Centene jobs in Trenton, NJ - 119 jobs

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. ***NOTE: For this role we are seeking candidates who live in New Jersey*** **Position Purpose:** Represent the company to all prospective and existing clients. Monitor client satisfaction and recommend changes to enhance satisfaction. Serve as a resource to other Account Executives. + Perform sales and marketing related activities for our specialty pharmacy + Partner with doctors and their practices to help patients get their specialty medications approved by insurance, their copays manageable and their shipments of meds arranged + Serve as the contact for client issues and inquiries and collaborate with various departments on resolutions ensuring clients needs are met + Analyze and utilize company provided data to identify potential business opportunities and grow business + Document sales activity in company CRM software + Complete basic administrative tasks in a timely manner + Develop and maintain relationships with various levels of clients utilizing current network for additional accounts + Monitor client satisfaction and recommend appropriate strategies, tactics, and operational initiatives to continuously enhance client satisfaction + Partner with pharmaceutical partners with whom we have contracts to ensure streamlined business + Work with them to gain access into offices where they may have access/relationships + Attend patient care conferences and professional in-services to ensure continuance of new products and strategies **Education/Experience:** Bachelor's degree in Business Administration, related field or equivalent experience. 5+ years of sales experience. Knowledge of third party reimbursement. Clinical patient support experience in physician's office, hospital or pharmacy setting preferred. Sales experience in pharmaceuticals/pharmacy or healthcare or equivalent in account management strongly preferred. **License/Certification:** Current state's driver license. Pay Range: $70,100.00 - $126,200.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Requisition ID JR1004767 Category Legal Type Regular Full-Time Responsible for managing a case load from inception to court in the state of Pennsylvania. Responsibilities include pre-trial discoveries, drafting pleadings, communicating with involved parties, and presenting defense strategies in court. Maintains a solid understanding of AmTrust's mission, vision, and values. Upholds the standards of the AmTrust organization. Responsibilities Independently represents the Employer/Carrier before the assigned Judge of Compensation Claims and present witnesses and evidence at administrative hearings on litigated workers' compensation claims. Analyzes complex legal and factual issues, conduct extensive, well-reasoned legal research, independently develop and present defense strategies on behalf of the Employer/Carrier. Prepares pleadings, written discovery, motions and briefs in support of defense strategies. Provides effective and timely communications, information, legal advice and other services to clients and claims professionals on legal and factual issues. Position requires the use of independent judgment, research, litigation and analytical skills. Assists in developing training materials for the WC claim department. Works with the WC claim department and Law Department on special projects related to the practice of workers' compensation. Communicates with the Office of the Judges of Compensation Claims, witnesses, opposing counsel and clients in a manner consistent with established office procedures. Responsible for the prompt, efficient and effective disposition of assigned cases. Keeps current with market trends and demands. Attends continuing legal education seminars in order to maintain high level of professional expertise. Performs other functionally related duties as assigned. Qualifications PA State licensed attorney. Knowledge of Workers' Compensation statutes and its application. 5+ years workers' compensation litigation experience The expected salary range for this role is $120,500-$175,000/year. Please note that the salary information shown above is a general guideline only. Salaries are based upon a wide range of factors considered in making the compensation decision, including, but not limited to, candidate skills, experience, education and training, the scope and responsibilities of the role, as well as market and business considerations. #AmTrust What We Offer AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include: Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off. AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected. This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities. AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice. Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices. It is an integral part of who we are as a company, how we operate and how we see our future. Connect With Us! Not ready to apply? Connect with us for general consideration.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today! If you are located within Northern New Jersey territory and willing to travel up to 20% of your time to assigned territory, you will have the flexibility to work remotely as you take on some tough challenges. Primary Responsibilities: Comprehensive Assessment & Care Planning Conduct thorough health assessments, including medical history, chronic conditions, behavioral health, and social determinants of health Develop individualized care plans that address medical, rehabilitation, behavioral health, and social needs Create personalized interventions that integrate medical treatment, support services, and community resources Member Engagement, Education & Self-Management Build and maintain relationships with an established caseload of high-risk members Provide education to members and caregivers on disease processes, treatment adherence, and lifestyle changes Encourage self-management strategies that support long-term wellness and reduce complications Maintain consistent outreach to support adherence to care plans and monitor evolving needs Intensive Care Coordination Coordinate services across providers, including PCPs, specialists, hospitals, LTSS, behavioral health, and pharmacy. Facilitate referrals for home health, hospice, palliative care, and DME Collaborate with Medical Directors during interdisciplinary rounds to review and align care for complex cases Discharge Planning & Transitional Care Support members through transitions of care such as hospitalization, skilled nursing, and rehabilitation Conduct "welcome home" and follow-up calls to ensure post-discharge services, medications, and follow-up appointments are in place Deliver intensive outreach during the 30-day post-discharge period to reduce avoidable readmissions and ED utilization Advocate for safe, coordinated, and timely transitions of care that align with the member's individualized care plan Field-Based Care Management (20% of Time) Conduct home and hospital visits in North Jersey as required by program guidelines Perform in-person assessments and provide care coordination to address high-risk needs and ensure continuity of care Collaborate directly with providers, facilities, and families during field visits to close care gaps and reinforce the care plan Monitoring & Clinical Oversight Monitor members' clinical conditions, care plan progress, and treatment adherence Reassess care plans regularly and adjust interventions based on changing needs or barriers Identify red-flag conditions and escalate urgent or complex cases for higher-level review and intervention Documentation, Compliance & Quality Outcomes Document all assessments, care plans, interventions, and communications per NCQA, CMS, and state regulatory requirements Ensure care management services align with DSNP/NCQA standards and contract requirements Track outcomes tied to quality metrics (HEDIS, STARs), utilization management, and member satisfaction Maintain audit readiness through timely, accurate, and comprehensive documentation 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, unrestricted RN license in New Jersey 2+ years of Case Management Experience serving complex, elderly and disabled Experience with government health programs (Medicaid/Medicare) Proficient in Microsoft Office Suite; tech-savvy with ability to navigate multiple systems simultaneously Demonstrated ability to talk and type proficiently at the same time Access to reliable transportation and the ability to travel up to 20% within assigned territory. Available for occasional in-person meetings as needed Preferred Qualifications: Certified Case Manager (CCM) Experience working with populations with special needs (DSNP) Experience with Managed Care Population Bilingual - English/Spanish *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 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 $28.27 to $50.48 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.

