You could be the one who changes everything for our 28 million members as a Customer Care professional at Centene. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
****Qualified candidates for this role should be bilingual in Korean and English and be able to work between the hours of 11AM-9PM EST****
**_Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT._**
**Position Purpose:** Serves as the first-line advocate that focuses on resolving inquiries, issues, or concerns for members and/or providers. Leverages a variety of communication channels to provide members and/or providers with timely, accurate, and personalized support on routine complaints.
+ Receives and responds to routine member and/or provider inquiries, requests and/or concerns in an accurate and timely manner
+ Mitigates and prevents complaints from being escalated to resolve in initial contact
+ Serves as the front-line resolution advocate on various member and/or provider inquiries, requests, or concerns
+ Resolves basic problems by communicating the requested information regarding the assessment of the member or provider needs, understanding the cause, and determining if problems need to be routed to other departments for further resolution
+ Maintains performance and quality standards based on established contact center metrics
+ Provides customer service in a high pace contact center environment over the phone, via live chats and emails
+ Documents all member or provider information and communications for quality and performance tracking through the Customer Relationship Management (CRM) applications
+ Remains up-to-date and adheres to quality standards, regulation, and all other policies to ensure quality, consistency, and compliance
+ Performs other duties as assigned
+ Complies with all policies and standards
**Education/Experience:** Requires a High School diploma or GED.
Entry-level position typically requiring little or no previous experience.
Experience interacting and multitasking using multiple systems and programs simultaneously preferred.
Pay Range: $16.35 - $23.46 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
$16.4-23.5 hourly 13d ago
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Senior Pharmacy Resolution Specialist
Centene Corporation 4.5
Centene Corporation job in Sacramento, CA
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.
**Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT**
**Position Purpose:** The Senior Pharmacy Resolution Specialist will act as a subject matter expert and handles more complex pharmacy issues and respond to escalated calls from members, provider/physician's offices and pharmacies. This role will make outbound calls and enters pharmacy overrides into systems based on approved guidelines and approvals provided from clinical pharmacists.
+ Takes member/prescriber/pharmacist inquiry calls for benefit questions including prior authorization requests
+ Offers options including submission of a prior authorization request
+ Thoroughly researches issues and takes appropriate action to resolve them using the appropriate reference material within turnaround time requirements and quality standards
+ Answers and conducts inbound and outbound calls with members and provider offices to provide resolution to claims (i.e.: additional information requests and medication determination updates)
+ Thoroughly researches issues and takes appropriate action to resolve them within turnaround time requirements and quality standards
+ Assists team members often guiding them to the appropriate resolution of more complex and difficult inquiries
+ Participates in the training of less experienced staff, including opportunity for job shadowing
+ Acts as a liaison between internal departments on data gathering and problem solving while investigating problems of an unusual nature in the area of responsibility
+ Presents proposed solutions in a clear and concise manner
+ Assists with audit preparation as needed
+ Assists with miscellaneous special project work as assigned
+ Performs other duties as assigned
+ Complies with all policies and standards
**Education/Experience:** High School Diploma / GED
2 years of experience
Call center / customer service experience
Experience in healthcare environment (pharmacy operations, managed care, pharmacy hospitals and or pharmacy retail settings)
**License/Certification:** Pharmacy technician certification preferred Pay Range: $19.43 - $32.98 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
$19.4-33 hourly 3d ago
Regional VP, Operations - Chief Financial Officer
Humana Inc. 4.8
Sacramento, CA job
Become a part of our caring community and help us put health first
The Regional VP, Operations in the Pacific Southwest Region is a Chief Financial Officer position with Operations elements as well. This person collects, analyzes and reports on various market data to connect financial outcomes with operational effectiveness. The Regional VP, Operations requires an in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide to develop strategies to improve outcomes that support the region's membership, medical expense, admin and margin targets.
The Regional Vice President, Operations, will provide leadership and direction in the areas of financial planning and operations to a team of regional and national associates. This individual will provide fiscal and operational oversight of the Pacific Southwest region senior products through development and oversight of the annual budget, financial planning and projections, risk management and operational metrics and reporting while working with value-based providers, physicians, IPAs and MSO leadership. The role interfaces regularly with regional, divisional and corporate leaders.
Develop strategic plans and objectives for the business unit and a fiscally responsible budget that supports its strategy
Direct the design and implementation of policies and procedures which result in increased performance, are properly integrated with other units, and comply with federal and state regulatory requirements
Establish and maintain management and performance controls by identifying, tracking, measuring and analyzing data to highlight problems, prevent losses, contain costs and direct the development of process improvements
Cultivate internal and external business relationships which will serve as resources for technical knowledge and performance improvement
Key Competencies
Accountability: Meets established expectations and takes responsibility for achieving results; encourages others to do the same
Acts Strategically: Makes decisions and sets strategy based on the long-term vision, uses an enterprise-wide perspective to translate strategies into actions, inspires others to embrace and advance the strategy, and creates a clear view of the future state
Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Humana's overall success first.
