assisting front desk in scheduling appointments and directing calls appropriately. 12. Assists in checking out patients and assists them with referral processing and scheduling process 13. Assist in other functions of the physician practice as needed $1000 Sign on bonus A non-exempt medical office position responsible for providing direct nursing care in a medical office setting under the direction of a physician, assists medical providers, and maintains a clean and safe environment in accordance with the policies and procedures of the practice. Education Required: * High school diploma/GED * Medical Assistant diploma from an accredited school or three years of relevant work experience in a healthcare setting in lieu of a Medical Assistant diploma Certification Required: CPR/BLS Certification Preferred: Medical Assistant Experience Required: Medical Assistant diploma from an accredited school OR three years of relevant work experience in a healthcare setting in lieu of a Medical Assistant diploma OR a Current Medical Assistant certification Preferred: Medical Assistant diploma from an accredited school and 1 year of relevant work experience highly preferred Tenet Healthcare/TPR complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law. #LI-MS3 Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** **Specialties** has an immediate opening for a friendly, patient focused and detailed oriented **Patient Service Specialist** to join our team. The **Patient Service Specialist** 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. **Location:** 101 Cedar Street, Milford, MA. Maybe asked to float to our other locations as needed. **Department:** Multi Specialties **Schedule:** Monday - Friday 8:00 AM - 4:30 PM **Primary Responsibilities:** + Verifies, re-verifies and authorizes patient insurance coverage and eligibility utilizing computer-based patient registration/scheduling system + Verifies and updates demographic, insurance, and other patient information + Confirms, collects, and posts patient co-payments and other outstanding balances + Addresses patient-care related telephone calls via an incoming work queue aligning with department metric + Identifies problem related priorities, and responds to emergency needs by contacting/interrupting physician/provider within guidelines + Enter new referrals or ensure that existing referral numbers are linked in the system to ensure managed care requirements + Provides patient education regarding managed care plans and referral process + Completes and maintains patient schedules. Schedules and coordinates patient visits, medical procedures for both inpatients and outpatients. Communicate with patients regarding all information related to scheduled appointments + Notifies providers, patients and others of changes such as new scheduling, re-scheduling, no-show, emergency appointments and add-ons + In patients when they enter the practice and check patients out and scheduled follow up appointments + 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 experience in customer service, including the ability to multi-task and resolve patient concerns in a timely manner + Access to reliable transportation and the ability to travel 10% of the time to other locations as needed for coverage + Ability to work Monday - Friday between the hours of 8:00 AM - 4:30 PM or 8:30AM - 5:00 PM at 101 Cedar Street, Milford, MA **Preferred Qualifications:** + Beginner level of understanding of software applications such as Microsoft Word, Excel, Outlook, etc. **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 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

**Become a part of our caring community and help us put health first** Behavioral Health CM Liaison builds behavioral health strategies within the enterprise, business or segment to develop best practices and processes to improve outcomes for members. Works on problems of diverse scope and complexity ranging from moderate to substantial The Behavioral Health CM Liaison develops behavioral health strategies that are inclusive of mental health and substance abuse services. Will assess and evaluate member needs and requirements to achieve and maintain optimal wellness state. As a member of the Interdisciplinary Care Team, the Behavioral Health CM Liaison will coordinate and employ a variety of strategies, approaches, and techniques to support the member's psycho-social health needs. **This position will be based from a home office and will travel 10-15% of the time, to an assigned area in Wayne or Macomb county, to conduct in home visits with Medicare/Medicaid members.** **Must reside in Michigan with the ability to drive to Wayne or Macomb Counties.** The LMSW Behavioral Health Field Care Manager will serve as the primary liaison between Prepaid Inpatient Health Plans (PIHP) and members already engaged in behavioral health services, facilitating timely service delivery, sharing updates, and resolving issues to support continuity of care. This position will support Humana member's access to behavioral health services, including a focus on the increased need in behavioral health services and will provide member outreach and education related to behavioral health including assessing risk, determining appropriate care in individual patient communities, collaborating with providers, bridging gaps between Health Plan and Prepaid Inpatient Health Plans (PIHPs) as well as clinicians across other Humana departments Position Responsibilities: + Receive and review referrals from Humana Behavioral Health for members newly identified with behavioral health needs. + Initiate appropriate service engagement with PIHP or other providers, ensuring prompt and accurate transition of care. + Conduct follow-up outreach to members based on referral outcomes, including those where PIHP was unable to contact or denied services, to address behavioral health needs and prevent care gaps. + Collaborate with Special Needs Plan Care Coordinators and other disciplines to address case management concerns, ensuring comprehensive and cohesive support for members across various departments. + Act as the principal behavioral health resource for care management teams, facilitating seamless coordination between Humana Behavioral Health, PIHP, and internal stakeholders, and providing follow-up support as needed. + Apply independent judgment to analyze complex behavioral health cases, determine optimal care strategies, and allocate resources effectively for positive member outcomes. + Oversee follow-up activities based on referral dispositions (e.g., unable to contact, denied), ensuring that behavioral health and care management needs are addressed efficiently and responsively. + Partner with Special Needs Plan Care Coordinators and interdisciplinary teams to identify and address holistic needs, promoting integrated care and improved member well-being. + Exercise autonomous decision-making in carrying out job duties and related tasks, functioning effectively under minimal supervision. + Travel may consist of assisting with community engagement and provider relations teams in providing a BH perspective for meetings and events with community organizations, provider groups, and advisory councils. **Use your skills to make an impact** **Required Qualifications:** + **LMSW/LCSW or LPC, with current, valid social service license in the state of Michigan** + **Must reside in the state of Michigan and be able to drive to Wayne and Macomb counties.** + **Ability to work effectively in a hybrid team setting of remote/in field. 10-15% travel** + Minimum 2 years in an integrated care setting managing children and adult members with Behavioral Health needs such as: Substance Use, crisis/ER experience, community mental health, behavioral health inpatient, assertive community treatment, etc. + Experience with behavioral change, health promotion, coaching and/or wellness + Demonstrated experience in care management liaison roles, strategy development and interdisciplinary collaboration. + Proficiency utilizing software programs, (e.g., Word, Excel & PowerPoint & shared systems) troubleshoot and resolve general technical issues. + Knowledge of regulatory standards and best practices in behavioral health. + Must have a separate room with a locked door that can be used as a home office to ensure continuous privacy while you work. + Valid state driver's license and personal vehicle liability insurance meeting minimum state requirements ($25,000 bodily injury per person/$25,000 bodily injury per event/$10,000 property damage or higher). **Preferred Qualifications** + Experience supporting patients telephonically. + Extensive experience working in Community Mental Health or as part of a crisis response team or Assertive Community Treatment (ACT) team, and substance use disorder treatment **Additional Information:** + Initial training: 4 weeks, Monday-Friday, 8:30am-5pm EST. + Post-training: 8-hour shift between 9am-5:30pm EST. **Work at Home Requirements** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information 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. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or 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 ***************************************************************************

**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 Nashville,** **Chattanooga, and Knoxville** **TN area working with your team and meeting members face to face. You must reside in Nashville, TN. 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 Nashville, TN 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. **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 ***************************************************************************