Join Our Team as a Senior Claims Resolution Specialist - MidAtlantic Region Are you ready to take your claims expertise to the next level? Personal Lines Casualty Complex is seeking a dedicated and experienced Senior Claims Resolution Specialist to lead the handling of challenging auto and homeowner's casualty claims across our MidAtlantic Region. In this pivotal role, you'll take ownership of complex, high-exposure cases, diving deep into investigations, evaluations, and strategic resolutions. This is your opportunity to make a real impact, handling severe and catastrophic injury claims that demand both skill and compassion. If you thrive in a fast-paced environment where your expertise drives meaningful outcomes, we want to hear from you! Preference for candidates who reside within Eastern or Central Time Zones. There is an in-office requirement twice a month if you live within 50 miles of one of our Hub locations. 10% travel may be required for mediations, arbitrations, trials and in-person events. Training is a critical component to your success and that success starts with reliable attendance. Attendance and active engagement during training is mandatory. Responsibilities: * Manages, investigates, and resolves auto and homeowner's casualty claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed procedures and authority. Recommends ultimate resolution on assigned cases in excess of their authority to local claims management and Home Office. * Identifies potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. * Prepares for and attends trials, hearings and conferences and reports to Home Office and local management on status. * Confers with trial counsel and prepares trial reports. * Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action. * Responds to various written and telephone inquiries including status reports. * Ensures adequacy of reserves. Recommends reserve increases on cases in excess of authority. * Accountable for security of financial processing of claims, as well as security information contained in claims files. * Responsible for managing the practices and billing activities of outside and in-house counsel. * May assist in the absence of the Claims Team Manager, representing the company on matters involving state or federal regulatory agencies. * May be involved in special projects and/or mentoring at the direction of local management. Ideal experience includes: * 5+ years of casualty and litigation experience * Expert knowledge of handling personal lines complex claims with severe to catastrophic injuries and fatalities Qualifications * Must have an advanced knowledge of coverage, liability, and complex claims handling procedures. * Must be knowledgeable of state and federal laws in the adjuster's jurisdiction. * A full working knowledge of claims operations and procedures is required. * Strong written and oral communication skills required as well as strong interpersonal, analytical, investigative, and negotiation skills. * The capabilities, skills and knowledge required is normally acquired through a Bachelor's degree or equivalent experience and at least 5-7 years of directly related experience. * Ability to obtain proper licensing as required. 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

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. The Self-Direction PPP Support Counselor is responsible for conducting quarterly in-person evaluations on members enrolled in the Personal Preference Program within Ocean County. During these quarterly meetings, the Support Counselor is responsible for all workforce functions including budgeting, back-up plan, capacity planning, forecasting, safety planning, scheduling and real time monitoring. The Support Counselor will provide member assistance and strategic insight during the development and review of the member's cash management plan, budget performance, review of monthly results and to ensure the cash management plan is meeting the member's needs. Job Responsibilities: Work with member to develop a cash management plan that is member specific, member choice and member centric; enabling the member to use their budget to meet their daily needs. Review monthly cash expenditures to ensure the member is within monthly budget allowance. Review monthly budget on a quarterly basis and update, as needed. Develop and review member's back-up plan on a quarterly basis. Review worker timecards to analyze PTO submissions, EVV compliance and hours of work. Update and maintain member's electronic medical record. Identify, report, and follow up on allegations or reports of suspected fraud, waste, neglect, or abuse. Identify and maintain available community resources and other services. Maintain timely documentation: in-home visits note must be completed during the time of visit and uploaded on the day of the participants' visit. Educate members on notification requirements for changes in condition, hospitalizations or caregiver issues. Provide education on safety tips including but not limited to fall risk prevention. Provide clear and consistent communication. Perform other relevant tasks as assigned by management. Disclaimer: This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job. Education/Experience: High School Diploma/GED required LPN or healthcare background preferred Equivalent and relevant professional experience in budgeting or finance preferred but not required Minimum of 3 years' experience in a health insurance industry or professional business related field required Experience with MS Office and other WFM solutions highly preferred. Knowledge: Knowledge of Healthcare industry helpful. Ability to balance multiple priorities. Team player, strong analytical and interpersonal skills. Proficient in MS Word, MS Excel and MS PowerPoint. Skills and Abilities: Demonstrate strong analytical skills with emphasis on forecasting. Ability and willingness to learn new software applications. Skills in problem solving, judgment, critical thinking and decision making. Ability to be highly organized with an emphasis on accuracy and timeliness. Ability to organize information and have attention to detail and accurately follow procedures. Ability to work alone with minimum supervision and with others in a team environment, occasionally under time pressure and on several tasks at the same time. Ability to visit a diverse population of participants in their homes, which may encompass a wide range of home settings. Ability to assume an increased home visit schedule (i.e., greater than 60% of working hours) as dictated by business needs. Ability to organize home visit caseload to ensure efficient use of driving time. Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware Salary Range: $63,000 - $84,420 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes: Comprehensive health benefits (Medical/Dental/Vision) Retirement Plans Generous PTO Incentive Plans Wellness Programs Paid Volunteer Time Off Tuition Reimbursement Disclaimer: This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job. Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