Leads Positively: Leads by example to cultivate a climate of motivation, positive energy and meaning in work. Assesses, selects, recognizes, develops, and empowers diverse talent
Use your skills to make an impact Required Qualifications
Knowledge of Medicare, Medicare Advantage and participation in the annual bid process
Bachelor's Degree in Business, Finance, Accounting or a related field
5 plus year of operations and/or finance experience in the health solutions industry (preferably a CFO role or COO with finance experience)
Experience building a high performing team to support a growth market
Familiarity or experience with CMS bid mechanics and bid tools
Excellent communication and presentation skills
Ability to collaborate in a positive manner with all levels of the organization
Progressive management and leadership experience with associates in multiple locations
Willingness to travel a minimum of 20%
Must Reside in or be willing to relocate within Pacific Southwest Region (CA, AZ, CO, NV, NM, HI)
Preferred Qualifications
Certified Public Accountant
Master's Degree in Business, Finance, Accounting or a related field
Knowledge of the Pacific Southwest regional markets, Value-Based Care and key Humana providers
Experience working with physician groups, provider contracting, market operations, and Medicare Risk Adjustment and Stars/Quality functions
Knowledge and Experience working with delegated value-based relationships in California markets
Understanding of SQL
Reporting Relationships
You will have direct/indirect reports, and you will report to the Regional President.
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.
$203,400 - $279,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-29-2026
About us
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
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$203.4k-279.8k yearly 3d ago
Marketing Coordinator
Centene Corporation 4.5
Centene Corporation job in Sacramento, CA
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.
**Marketing Coordinator will work on Medi-Cal member materials for 3 lines of business (LOBs). Develop member-facing collateral, communications, and content for public web pages.**
**Primary Focus on creating Marketing Collateral (brochures, booklets, flyers, kits, member data, member emails, etc.)**
**Position Purpose:** Support the California Marketing department's needs including product, operations, project management and all other activities related to marketing and communications.
+ Update project tracking for various work using the project management templates developed
+ Assist with approval need for various material, including uploading into our review and approval system
+ Support promotional and print product pricing, ordering, and distribution
+ Develop department documents such as contact and vendor lists; keep these lists updated
+ Develop and implement a department CNET strategy and ensure the site is kept updated
+ Track communication activities, including developing a way to track and report findings
+ Support department on various other projects and perform some administrative work
**Highly Preferred Experience/Skills**
+ **Healthcare Insurance experience**
+ **Experienced Marketing Coordinator**
+ ***** Creating Marketing Collateral (brochures, booklets, flyers, kits, member data, member emails, etc.)**
+ **Strong organizational skills**
+ **Strong administrative skills**
+ **CA Residents**
**Education/Experience:**
Bachelor's degree or equivalent in Marketing, Public Relations, Communications or related area.
1-2 years of experience in community development, communications, marketing or branding.
Healthcare experience a plus.
Pay Range: $23.23 - $39.61 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
$23.2-39.6 hourly 21d ago
Staff Pharmacist - Part Time
Unitedhealth Group 4.6
Sacramento, CA job
**Explore opportunities with CPS,** part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind **Caring. Connecting. Growing together.**
As a part time, nonexempt Staff Pharmacist you'll play a vital role in delivering safe, accurate, and efficient pharmacy services. This is a hands-on opportunity to make a direct impact by ensuring the accuracy of medication orders, verifying technician-prepared products, and safeguarding controlled substances. You'll contribute to a high-performing team by mentoring new staff, maintaining seamless daily operations, and supporting the Director in optimizing pharmacy performance.
**Primary Responsibilities:**
+ Processing orders with accuracy and monitoring for drug interactions
+ Cognizant of inventory and controlled substance inventory
+ Controlled substance audit and med room audit
**About the Facility:** Heritage Oaks Hospital is a leader in psychiatric and addiction treatment. Located in Sacramento, the hospital offers 125 inpatient beds in a beautiful, state-of-the art facility.
**About the Pharmacy:** The pharmacy utilizes HCS EMR and automated dispensing cabinets. Pharmacy hours of operation are Monday-Friday, 6:30am-7:00pm, and Saturday and Sunday from 8:00am-1:00pm.
**Schedule:** This part-time, nonexempt position will work up to 24 hours/week.
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:**
+ Pharmacy degree (BS or PharmD) from an ACPE accredited school of pharmacy
+ Current California Pharmacist license in good standing
**Preferred Qualification:**
+ Experience working within the psychiatric field
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $44.09 to $78.70 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
$44.1-78.7 hourly 7d ago
Executive Underwriter, Middle Market Construction
Liberty Mutual 4.5
Rancho Cordova, CA job
The Executive Underwriter works independently and autonomously on all but the most complex accounts/cases (subject to required process oversight). Underwrites policies within underwriting authority. Makes decisions on whether to accept business by making analytical, data-driven decisions based on data and information provided, including pricing the risk.
Responsibilities:
* Manages a portfolio of Construction brokers/agents and clients, leveraging market presence and expertise to develop and underwrite profitable business while acting as a representative for Liberty.
* Maintains relationships with senior or market-leading brokers and key agents, sustaining a strong market presence and established agent/broker relationships.
* Strengthens existing relationships and develops new ones, articulating key coverage differences with a high degree of detail.
