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CorVel jobs in Columbia, SC

- 38 jobs
  • Medical Case Manager II

    Corvel Career Site 4.7company rating

    Corvel Career Site job in Columbia, SC

    CorVel Corporation is hiring a caring, self-motivated, energetic and independent registered nurse to fill a Medical Case Manager position in the Columbia, SC area. Work from home, and on the road. Monday - Friday, regular business hours. As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and their families. Your responsibilities include working closely with injured workers to facilitate their recovery. You will work collaboratively with the patient, their family, medical providers, members of our team, and others. This is a heavy local travel role responsible for working with a caseload of workers compensation injured workers within a defined jurisdiction. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provides in-person and telephonic Medical Case Management to individuals, involving the patient, physician, other health care providers, the employer, and the referral source Utilizes their medical and nursing knowledge to discuss the current treatment plan with the physician and discuss alternate treatment plans Provides assessment, planning, implementation, and evaluation of patient's progress Evaluates patient's treatment plan for appropriateness, medical necessity, and cost effectiveness Attends doctors, other providers, home and in some cases, attorney's visits Attends hospital and/or long-term facility discharge planning conferences, etc. for the purpose of determining appropriateness of care and developing an effective long-term care strategy Conducts home visit for initial evaluation Implements care such as negotiating the delivery of durable medical equipment and nursing services This role requires regular travel, dependent on the injured worker's injuries and needs. The employee must be available for local travel up to approximately 60% of the work week/month This role may require overnight travel Additional duties as required KNOWLEDGE & SKILLS: Effective communication and multi-tasking skills in a high-volume, fast-paced, team-oriented environment Ability to meet with the patient, their physicians, other healthcare providers, attorneys, advisors/clients, and coworkers A cost containment background, such as utilization review or managed care is helpful Strong interpersonal, time management, and organizational skills Computer proficiency and technical aptitude with the ability to utilize Microsoft Office, including Excel spreadsheets Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: Experience as an RN Medical Case Manager is ideal, or a clinical background in orthopedics, neurology, or rehabilitation is preferred Graduate of accredited school of nursing Current RN Licensure in state of operation Certification as a CCM, CIRS, or other Case Management certifications preferred A valid driver's license, reliable transportation, and ability to travel to assigned locations is required PAY RANGE: CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time. For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process. Pay Range: $65,436 - $98,982 A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first. ABOUT CORVEL - Medical Case Managers: CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!). A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off. In addition, Medical Case Managers are eligible for bonus and will be provided state-of-the-art technological devices to ensure ready access to CorVel's proprietary Case Management application, enabling staff to retrieve documents on the go and log activities as they occur. CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable. #LI-Remote
    $65.4k-99k yearly 4d ago
  • Center Administrator