Underwriting experience is required for this position, and Commercial Auto Underwriting exposure is highly preferred! Use your advanced Underwriting experience to join an exciting new opportunity! The GRS North America Auto Underwriting Performance team is hiring an Assistant Director or Director to support our Commercial Auto portfolio across North America. This role partners closely with cross-functional teams-including Liability Performance, Auto Product, Actuarial & Analytics, Data Science, the Office of Underwriting, and segment/field underwriting teams-to monitor and drive profitable growth of the Commercial Auto portfolio. Responsibilities include analyzing performance data to identify portfolio trends and insights, communicating those insights to diverse stakeholders, and using them to generate and execute impactful portfolio and underwriting improvement opportunities. This role requires deep knowledge of commercial auto insurance and underwriting to operationalize opportunities within the business. The ideal candidate brings cross-functional project leadership, strong communication skills, and technical acumen in portfolio analysis. This role reports to the Executive Underwriting Officer, Auto. If you reside within 50 miles of a hub office, you will be required to be onsite two days per week. We are open to filling this role at the Assistant Director or Director level based on experience. Responsibilities: * Analyze a wide range of performance reports and metrics and identify portfolio trends and insights on a regular cadence. * Synthesize and communicate relevant trends and insights to diverse stakeholders through recurring updates. * Use insights to identify, research, develop, and socialize business cases for actionable portfolio and underwriting improvement opportunities. * Lead execution of prioritized initiatives, including cross-functional coordination and project management (building work plans, aligning stakeholders, managing timelines, and tracking outcomes), along with role-specific work. * Support competitive intelligence, pricing and product strategy research, and market monitoring to inform underwriting strategy in support of annual planning, State of the Line, and other strategic forums. * Support Office of Underwriting-prioritized processes and tools, such as the go-forward data architecture. * Partner with segment/field teams to complete prioritized projects such as auto audits, technical underwriting assessments, and targeted deep dives. * Draft and maintain Commercial Auto technical underwriting reference materials as needed. * Serve as a technical Commercial Auto Underwriting SME to Product, Actuarial & Analytics, Data Science, Technology and segment/field Underwriting Teams. Qualifications * Deep knowledge of commercial auto insurance across underwriting, product, pricing, and applicable rules/regulations. * Auto underwriting experience. * Project leadership experience, ideally in a matrixed, cross-functional environment. * Professional curiosity, strategic mindset, and strong critical thinking skills. * Objective, results-oriented, with a track record of delivering measurable outcomes. * Analytical experience and/or training is highly desirable. * Telematics experience is highly desirable. * 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

**Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. _This a remote nationwide position_ The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + Associate of Society of Actuaries (ASA) designation + MAAA + Strong communication skills + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Prior Part D experience + Strong SAS skills + Prior Databricks experience **Our Hiring Process** As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you. If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. **Alert:** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. **_Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful._** \#LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $106,900 - $147,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-29-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