* Manages an assigned book of business to optimize rate adequacy, retention, profitability, and sustainable growth by monitoring portfolio performance and loss trends, adjusting pricing and underwriting decisions, and pursuing targeted renewal, cross-sell, and risk-selection strategies within guidelines.
* Provides significant input into the business and marketing planning process, including advanced data-driven insights from portfolio analysis. Participates in cross-departmental projects aimed at driving underwriting and process excellence (e.g., serving on working teams).
* Models effective collaboration across teams, stakeholders, and partners (e.g., UW Support, Claims, Actuarial, Directors of Underwriting in North America). Possesses strong knowledge of key legal cases, legislation, and regulation impacting underwriting expertise areas.
* Shares knowledge based on technical expertise, including providing external thought leadership.
* Mentors, coaches, and trains other underwriters and internal partners.
Qualifications
* Degree in Business or equivalent typically required
* A minimum of 7 years expected, typically 10 years or more, of progressive underwriting experience and/or other related business experience
* CPCU or professional insurance designation preferred
* Proven analytical ability to evaluate and judge underwriting risks within scope of responsibility
* Demonstrated ability to communicate complex analyses and information in understandable written and/or oral directives to other persons in the organization for underwriting or training purposes
* Demonstrated effective communication and interpersonal skills in dealing with internal and external stakeholders
* Must demonstrate comprehension of most complex technical underwriting issues and be capable of defining and implementing necessary underwriting and administrative processes/workflows to properly manage or administer those issues
* Proven track record of developing and underwriting profitable business
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
* California
* Los Angeles Incorporated
* Los Angeles Unincorporated
* Philadelphia
* San Francisco
$103k-147k yearly est. Auto-Apply 16d ago
Senior Digital Designer
Humana 4.8
Sacramento, CA job
**Become a part of our caring community and help us put health first** The Senior Digital Designer responsible for creating, executing, developing, and maintaining digital design elements across multiple platforms. The Senior Digital Designer work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Digital Designer collaborate closely with cross-functional teams to conceptualize, design, and produce digital content, graphics, animations, and user interfaces that align with organizational goals and enhance the user experience. Utilize common frameworks to build and develop interactive and responsive digital solutions that ensure compatibility, efficiency, and maximum value for the end-user. Support various business objectives, including product development, advertising, marketing, media, and communications. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**Use your skills to make an impact**
Typically requires Bachelor's degree or equivalent and 5+ years of technical experience
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$94,900 - $130,500 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-29-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$94.9k-130.5k yearly 16d ago
Associate Actuary
Humana 4.8
Sacramento, CA job
**Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
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: 02-15-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$106.9k-147k yearly 60d+ ago
Broker Sales Support Specialist I
Centene Corporation 4.5
Centene Corporation job in Sacramento, CA
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:**
This position supports Ambetter Brokers and the Sales team with commission & contracting related questions, which are not limited to, more in-depth research of the issues, which requires strong communication skills to accurately relay the findings back. Collaborating with their leadership team, and other internal teams, including the Sales team, on member related issues that are identified by the Ambetter Brokers and initially reported to the Broker & Sales Support team, ensuring initial research is completed and documented, following up until a resolution is obtained. Partnering with the Sales team to make outreaches to their brokers, in an attempt to secure and retain membership, to ensure organizational goals are met.
+ Handles provider issues that brokers call or email in about.
+ Determine if the issue needs to be escalated to the Provider Management team and Health Plan contacts.
+ Empowered to collaborate with the Provider Management Team and Health Plan to resolve the issue.
+ Research commission issues in determining if a Broker should be paid commissions.
+ If the commission issue is not complex, the Specialist is authorized to have the correction made Responsible for the Broker to be paid or not paid based on their evaluation.
+ Performs other duties as assigned.
+ Complies with all policies and standards.
**Education/Experience:**
High School Diploma / GED. 1+ year of customer service or health insurance industry experience.
**License/Certification:** Department of Insurance Life/Health License is required, or ability to obtain license within 120-days of being hired.
Pay Range: $19.43 - $32.98 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
$19.4-33 hourly 16d ago
Business Intelligence Lead - Digital VOC
Humana 4.8
Sacramento, CA job
**Become a part of our caring community and help us put health first** The Digital Voice of Customer (VoC) Program Leader & Insights Champion will own and advance the end-to-end VoC strategy across Digital CW, ensuring measurement approaches align with customer experience goals and business priorities. This position is responsible for vendor management (Qualtrics), cross-functional stakeholder collaboration, and driving everyday self-service and adoption of VoC insights throughout the organization. The ideal candidate will develop diverse VoC touchpoints, analyze structured and unstructured data, present findings through effective storytelling, and serve as a thought leader to educate and empower teams for data-driven decision-making.
**Key Responsibilities** :
+ Develop, execute, and continuously refine the comprehensive VoC Program strategy for Digital CW, ensuring alignment with enterprise customer experience objectives and business priorities.
+ Manage and cultivate the vendor relationship with Qualtrics, representing the interests of Digital CW and collaborating with the Humana Digital lead.