The Chief Medical Officer will be responsible for the following key areas of focus: **Implements Clinical Strategy, Solution and Program Design-** Implements and advances the overall clinical strategy in support of the transformation of the health plan offerings to deliver value through exceptional patient and provider experience, high quality outcomes, more affordable care, and with the use of modernized digital, technology, and data capabilities. **Oversees Medical Management** - Provides strategic leadership and oversight for all medical management functions, including case management (CM), utilization management (UM), and escalated case review. Ensures policies, procedures, and governance frameworks are in place to deliver a high-functioning, compliant health plan that meets regulatory requirements and internal standards. Drives excellence in clinical quality and consistency across programs while maintaining a seamless, positive experience for members and providers. Partners with internal teams to monitor performance, resolve complex cases, and continuously improve processes that safeguard patient outcomes and operational integrity. **Serves as the External Clinical Face of Health Plan to the Market** - Acts as the primary clinical ambassador for Cigna Healthcare, engaging with clients of all sizes across employer groups, as well as consultants and brokers. Plays a critical role in the sales process, account management, and ongoing performance oversight by providing clinical insight and executive sponsorship. Builds and nurtures strategic relationships with key stakeholders to strengthen trust and partnership. Represents Cigna in the provider community to foster collaboration, influence clinical policy, and advance value-based care initiatives. Ensures that every external interaction reflects Cigna's commitment to quality, affordability, and an exceptional member experience. **Drives Clinical Product Strategy and Design** - Leads the development and execution of Cigna Healthcare's clinical product strategy to ensure a market-leading clinical value proposition and compelling external narrative. Shapes and oversees the design of differentiated programs, including best-in-class case management and innovative solutions in high-impact areas such as GLP-1 therapies, gene therapy, women's health, and other core and emerging clinical domains. Partners with product, technology, operations, and business teams to create solutions that deliver measurable outcomes, supported by robust proof points and performance metrics. Ensures that Cigna's clinical programs stand out in the marketplace through demonstrated results, scalability, and alignment with client needs, while reinforcing our commitment to quality, affordability, and innovation. **Implements and Advances Value-Based Care Strategy** - Leads the next chapter of Cigna Healthcare's value-based care (VBC) journey, including oversight of our ACO model and development of innovative approaches to strengthen plan-provider alignment. Drives adoption of VBC enablers such as data integration, performance measurement, and incentive structures that improve quality and affordability. Pilots novel care models and partnerships to accelerate transformation while ensuring alignment with the broader enterprise network strategy. Positions Cigna as a market leader in value-based care through measurable outcomes, proof points, and a compelling external narrative. **Collaboration Across Clinical Leadership** - Ability to work seamlessly with other clinical leaders across the enterprise, serving as a key member of the clinical leadership bench. Thought partner to the enterprise CMO and peers to ensure integration of clinical strategy with each business's objectives, fostering alignment and shared accountability. **Advances Clinical Data and AI Strategy** - Champions a data-first mindset to transform CHC's clinical strategy through advanced analytics and AI. Leads efforts to harness data and AI for superior member experience, personalized care, improved outcomes, and operational efficiency. Partners closely with data, technology, and business teams to identify and execute clinical use cases that drive measurable impact. Ensures all AI applications adhere to rigorous clinical standards and governance guardrails to maintain trust and safety. Positions Cigna Healthcare at the forefront of digital innovation by embedding AI into clinical workflows while maintaining transparency, compliance, and a commitment to quality. **Drives Health Equity Strategy** - Leads the design and implementation of the next phase of Cigna Healthcare's health equity strategy, ensuring measurable business impact and alignment with our mission. Embeds a health equity lens across clinical programs to drive better outcomes for all patients, reduce disparities, and improve access to high-quality care. Establishes clear proof points and performance metrics to demonstrate progress and accountability, while partnering across the enterprise to integrate equity principles into product design, policy, and care delivery. **Builds and Inspires our New Age Clinical Workforce-** Sets the sourcing, recruitment, and onboarding strategy for building the team of clinicians who can support and drive the business strategy. Ensures our clinical teams are supported, engaged, and inspired to deliver exceptional outcomes. Leads and executes strategies to make Cigna an employer of choice for clinical talent through a differentiated employee value proposition that ensures the sustainability and well-being of our teams. The CMO will be the major clinical voice for Cigna Healthcare's US market president and senior leadership team. **Partners with Enterprise Clinical Leadership** - Collaborates and engages Clinical leaders/peers across the enterprise to support the enterprise clinical strategy and build out clinical community. The successful candidate will be a forward-thinking, flexible physician executive with a broad understanding of the healthcare industry, its challenges and opportunities, and deep experience within health plans. This leader will know how to navigate the complexities of a health plan environment to deliver results that align clinical priorities with business strategy. They will demonstrate genuine intellectual curiosity and a collaborative mindset, working effectively across a complex, matrixed organization with a servant leadership disposition. The individual will be an innovative thinker and problem-solver with a proven ability to lead transformative change while fostering trust, engagement, and retention of top clinical talent. The ideal candidate will combine clinical expertise, digital and technology depth, and strong business acumen with a results-oriented focus-driving measurable impact on both clinical outcomes and enterprise growth objectives. **Experience & Expertise:** + **Clinical Execution** : Ability to deliver a clinical vision for the business. The skills to shape and implement the development of forward-looking strategies that align with overarching enterprise objectives. Can identify opportunities for improvement that balance profitable business and clinical outcomes (e.g., patient outcomes, cost containment, and quality of healthcare services). + **Enterprise Value Creation and Scaling Commercial Solutions** : Ability to align clinical metrics/outcomes with a direct linkage to enterprise value creation and member health to create a clear mandate and accountability that prioritizes high-value areas. Experience overseeing the end-to-end development and scaling of healthcare solutions. Can drive innovation through the implementation of technologies and care models. Strong understanding of finance, technology, and the levers to pull in business development and sales. + **Thought Leadership and Clinical Face-To-Market** : Track record of engaging with diverse external stakeholders in the community to stay informed and shape the latest clinical and policy developments. Experience serving as the clinical face outside the organization to help inform and validate decision-making processes and provide insight supporting the business development lifecycle. Fosters collaborations to enhance care delivery and contribute to discussions in the public policy arena. Plays a crucial role in market-facing change and crisis management communications related to the Cigna health plan, ensuring effective and clear messaging to all stakeholders. + **Clinical Leadership** : Gravitas to serve as the highest point of clinical leadership in Cigna Healthcare. Skills and experience to effectively have end-to-end oversight of the clinical model (including P&L) for all programs and care delivery businesses while creating a high-quality patient care culture. Can balance clinical choices with business outcomes to gain market traction and deliver financial results. + **Health Plan and Medical Management Expertise** : Deep experience operating within health plan environments, including fluency in medical management functions such as utilization management (UM), case management (CM), policy development, and governance. Proven ability to navigate complex plan structures and deliver compliant, high-performing operations that enhance member experience and clinical quality. + **Transformation & Change** : Leads masterfully and empathetically through change in a complex matrixed environment (e.g., transformation of ways of working/processes, vision/priorities/culture and technology application). Manages transformation through practices such as creating a vision and purpose, frequent and timely communication, leadership alignment, stakeholder engagement, educating/training the organization, and overcoming resistance. Builds strong working relationships rooted in collaboration and trust. + **Value-Based Care** : Deep experience transitioning healthcare delivery models toward value-based care, emphasizing outcomes and cost-effectiveness. + **Building Next Generation Clinical Talent** : Has direct people management responsibility for a team through the full talent lifecycle: attracting, hiring, onboarding, developing, managing performance, and promoting talent, as well as existing team members when necessary. + **Compliance, Safety and Quality Care** : Cultivates a culture and fosters practice across the care delivery teams that prioritizes high quality, safe, and compliant operations within the Healthcare Sector. **REQUIRED SKILLS:** + MD/DO degree required; MBA and/or relevant business experience (10+ years) preferred. + 10+ years of experience in healthcare leadership. + Excellent leadership skills including the ability to think strategically, develop vision, and execute for results. + Proven thought leader of innovative, effective clinical solutions; must have end-to-end experience in deriving clinical and business value from clinical interventions, programs, and solutions. + Experience demonstrating iterative and synergistic solutions with near-term value delivery in service of longer-term pivots. + Experience with Commercial health plan product constructs, design, and innovative benefit structures. + Demonstrated ability to deliver creative solutions to complex challenges. + Experience working in a highly matrixed organization, with proven ability to develop internal enterprise relationships and influence partners. + Strong communication skills, particularly the ability to translate complex topics into consumable formats. + Willingness to travel as needed to support provider and regional team engagement. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. **About The Cigna Group** Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. _Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws._ _If you require reasonable accommodation in completing the online application process, please email:_ _*********************_ _for support. Do not email_ _*********************_ _for an update on your application or to provide your resume as you will not receive a response._ _The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State._ _Qualified applicants with criminal histories will be considered for employment in a manner_ _consistent with all federal, state and local ordinances._

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. This is a one-year, structured post-graduate education and training program in a Medicaid managed care HMO. The goal of the position is to provide advanced knowledge and skills regarding drug therapy and pharmaceutical services in a managed care environment.Responsibilities: Clinical program incorporation into an on-line claims processor. Pharmacy case management. Development of therapeutic class reviews and drug monographs. Formulary development. Disease state management. Development of clinical policies. Prior authorization process. Drug utilization review. Outcomes research. Unique focus on government programs. Professional skills development and business administration. Assist with Pharm.D. student oversight. Education/Experience: Requires a bachelor's of science degree in pharmacy from an accredited college or university. Requires a Pharm D from an accredited college or university. Letter of Intent Curriculum Vitae Three Letters of Recommendation Additional licensing, certifications, registrations: Active Unrestricted Pharmacist License Required Only If Making UM Decisions; NJ License Preferred. Knowledge: Requires knowledge of a spreadsheet software package. Requires knowledge of a database software package. Requires project management knowledge. Requires knowledge of internet clinical information databases. Skills and Abilities: Requires the ability to utilize a personal computer and applicable software. Requires the ability to think analytically. Requires excellent verbal and written communication skills. Requires strong organizational skills. Requires the ability to analyze medical literature, i.e. clinical trials This is a pipeline requisition for the 2026 Pharmacy Residency Program, not currently an open position. Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware Salary Range: $43,900 - $58,800 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes: Comprehensive health benefits (Medical/Dental/Vision) Retirement Plans Generous PTO Incentive Plans Wellness Programs Paid Volunteer Time Off Tuition Reimbursement Disclaimer: This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job. Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The RN Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. Expect to spend about 80% of your time in the field visiting our members in their homes or in long-term care facilities. You'll need to be flexible, adaptable and, above all, patient in all types of situations. Do you live or are you willing to travel to any of the following counties? Middlesex County, NJ Primary Responsibilities: Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team 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, unrestricted independent licensure as a Registered Nurse 2+ years of clinical experience 1+ years of experience with MS Office, including Word, Excel, and Outlook Access to reliable transportation and the ability to travel up to 80% of your time within assigned territory to meet with members and providers Preferred Qualifications: BSN, Master's degree or higher in clinical field CCM certification 1+ years of community case management experience coordinating care for individuals with complex needs Experience working in team-based care Background in managed care Physical Requirements: Ability to transition from office to field locations multiple times per day Ability to navigate multiple locations/terrains to visit employees, members and/or providers Ability to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.) Ability to remain stationary for long periods of time to complete computer or tablet work duties 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 $40.00 to $54.00 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.

We are seeking an experienced Executive Underwriter to underwrite middle market technology accounts focused on Property & Casualty and Technology Errors & Omissions (Tech E&O). This role combines autonomous underwriting authority with commercial development: you will manage a portfolio of brokers and clients, underwrite complex/mid-to-large risk technology accounts, price risk analytically, and shape product and go-to-market strategy for the technology vertical. Responsibilities: * Risk Selection: Reviews, rates, underwrites, evaluates, or assesses the business applying for insurance by qualifying accounts, identifying, selecting and assessing risks, determining the premium, policy terms and conditions, obtaining approvals, creating/presenting the proposal to the agent/broker, and successfully negotiating deals. * Agent/Broker Relationships: Demonstrates a high level of responsiveness and focus on supporting Agents and Brokers objectives. Establishes, develops, and maintains successful relationships with Agents and Brokers to facilitate marketing of products, through responsive service, site visits, in person renewal meetings or enhanced knowledge of their customers businesses. Develops strong personal brand to build and maintain a long-term quality pipeline with Agents/Brokers. * Portfolio Management: Manages a sizable and complex book of technology business by analyzing the portfolio, identifying areas of opportunity for improved growth, profit and diversification, and executing marketing plans to increase market share by making marketing calls to brokers to market and cross market. * Documenting the Deal: Documents files in a way that reflects a solid thought process and decision making through comprehensive account reviews, sign-offs and referrals that comply with state regulations, letter of authority, and underwriting guidelines. * Leadership: Formally guides, mentors, and coaches underwriters and account analysts in both technical and professional skills. Demonstrates an area of expertise and provides regular updates to other underwriters. * Continuous Improvement: Actively participates in continuous improvement by generating suggestions, participating in problem solving activities and using continuous improvement tools to support the work of the team. 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