+ Partner with stakeholders across UX, Product, Business Intelligence, Operations, and other lines of business to strategize, design, and implement optimal VoC touchpoints-including expansion beyond digital channels-to capture actionable customer insights.
+ Champion the incorporation of VoC metrics into everyday business practices, fostering a pull-driven, self-service engagement model across the enterprise.
+ Analyze structured and unstructured data to identify trends, friction points, opportunities for improvement, and root causes impacting user experiences.
+ Synthesize and communicate insights through compelling storytelling to influence cross-functional teams and drive user-backed optimizations.
+ Stay current with industry trends, emerging tools, and best practices to enhance VoC program effectiveness and operational efficiency.
+ Serve as a thought leader, educating stakeholders and promoting a culture of data-driven decision-making.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree and 8 or more years of technical experience in data analysis OR Master's degree and 4 years of experience
+ 2 or more years of project leadership experience
**Preferred Qualifications**
+ Demonstrated experience leading VOC or customer experience programs in a digital environment
+ Strong vendor management skills, preferably with Qualtrics or similar platforms
+ Knowledge of current trends and tools in customer experience measurement and analytics
+ Advanced experience in analysis and synthesis of quantitative and qualitative data
+ Excellent communication, presentation, and storytelling skills to inform and influence senior and executive leadership
+ Experience aggregating data across multiple sources (e.g., primary research, secondary research, operational data)
+ Working knowledge of primary research techniques (e.g., basic survey design)
+ Advanced Degree in a quantitative discipline, such as **Business, Marketing, Analytics** , Mathematics, Statistics, Computer Science, or related field
+ Passion for contributing to an organization focused on continuously improving consumer experiences
+ Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction
+ Advanced experience working with big and complex data sets within large organizations
+ Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs
+ Proficiency in understanding Healthcare related data
+ Experience creating analytics solutions for various healthcare sectors
+ Advanced in SQL, SAS and other data systems
+ Experience with tools such as Tableau and Qlik for creating data visualizations
+ Expertise in data mining, forecasting, simulation, and/or predictive modeling
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$117,600 - $161,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 04-17-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$117.6k-161.7k yearly 15d ago
Associate Account Analyst
Liberty Mutual 4.5
Rocklin, CA job
The selected candidate will support Middle Market - Office of the Underwriting Team with a goal of acquiring a basic understanding of risk evaluation on new and renewal business. This is a hybrid position. Candidates within 50 miles of the following office are required to report onsite twice a week: Plano, TX; Boston, MA; Suwannee, GA; Orange, CA; Chicago, IL; New York, NY; Walnut Creek, CA, Charlotte, NC, Warrenville, IL office. Open to remote. Please note this is subject to change.
Note that the starting salary for the role is $52,000.
* Gathers, organizes and enters information into pricing models; and performs the initial analysis of exposure, loss and coverage for the underwriter.
* Supports the underwriter and agent/broker with highly responsive service by managing the workflow from clearance through policy issuance and file documentation.
* Coordinates service requests in a timely manner.
* Deconstructs submissions by identifying, gathering and entering information into systems, pricing tools and models; flagging referral triggers, and initiating/managing requests to internal service providers (e.g., rating).
* Gathers, analyzes and ensures the accuracy of pricing and proposal information (rating and pricing tool output, proposal language, coverage forms and endorsements, financial and legal agreements and offer/ disclosure /election forms) used by the underwriter to complete the coverage review, hazard analysis, pricing strategy and proposal.
* Provides customer service to brokers and agents to facilitate the processing of business; answers questions, resolves problems on topics such as policy transactions, billing, and service needs.
* Executes post-sale account management workflow, including initiation of billing, policy issuance, acquisition of account agreements and file documentation.
* Initiates pre-renewal communications via conditional/non-renewal notice draft when necessary.
* Supports the underwriter with mid-term account reviews / stewardship, ongoing service, service planning and endorsements.
Qualifications
* Capabilities include critical thinking/problem solving, decision making, customer focus, detail orientation, written/verbal communications, organization, adaptability, courtesy, dependability and ability to learn/apply new information quickly and accurately.
* Knowledge, skills and capabilities typically acquired through 2 or more years of related work experience.
* Associates or bachelor's degree preferred.
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
* California
* Los Angeles Incorporated
* Los Angeles Unincorporated
* Philadelphia
* San Francisco
$52k yearly Auto-Apply 23d ago
Business Lines Territory Manager
Liberty Mutual 4.5
Sacramento, CA job
Owns and manages an assigned territory, driving profitable premium growth to achieve financial and operational goals. Under limited to moderate supervision, manages broad and diverse agency partnerships, handles 200+ agency storefronts potentially over multiple states, and optimizes territory performance. Creates, implements and executes territory and agency strategies to achieve goals using all company programs, tools and resources while collaborating with internal business partners. Conducts agency outreach primarily virtually, via audio or video conferences, supplemented by email and other digital media.
Line of business emphasis on business lines, working across a wide breadth of commercial products, coverages and market appetite. Works closely with agents and brokers to drive flow of small commercial business. Balances engagement with agents and brokers to secure larger targeted accounts and managing account pipeline end-to-end. Manages renewal processes and works across multiple underwriting segments.