Are you a whiz at analyzing business risks? Are you a natural problem solver? Do you never get tired of answering the question, "What if?" Then be in your element when you're part of the collaborative underwriting team at Liberty Mutual. The Details Our underwriters focus on two fundamental questions: Should Liberty Mutual write a policy for a particular customer? What is a fair price for the risk that we would incur by writing the policy? Join our team and you'll challenge yourself to uncover these and other answers. As an Underwriting Trainee, you'll draw upon your strong analytic, communication, and negotiation skills to understand our customers and their needs, and how to profitably accept the risks that our policies cover. Best of all, at the close of your training, you'll have the opportunity to explore a future career with Liberty Mutual, one of the leading property and casualty insurers in the country. We encourage interested candidates to apply promptly, as the role may be unposted once we've received a sufficient number of candidates. We conduct interviews and extend offers on a rolling basis. Qualifications What you've got * You have 0-2 years of professional experience. * You hold a Bachelor's degree with a minimum 3.0 cumulative GPA. * You possess strong analytical, decision-making, and negotiating skills. * You have solid interpersonal skills and demonstrate a passion for customer service. * You must be willing to complete professional designation(s) and continued insurance education. * You must have permanent work authorization in the United States. * You must possess and maintain a valid driver's license for regular travel to customer locations 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

Drive global adoption and market advocacy of the company's Cyber insurance products. Support to build and deliver best-in-class training, broker engagement, market intelligence, competitor benchmarking, and product marketing content that empowers local teams, strengthens broker relationships, and drive profitable growth. Key responsibilities Broker engagement and product evolution * Set up a broker framework and QBR's, and advisory councils to socialize product updates, gather feedback, and co-create market-relevant enhancements. * Build a structured broker feedback loop and sentiment tracking; synthesize insights into recommendations for product, pricing, and wordings changes. * Develop pitch materials, RFP/RFI response content, and win themes aligned to broker needs and buying criteria. Market intelligence and competitor awareness * Establish a global market monitoring cadence covering rates, appetite, wordings, services, and distribution moves. * Produce concise market updates and quarterly landscape reports for leadership and regional teams; highlight implications for positioning and training. * Track regulatory developments (e.g., NIS2, SEC disclosure, Lloyd's guidance) with Legal/Compliance to inform content and broker messaging. Competitor comparisons * Build and maintain coverage comparison matrices and side-by-side analyses (insuring agreements, exclusions, endorsements, services, limits/attachments) and work closely with our Global Cyber Product lead to optimize our product offering. * Equip underwriting and distribution with clear differentiation narratives and objection handling anchored in facts and client outcomes. * Update comparisons promptly following competitor filings or major product announcements; enforce governance to ensure accuracy and compliance. Product marketing content * Partner with Marketing/Comms to develop thought leadership, case studies, one-pagers, brochures, and digital content that articulate our value proposition. * Create segment-specific messaging (industry verticals, size tiers, OT/ICS, cloud dependency) and service storylines (pre-breach, IR panels, resilience). * Ensure consistency of brand voice and alignment with global product strategy; measure content performance and iterate. Collaboration and governance * Work closely with Product, Underwriting, Claims, Actuarial, and Legal to ensure content accuracy, compliance, and timely updates positioning. * Coordinate with regional teams to plan campaigns, events, and joint broker activities; support major renewals and new product launches. Qualifications * 7-10+ years in cyber insurance across product marketing, underwriting, broking, or distribution enablement; global or multi-region experience preferred. * Strong understanding of cyber coverage constructs, wordings, exclusions, pricing drivers, and claims dynamics. * Extensive broker relationships within the industry (Global, US and London markets) * Proven ability to translate complex technical and actuarial concepts into clear, compelling training and sales materials. * Familiarity with cybersecurity practices and frameworks (e.g., NIST CSF, ISO 27001), common threats (ransomware, BEC, supply chain), and incident response ecosystem. * Exceptional writing, presentation, and facilitation skills; comfortable delivering to executive and technical audiences. * Bachelor's degree required; advanced degree or relevant certifications (e.g., CII, CPCU, CISSP, CISM) a plus. * Strong stakeholder management and cross-cultural communication; ability to operate in a matrix and influence without direct authority. * High attention to detail and compliance rigor in all external-facing materials. Qualifications * Bachelor's degree in Marketing or Business plus a minimum of 10+ years of proven progressive experience in marketing-driven organization and a minimum of three years of proven team management and leadership experience * MBA or advanced degree preferred * Proven ability to integrate marketing strategies and programs across multiple sectors * Strong ability to effectively interact with all levels of the organization * Must possess strong analytical, strategic, project management, decision-making and problem-solving skills * Strong communication and interpersonal skills required 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

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. This position is responsible for performing behavioral health duties using established guidelines to ensure an appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management.Responsibilities: Knowledge of NJ State Autism Mandate to apply when reviewing for medical necessity. Reviews Applied Behavior Analysis evaluations and progress reports of member assigned to determine appropriate authorization or denial recommendations. Presents cases to Autism Joint Case Rounds with medical directors, Behavioral Health and Physical Health interdisciplinary team. Evaluates the necessity, appropriateness and efficiency of behavioral health medical services and procedures provided. Coordinates and assists in implementation of plans for members. Monitors and coordinates services rendered outside of the network, as well as outside the local area, and coordinates internally for negotiation of fees for such services as appropriate. Coordinates with patient, family, physician, hospital, and other external customers with respect to the appropriateness of care from diagnosis to outcome. Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care. Monitors patient's behavioral health medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness. Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided. Encourages member participation and compliance in the behavioral health case/disease management program efforts. Documents accurately and comprehensively based on the standards of practice and current organization policies. Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care. Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes. Evaluates care by problem solving, analyzing variances, and participating in the quality improvement program to enhance member outcomes. Completes other assigned functions as requested by management. Disclaimer: This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job. Education/Experience: High School Diploma/GED required. Bachelor's degree required. Graduate degree preferred or relevant experience in lieu of degree. Requires a minimum of two (2) years behavioral health clinical experience. Behavioral health experience, preferably in a managed care setting, strongly preferred. Additional licensing, certifications, registrations: Active Licensed Behavioral Analyst (LBA) is required. Knowledge: Requires working knowledge of principles and clinical services for Applied Behavior Analysis Prefers proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; prefers knowledge in the use of intranet and internet applications. Prefers working knowledge of case/care management principles. Prefers working knowledge of principles of utilization management. Prefers basic knowledge of health care contracts and benefit eligibility requirements. Prefers knowledge of hospital structures and payment systems. Skills and Abilities: Analytical. Compassion. Interpersonal & Client Relationship Skills. Judgment. Listening. Planning/Priority Setting. Problem Solving. Team Player. Time Management. Written/Oral Communication & Organizational Skills. Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware Salary Range: $70,500 - $94,395 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes: Comprehensive health benefits (Medical/Dental/Vision) Retirement Plans Generous PTO Incentive Plans Wellness Programs Paid Volunteer Time Off Tuition Reimbursement Disclaimer: This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job. Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.

**Explore opportunities with CPS,** part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind **Caring. Connecting. Growing together.** The Clinical Staff Pharmacist will have the opportunity to apply your clinical expertise by evaluating and interpreting medication orders, compounding, and dispensing prescriptions in accordance with legal and professional standards. You will play a critical role in identifying, preventing, and resolving medication-related issues to ensure safe, effective, and individualized patient care. Through the application of evidence-based protocols, you will promote clinically sound and cost-effective drug therapy, contributing to improved patient outcomes and advancing the standard of pharmaceutical care. **Schedule:** This position will work up to 19 hours per week, providing coverage "as needed". This position will primarily provide coverage between the hours of 8:00 am-2:30 pm Monday-Friday. This position has no regularly scheduled hours. **About the Facility:** Haven Behavioral Hospital of Philadelphia which opened in 2013, is a licensed 42-bed acute care psychiatric hospital providing inpatient psychiatric stabilization and treatment to adults ages 55 and older who are experiencing acute symptoms of depression, anxiety, mood disorders and psychosis. We also treat individuals who are suffering from other medical conditions such as dementia and Alzheimer's disease. Patients are treated through a program of comprehensive assessments, medication evaluation and stabilization before a coordinated return to an appropriate environment. We are a facility committed to excellence for the treatment of our patients. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + ACPE-accredited pharmacy degree + Active applicable state pharmacist license in good standing **Preferred Qualifications:** + PharmD + 1+ years of recent inpatient pharmacist experience + 1+ years of experience as a licensed pharmacist + Experience utilizing pyxis automated dispensing 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 $43.22 to $77.21 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _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._

This is an entry level position within the Account Analyst job family, with a goal of acquiring a basic understanding of risk evaluation on new and renewal business. This is a hybrid position. Candidates residing within 50 miles of Plano, TX; Boston, MA; Chicago, IL; Plymouth Meeting, PA and Suwanee, GA offices are required to report onsite twice a week. Please note that this is subject to change. 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 We can recommend jobs specifically for you! Click here to get started.

The Senior Underwriting (UW) Officer, Excess Casualty, will report to the Executive Underwriting Officer of Major Accounts Casualty. Major Accounts works with large and complex commercial risks to deliver Primary and Excess Casualty programs to these highly valued customers. You will focus on our Majors Excess Casualty portfolio, which services some of the largest companies in the U.S. The Senior Underwriting (UW) Officer, Excess Casualty, will work with the leadership team, deliver technical expertise, and serve as the point of contact for the frontline underwriting teams for all questions, key decisions, or referrals. The role will engage with various product sets in Umbrella, Excess, and Alternative Risk Transfer (ART). Responsibilities: Provides expert technical underwriting assistance and formal referral approval for assigned lines of business (lead umbrella/excess) in Majors Excess Casualty. Interacts independently with field underwriters and directly with UW managers on all mandatory referral cases and voluntary consultation items. Ensures continuity and alignment between Primary and Excess Casualty placements. Supports Executive Underwriting Officer on transactions and serves as trusted advisor in the areas of exposure, coverage analysis, and key pricing/financial elements within their authority. Monitors frameworks for underwriting decisions (e.g., referrals, technical reviews) and recommends improvements, as needed. Evaluates portfolio performance regularly in Majors Excess Casualty, working with Underwriting Leaders to identify drivers of performance, risks, and opportunities. Drives UW technical excellence across Majors Excess Casualty, working with Underwriting Leaders to identify and resolve issues. Works with Underwriting Leaders to identify product and services enhancements, underwriter capability development opportunities (e.g., skills, tools), and elevates to Executive Underwriting Officer and Majors CUO. Models effective collaboration within/across teams, stakeholders and partners (e.g., UW Support, Claims, Actuarial, NA Product Teams). Qualifications Preparation, Training & Experience Expert-level knowledge of all aspects of coverage forms, exclusions, and exposure. Experience underwriting Umbrella, Excess, and ART, including pricing, structure, rating plans, loss forecasting, credit risk, market knowledge. Advanced knowledge of and experience operating within several different industry segments; insurance operations; claims, finance and actuarial concepts; regulatory environment; loss control/risk engineering; reinsurance; account management; product development; and industry trends. Must be a skilled collaborator who is willing to assess all sides of an issue, bring in others with expertise, and independently execute and advance the collaboration model. Other professional skills required include superior communication skills (written, verbal, presentation, listening); approachability; tact; coaching/development; analyzing and problem solving; relationship and service driven; clear solutions orientation and commitment to achieving segment operational and financial objectives; negotiation skills; and demonstrated ability to consistently and positively influence others both internally and externally (brokers/customers) as required. Bachelor`s degree, 10 or more years of relevant experience that includes underwriting, claims, reinsurance, coaching/developing others, working with brokers/agents and currency with market trends and developments. About Us Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: *********************** Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices California Los Angeles Incorporated Los Angeles Unincorporated Philadelphia San Francisco We can recommend jobs specifically for you! Click here to get started.