* Owns and manages assigned territory driving profitable growth to achieve financial and operational targets.
* Leads territory and agency management processes across multiple territories (e.g. Agency prospecting, business planning, engagement, training, compensation, plant optimization, etc).
* Builds and cultivates mutually beneficial agency partnerships virtually with agency ownership, management and frontline staff. Establishes position as a trusted advisor while delivering product, underwriting philosophy, appetite and system training, support retention and new business development to increase depth and maximize agency revenue.
* Using agency analysis, insights, internal partner feedback and local marketplace expertise creates and executes high-quality agency strategies to achieve direct written premium, profit and new business goals. Plans include strategic and tactical components and are aligned with key Personal Lines or Business Lines business strategies including carrier consolidation (book transfer), agency plant expansion, agency marketing & service programs and new product/program rollout support.
* Under limited to moderate supervision, drives and ensures quality of new business flow, appropriate book mix, and overall risk management of both individual agency books and overall assigned territory. Provides appetite and target market clarity, identifies and addresses profit or quality of business concerns to ensure profitability across territory.
* Collaborates, influences and supports internal business partners (underwriting/product management/claims/risk control) to identify and capitalize on opportunities, solve problems, share key competitor and industry intel and provide voice of our agent/customer. Collaborates with Personal Lines (PL) or Business Lines (BL) counterparts to effectively partner with shared agency assignments.
* Strategically utilizes internal and external programs and tools designed to support the Independent Agent channel and Territory Manager agency management including all marketing and development programs, new business development tools and internal production/profitability data and analysis.
* Provides guidance on agency initiatives and contributes ideas for continuous improvement.
* Performs other duties as assigned
Qualifications
* Bachelors` Degree or equivalent industry experience. Minimum three+ years of insurance experience within a carrier or agency.
* Knowledge of company services, products, marketing techniques/principles and insurance industry trends.
* Exposure of revenue growth and sales success in a prior role.
* Proven success in developing and building partnerships, decision making and problem solving.
* Working knowledge of the business including production management, claims, loss prevention, underwriting, administration, sales operations and agency business operations.
* Highly effective written and oral communication skills, including presentation, persuasion, timing, tact and negotiation skills. High degree of customer focus, interpersonal relationship skills and problem solving.
* Strong analytical thinking, business analytics and business development skills. Strong time management and team orientation skills.
* Must be licensed by the state if required.
* Ability to travel up to 25% with occasional overnight travel.
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
* California
* Los Angeles Incorporated
* Los Angeles Unincorporated
* Philadelphia
* San Francisco
$64k-80k yearly est. Auto-Apply 18d ago
Registered Nurse -Field Assessor
Unitedhealth Group 4.6
Sacramento, CA job
**Explore opportunities with Long Term Solutions,** a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.**
As the Registered Nurse you will provide and direct provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. You will also coordinate total plan of care with other health care professionals involved in care and helps to achieve and maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources.
**Primary Responsibilities:**
+ Provide high-quality clinical services within scope of practice and infection control standards
+ Coordinate care with other members of the patient/client's care team from admission to discharge
+ Complete clinical nursing assessments per federal/state program requirements and payer needs
+ Ensure patient/client eligibility and medical necessity for services as defined by payer and agency policy
+ Develop and revise individualized plans of care/service plans with other community providers
+ Ensure plan of care frequency and duration meets patient needs and initiate revisions with physician approval
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Current and unrestricted RN licensure in the state of practice
+ Current driver's license, vehicle insurance and access to a dependable vehicle or public transportation.
+ Current CPR certification
+ Demonstrated ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
**State Specific Requirement:**
+ CA:
+ 1+ years of professional nursing
**Preferred Qualifications:**
+ 1+ years of RN experience
+ Demonstrated ability to work independently
+ Proven good communication, writing, and organizational skills
**Pay Range**
$64,100 - $141,500 annual total cash target pay
$36.98 - $81.63 per visit point
$30.82 - $68.03 hourly rate
Annual total cash compensation for this role assumes full-time employment (40 weekly hours) at full productivity and generally follows the range above. Total cash compensation includes earnings from per visit point pay and hourly pay and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. This role receives two types of compensation depending on the work being performed. When conducting visits, you will be paid per visit point rate compensation. Your per visit pay will be calculated by multiplying your per visit point rate by the productivity points you accrue for various types of visits. Each type of visit is assigned a certain number of productivity points that is inclusive of "direct" and "indirect" patient care activities. Visits are assigned based on patient and business needs. The number of visits performed each week will vary based on individual productivity targets and the productivity points assigned to the visits performed. You will be paid your hourly rate for certain non-visit activities such as orientation. We comply with all minimum wage laws as applicable. In addition to your pay, we offer benefits such as, a comprehensive benefits package, recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
$64.1k-141.5k yearly 43d ago
Medical Assistant for Vascular and Endovascular Clinic
Tenet Healthcare Corporation 4.5
Live Oak, CA job
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.
$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.
Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of Tenet Physician Resources.
Adheres to the Tenet HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement.
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.
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.
Completes all necessary documentation in the patient's medical record in accordance with practice's charting policy.
Prepares equipment and assists physicians with medical treatments, exams and medical procedures
Administers prescribed oral medications and gives intramuscular and subcutaneous and intradermal injections. Performs venipunctures, CLIA-Waived and non-CLIA Waived lab testing.
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.
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.
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.
Answering office phones, assisting front desk in scheduling appointments and directing calls appropriately.
Assists in checking out patients and assists them with referral processing and scheduling process
Assist in other functions of the physician practice as needed
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 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
#LI-CC3
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.
**********
$39k-45k yearly est. 39d ago
Senior Compliance Professional
Humana 4.8
Sacramento, CA job
**Become a part of our caring community and help us put health first** The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Compliance Professional develops and implements compliance policies and procedures. Researches compliance issues and recommends changes that assure compliance with contract obligations. Maintains relationships with government agencies. Coordinates site visits for regulators, coordinates implementation and compliance with corrective action plans, as needed. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree
+ 3 or more years of experience with applying regulations to operational processes
+ Knowledge/understanding of laws and regulations governed by the Department of Insurance and CMS
+ Experience with corrective action plans and regulatory reporting
+ Audit or consulting experience
**Preferred Qualifications**
+ Graduate or advanced degree ( MBA, JD, etc)
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: 05-30-2026
**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 ***************************************************************************
$86.3k-118.7k yearly 9d ago
Speech Therapist -PRN-Stockton, CA
Unitedhealth Group 4.6
Stockton, CA job
Explore opportunities with Blossom Ridge Home Health, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.**
As the Speech Therapist in Home Health is responsible for the assessment and evaluation of patient care needs related to treating speech and language disorders, and functional training in communication, swallowing, and cognitive impairments. Based on this assessment and evaluation, the Speech Therapist works to help determine a treatment plan, performs interventions aimed at improving and enhancing the patient's well-being, and evaluates the patient's progress.
**Primary Responsibilities:**
+ Provides services within the scope of practice as defined by the state laws governing the practice of speech therapy, in accordance with the plan of care, and in coordination with other members of the health care team
+ Evaluates the patient's level of function by applying diagnostic and prognostic functional ability tests. Assists the physician in the development of the therapy plan of care
+ Treats patients to communicate effectively by expressing thoughts according to the patient's condition using acceptable standards of practice
+ Observes, records, and reports to the supervising nurse and/or physician the patient's response to treatment and changes in the patient's condition
+ Instructs the patient, the family and/or caregiver and other members of the health care team in areas of speech therapy in which they can participate
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Licensed in Speech Therapy in the state of California
+ Current CPR certification
+ Current driver's license, vehicle insurance, access to a dependable vehicle or public transportation
+ Available to work a weekend rotation
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 $35.00 to $62.50 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._
$35-62.5 hourly 15d ago
Medical Director - IP Claims Management
Humana 4.8
Sacramento, CA job
**Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, CMS and state policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicare Advantage, and Medicaid requirements and will understand how to operationalize this knowledge in their daily work.
The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management. May occasionally participate in discussions with external physicians by phone to gather additional clinical information or discuss determinations which may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, dispute, grievance, and appeals processes, and outpatient services and equipment, within their scope.
The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. Medical Directors support Humana values throughout all activities.
**Use your skills to make an impact**
**Responsibilities**
The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS and state Medicaid requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, and Humana colleagues. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines. Supports the assigned work with respect to market-wide objectives and community relations as directed.
**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(s), if required.
+ No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.
+ Excellent verbal and written communication skills.
+ Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation.
**Preferred Qualifications**
+ Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.
+ Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance.
+ Experience with national guidelines such as MCG or InterQual
+ Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists
+ Advanced degree such as an MBA, MHA, MPH
+ Exposure to Public Health, Population Health, analytics, and use of business metrics.
+ Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health.
+ The curiosity to learn, the flexibility to adapt and the courage to innovate
**Additional Information**
Typically reports to a Lead Medical Director, depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care received by members in an assigned line of business, member population, or condition type. May also engage in dispute, grievance, and appeals reviews. May participate on project teams or organizational committees.
\#physiciancareers
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$223,800 - $313,100 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 02-28-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$223.8k-313.1k yearly 56d ago
Financial Reporting Professional 2
Humana 4.8
Sacramento, CA job
**Become a part of our caring community and help us put health first** The Financial Reporting Professional 2 prepares and distributes periodic financial statements. The role requires data driven technical skills to support process improvement. The Financial Reporting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
This role is suited for a technically capable reporting professional who can work directly with data, understand end to end reporting flows, and exercise sound judgement within established accounting and organizational guidelines to deliver accurate and timely financial information. Individual will own assigned reporting processes and schedules within the financial reporting team with accountability for data readiness, documentation and adherence to filing requirements/timelines.
The individual will partner with finance, accounting and engineering teams on broader automation and efficiency initiatives. The role requires the ability to implement basic technical solutions including revising SQL queries and modifying lightweight automation solutions. Advanced system development is NOT required
**Key responsibilities**
+ Contribute to light automation and workflow improvements while partnering with technical resources for more complex development.
+ Maintain reporting calendars and filing schedules for regulatory submissions.