**Become a part of our caring community and help us put health first** The Provider Analytics organization's vision is to improve member healthcare through innovative analytics and actionable insights, which empower members, and providers to drive higher quality, lower cost of care, and improved health outcomes. Provider Analytics develops and applies actionable analytics and insights, which are integral to business needs, to drive informed provider network strategy and is looking for an Informaticist 2 to join their team. The Informaticist 2: + Designs and constructs models to estimate impact of contractual changes tied to ancillary and industry leading innovative care delivery models + Collates, models, interprets and analyzes data in order to identify, explain, and influence variances and trends + Explains variances and trends and enhances modeling techniques + Utilizes multiple data sources such as SQL, Power BI, Excel, etc., to create advanced analytics to facilitate contracting initiatives + Uses a consultative approach to collaborate effectively with the markets, and other customers, building productive cross-functional relationships + Extracts historical data, performs data mining, develops insights to drive provider contracting strategy and reimbursement terms for National Ancillary Contracting + Develops tools and automates processes to model financial implications of ancillary contracted rate changes, including changes in capitated arrangements In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits + Health Savings Accounts + Flex Spending Accounts + Life Insurance + 401(k) + PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time + And more **Use your skills to make an impact** **Required Qualifications** + 3+ years of demonstrated healthcare analytical experience + 1+ years SQL experience + 1+ years' experience in data visualization (ie. Power BI, Tableau, etc.) + Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends + Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues + Possess a working knowledge and understand department, segment and organizational strategy **Preferred Qualifications** + Bachelor's Degree in analytics or related field + Advanced Degree + Understanding of healthcare membership, claims, and other data sources used to evaluate cost and other key financial and quality metrics **Additional Information** Work at Home/Remote Requirements **Work-At-Home Requirements** + To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate. + Wireless, Wired Cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.) + Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Our Hiring Process** As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging, and/or Video Interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone or computer. You should anticipate this interview to take approximately 10-15 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. \#LI-LM1 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. $73,400 - $100,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-21-2026 **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 ***************************************************************************

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. The Care Manager I - Specialty Programs is responsible for performing care coordination duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care for specialty populations. This position implements interventions to ensure efficient utilization of benefits. Job Responsibilities: Assess member's clinical need against establish guidelines and/or standards for specialty population-based members. Implement the delivery of high quality, cost-effective care based on a customized population model of care supported by clinical practice guidelines established by the plan. Partner with the member/family, physician, and all members of the healthcare team to ensure the member's needs are met, internal and external to this organization. Advocate for the member among various sites to coordinate resource utilization. Utilize the care management process to set priorities, plan, organize, and implement interventions that are goal directed toward self-care outcomes, and the transition to independent status. Ensure care for mandated non-compliant members through the monitoring of utilization. Document accurately and comprehensively based on the standards of practice and current organization policies. Evaluate care by problem solving, analyzing variances, and participating in quality improvement to enhance member outcomes. Monitor member's care activities, regardless of the site of service or network participation, and outcomes for appropriateness and effectiveness. Consult with internal stakeholders on complex cases and escalate as appropriate to internal physician resources. Complete other assigned functions as requested by management. Disclaimer: This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job. Education/Experience: Requires a license as an RN, or Bachelor degree in social work, health or behavioral science. Graduate level degree in Social Work or Health and Behavioral Science preferred. Requires a minimum of three (3) years' experience serving members with special needs. Knowledge: Requires strong knowledge of the standards of practice for case managers. Requires strong knowledge of managed care principles. Requires strong knowledge of specialty population, as applicable. Skills and Abilities: Requires strong organizational skills. Requires strong oral and written communication skills. Requires good PC skills and the ability to utilize Microsoft Office applications (Excel, Access, Word, etc.) Requires good problem solving and conflict resolution skills. Requires a car with valid New Jersey State License and Insurance for certain positions. Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware Salary Range: $70,500 - $94,395 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes: Comprehensive health benefits (Medical/Dental/Vision) Retirement Plans Generous PTO Incentive Plans Wellness Programs Paid Volunteer Time Off Tuition Reimbursement Disclaimer: This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job. Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.