+ Coordination with Compliance to ensure deadlines are tracked and met across multiple states and programs
+ Support financial and regulatory reporting through accurate execution of reporting process
+ Post journal entries and perform data reconciliations across source systems and the general ledger
+ Load, validate and maintain reporting data tables
+ Operate as business owner for existing tools including coordination of inputs, validation of outputs, and design changes
+ Ensure compliance with internal controls and regulatory requirements
+ Analyze data flows and identify opportunities to improve accuracy, efficiency and automation
+ Collaborate with cross functional partners on finance and accounting initiative
+ Write and modify basic SQL queries and support data validation and troubleshooting
**Use your skills to make an impact**
**Required Qualifications**
+ Undergraduate degree with emphasis in Finance, Accounting, Data Analytics or related field
+ 3 years of experience in accounting/finance department
+ Basic understanding of SQL and Microsoft Power Platform
+ Intermediate Excel
+ Strong analytical and problem-solving capabilities
+ Experience supporting or improving financial reporting processes
+ Working knowledge of general ledger and financial statement preparation
+ Ability to work independently and exercise sound professional judgment
**Preferred Qualifications:**
+ Healthcare insurance experience, including CMS and MLR ( **Medical Loss Ratio)** reporting requirements
+ Experience building apps on Microsoft Power Platform (Power BI, Power Apps, Power Automate, SharePoint)
+ Advanced SQL and/or VBA
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-29-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$71.1k-97.8k yearly 15d ago
Lead Solutions Architect
Humana 4.8
Sacramento, CA job
**Become a part of our caring community and help us put health first** The Lead Solutions Architect provides architecture leadership for CenterWell Home Health programs and platforms, shaping conceptual and reference architectures, governing solution designs, and aligning delivery teams to cloud and data strategies. The scope includes high priority initiatives as well as interoperability and provider‑data integrations that span CenterWell and Humana Insurance.
You will operate within CenterWell IT - Cross‑CenterWell Architecture, collaborating with product, engineering, EA Activation, security, data, and operations, and engaging governance forums to enable Integrated Health across CenterWell and Humana Insurance.
You will operate within CenterWell IT - Cross‑CenterWell Architecture, collaborating with product, engineering, EA Activation, security, data, and operations, and engaging governance forums to enable Integrated Health across CenterWell and Humana Insurance.
**Key Activities**
+ Quickly conduct structured knowledge transfer with existing architects and relevant stakeholders to capture critical in-flight designs and decisions.
+ Review current initiatives and establish an architectural roadmap aligned with organizational priorities.
+ Develop or refine reference architectures and design patterns for core platforms and solutions.
+ Collaborate with governance and compliance teams to validate designs against enterprise standards and regulatory requirements.
+ Define integration strategies and solution blueprints for key systems and data flows.
+ Establish architecture review processes and decision forums to support delivery readiness and quality assurance.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's Degree in Computer Science or a related field
+ 8 years of progressive information technology experience directly related to architecture/engineering, information security, or other specialized technology field
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Core Responsibilities**
+ **Architectural leadership:** Own end‑to‑end solution architecture for Home Health initiatives, translating business outcomes into composable designs across systems of experience, operations, and insight.
+ **Reference architectures & patterns:** Author and maintain reference architectures for data platform, clinical documents NLP, RPA/automation, and interoperability patterns; steward pattern reuse across CenterWell when applicable.
+ **Governance & compliance:** Lead architecture checkpoints and risk reviews; ensure designs conform to enterprise guardrails and privacy/security requirements. Participate in governance forums (e.g., ARB, TRB, MOR ).
+ **Delivery enablement:** Partner with product and engineering to convert conceptual designs into executable architectural runways; de‑risk delivery with measurable non‑functional requirements (NFRs).
+ **Data & integration strategy:** Define integration contracts and domain boundaries for provider data, EMR, and Snowflake/Databricks/Azure data platforms; ensure observability, lineage, and data protection.
+ **Stakeholder engagement:** Collaborate with CenterWell leaders, EA Activation, security, and segment CIO teams; communicate decisions clearly to executives and delivery teams.
**Preferred Qualifications**
+ Master's Degree
+ 5+ years of solution architecture experience with healthcare delivery or payer/provider ecosystems; proven delivery within regulated environments (HIPAA/PHI).
+ Hands‑on architecture across Azure services and Snowflake/Databricks (data lake/data platform patterns, data sharing, identity & access, vault/secrets management).
+ Experience integrating EMR (e.g. Homecare Homebase (HCHB)) and provider data sources into enterprise data domains.
+ Demonstrated leadership producing reference architectures and governing solution designs across multiple teams.
+ Strong competency in APIs/event‑driven integration, security models, and NFRs (availability, performance, resilience).
+ Executive‑level communication and stakeholder management across product, engineering, and enterprise functions.
**Preferred Qualifications (Core Home Health)**
+ Experience with clinical document NLP pipelines and automation/RPA in Home Health workflows (eligibility, authorization).
+ Familiarity with Home Healthcare solutions conceptual architecture and operating models and artifacts; ability to evolve them with measurable outcomes.
+ Knowledge of enterprise identity/Access Management flows and Azure group governance within tenants.
+ Experience participating in portfolio governance and activation forums (e.g., ARB, TRB, MOR) and translating those decisions into architectural runways.
**Preferred Qualifications (Generative & Agentic AI, multi cloud)**
+ A seasoned Solutions Architect with hands on experience delivering generative and agentic AI on Google Cloud, Azure, and AWS-leveraging services like Vertex AI, Azure OpenAI, and Amazon Bedrock-to implement production grade capabilities including RAG, fine tuning, prompt/knowledge management, and secure data integrations. Demonstrated depth in agent orchestration (tools/function calling, planning, memory, multi agent collaboration), enterprise guardrails (security, compliance, responsible AI), and robust MLOps/LLMOps practices for observability, evaluation, and cost/performance optimization. Proven ability to integrate AI systems with event driven microservices, vector databases/feature stores, and CI/CD pipelines, while leading reference architectures and cross cloud patterns that scale reliably.
**Preferred Qualifications Agentic AI Skills**
+ Agent orchestration: planning, tool/function calling
+ Long/short-term memory and context management
+ Multi-agent collaboration and role assignment
+ Human-in-the-loop review and overrides workflow
+ Safety guardrails, policy enforcement, governance
+ Telemetry: tracing, evaluation, A/B testing
+ Reliability: retries, fallbacks, deterministic handoffs
+ Tool ecosystem integration (APIs, MCPs)
**Additional Information**
**Work-At-Home Requirements**
+ WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
+ A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
+ Satellite and Wireless Internet service is NOT allowed for this role.
+ A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
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.
$142,300 - $195,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-29-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$142.3k-195.7k yearly 22d ago
Medical & Disability Nurse Case Manager
Liberty Mutual 4.5
Rocklin, CA job
If you're a registered nurse looking for a new opportunity to work in a fast-paced, professional environment where your talent contributes to our competitive edge, Liberty Mutual Insurance has the opportunity for you. Under general technical direction, responsible for medically managing assigned caseload and by applying clinical expertise ensure individuals receive appropriate healthcare in order to return to work and normal activity in a timely and cost effective manner. Caseload may include catastrophic/complex medical/disability cases, lost time, and/or medical only claims. Also act as a clinical resource for field claim partners.
This is a remote position, however, you will be required to report into the office twice a month per business requirements if you reside within 50 miles of the following offices: Lake Oswego, OR, Chandler, AZ, Hoffman Estates, IL, Suwanee, GA, Indianapolis, IN, Plano, TX, Boston, MA, Westborough, MA, Las Vegas, NV, and Weatogue, CT. Please note this policy is subject to change.
Responsibilities:
* Follows Liberty Mutual's established standards and protocols to effectively manage assigned caseload of medical/disability cases and by applying clinical expertise assist to achieve optimal outcome and to facilitate claim resolution and disposition.
* Effectively communicates with injured employees, medical professionals, field claims staff, attorneys, and others to obtain information, and to negotiate medical treatment and return to work plans using critical thinking skills, clinical expertise and other resources as needed to achieve an optimal case outcome.
* Utilizes the Nursing Process (assessment, diagnosis, planning, intervention and evaluation) to facilitate medical management to attain maximum medical improvement and return-to-work (RTW) per state jurisdictional requirements.
* Appropriately utilizes internal and external resources and referrals i.e., Utilization Review, Peer Review, Field Claims Specialists, Regional Medical Director Consults, and Vocational Rehabilitation to achieve best possible case outcome.
* Follows general technical direction from nurse manager, senior medical and disability case manager and/or CCMU staff to resolve highly complex medical and/or RTW issues and/or successfully manage catastrophic injuries.
* Documents all RN activities accurately, concisely and on a timely basis. This includes documenting the medical and disability case management strategies for claim resolution, based on clinical expertise. Adheres to confidentiality policy.
* Appropriately applies clinical expertise to claims and delivers services in an efficient and effective manner.
* Accurately and appropriately documents time tracking for work performed. Achieves annual time tracking goal.
* Handles special projects as assigned.
Qualifications
* Ability to analyze and make sound nursing judgments and to accurately document activities.
* Strong communication skills in order to build relationships with injured employees, medical professionals, employers, field claims staff and others.
* Good negotiation skills to effectively establish target return to work dates and coordinate medical care.
* Knowledge of state, local and federal laws related to health care delivery preferred.
* Personal computer knowledge and proficiency in general computer applications such as Internet Explorer and Microsoft Office (including Word, Excel and Outlook).
* Degree from an accredited nursing school required (prefer Bachelor of Science in Nursing).
* Minimum of 3 to 5 years of clinical nursing experience; prefer previous orthopedic, emergency room, critical care, home care or rehab care experience.
* Previous medical case management experience a plus.
* Must also have current unrestricted registered nurse (R.N.) license in the state where the position is based and other assigned states as required by law.
* Must have additional professional certifications, such as CCM, COHN, CRRN, etc., where required by WC law.
About Us
Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.
At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in
every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive
benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve.
We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: ***********************
Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.
Fair Chance Notices
* California
* Los Angeles Incorporated
* Los Angeles Unincorporated
* Philadelphia
* San Francisco