    Humana Inc. 4.8company rating

    Columbia, SC job

    Become a part of our caring community and help us put health first The Center Administrator is a healthcare professional who leads the daily operations of our senior primary care centers and upholds our model of care that puts patients at the center of everything we do. The Center Administrator (CA) leverages strategic leadership to launch a new center or manage an existing center which has an established significant patient volume, revenue, and staff. Prioritizing team building, enhancing market presence, and developing comprehensive operational standards to ensure seamless operations, effective financial management, and high patient satisfaction. The CA develops and implements staffing plans, policies, and procedures, and collaborates with clinicians to achieve optimal patient outcomes and company initiatives, including Quality, HEDIS/STARs, AHCA, financial management, and employee and patient retention. Specific details may vary by market/center at the discretion of local leadership. KEY RESPONSIBILITIES Leadership & Operational/Organizational Management: * Oversee operations within a multi-physician office or clinical group, maintaining an owner-operator mindset and leading by example, while supervising and managing Medical Assistants (MA) and Front Office (FO) staff to promote a positive team culture, guide performance expectations, and manage daily schedules. * Ensure adherence to state and federal regulations. * Plan and execute staff meetings, demonstrating strong financial acumen and managing Profit & Loss (P&L) to connect strategy with business results. * Manage front-of-house and back-office operations, ensuring the center is clean, organized, and welcoming. * Manage center associates ensuring sufficient staff, onboarding new associates, including providers, and ongoing training and development * Conduct monthly meetings with Regional Associate Operations Director (AOD), Assistant Medical Directors (AMD), and providers. * Monitor and improve NPS Scores, providing explanations and conducting service recovery requests. * Foster effective collaboration and communication with colleagues, patients, and key stakeholders. * Provide assistance with administrative duties such as expense reporting, new provider hiring/onboarding, license/credentialing management, scheduling, etc. Clinical/Patient Management: * Commitment to creating patient-centric environments and fostering a culture of care and connection. * Deliver service excellence by prioritizing patient needs, ensuring high satisfaction, and including their perspectives in decision-making. * Address clinician performance issues and manage and resolve patient complaints, focusing on retention and acquisition. * Focus on patient outcomes and integrate Value-Based Care (VBC) principles into daily operations. * Conduct monthly safety audits, manage MSDS and OSHA concerns, and address clinic operation opportunities. * Collaborate with providers on patient terminations in compliance with regulations Dyad Partnership: * Collaborate with clinical dyad partners, meeting regularly to align on clinical and operational goals and building high-performing teams with clinical and operational staff. * Maintain regular communication to align on performance, strategies, and team management. * Ensure unified decision-making and consistent messaging for cohesive leadership. * Work together towards common goals that support the mission, vision, and values, along with overall patient experience outcomes. * Manage clinic/market dynamics and engagement interdependently. * Monitor and communicate incentive plans effectively. * Develop provider engagement strategy plan to mitigate turnover, improve provider satisfaction and burnout. Use your skills to make an impact Required Qualifications: * Must be able to work on-site at assigned Center(s). * 5+ years of operational leadership experience within a multi-physician office or clinical group, including front of house management and clinical operations, along with direct leadership experience and a demonstrated ability to lead, coach, and mentor teams. * Primary Care experience, full-risk VBC experience, understanding of state and federal healthcare regulations. * Experience with Electronic Medical Record (EMRs) or Health Information Management (HIMs) systems and knowledge of various software tools. * Proven interpersonal skills with the ability to interface effectively both internally and externally with a wide range of people including physicians, office staff, hospital executives, medical groups, IPA's, community organizations and other health plan staff. * Job is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. Candidates selected for this job will be required to be screened for TB. * Candidates selected for this job will be required to adhere to Humana's flu vaccine policy. * Current CPR certification Associates working in the State of Florida will need ACHA Level II Background clearance. Preferred Qualifications: * Bachelor's degree, preferably in Business Administration, Healthcare Administration, or a related field; or, in lieu of a bachelor's degree, 5+ years of Healthcare Administration/Leadership experience * Basic knowledge of Population Health Strategy * Familiarity with Medicare * Experience managing a budget of $500,000+ #LI-MD1 Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 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.
    $71.1k-97.8k yearly 56d ago
  • Sr. Program Delivery Professional IWHA-Interoperability

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Program Delivery Professional - IHWA Interoperability plays a key role in driving seamless data integration and collaboration within the In-Home Health and Wellbeing Assessment (IHWA) team and across interoperability initiatives. Serving as a business subject matter expert (SME), this individual partners closely with internal and external stakeholders, as well as the Interoperability team, to advance program objectives. Key responsibilities include collaborating with leaders on implementation planning, reviewing and communicating program results, and contributing to the ongoing improvement of processes and automation. The role also begins to influence departmental strategy and requires independent decision-making on moderately complex to complex technical matters related to project components. Work is performed without direct supervision, with considerable latitude in determining objectives and approaches to assignments. The ideal candidate demonstrates a collaborative approach, a strong interest in technology solutions, and a commitment to continuous process improvement. **Use your skills to make an impact** **Required Qualifications** + Minimum three, (3) years of IT project management or business process automation, experience in technology solutions. + Excellent communication skills, both oral and written + Proven experience in interoperability or data integration within a healthcare or technology setting. + Strong problem-solving skills with demonstrated success in process improvement initiatives and process automation. + Familiarity with various technology solutions and interest in exploring new innovations. + Excellent collaboration, and stakeholder management abilities. + Experience with managing and monitoring successful and impactful projects. + Self-starter with the ability to work independently and as part of a team. + Futuristic and broad thinker with attention to detail and downstream impacts. **Preferred Qualifications** + Bachelor's degree in Information Technology, Computer Science, Information Systems, or a related field. + Experience with EHR integration or usage. + Experience with AI integration. + Experience automating business processes. + PMP certification a plus + Knowledge and experience in health care environment/managed care + Strong analytical skills **Workstyle** : Open for Hybrid or Remote Work at Home **Location:** U.S. **Schedule:** 8:00 AM - 5:00 PM Eastern Time Monday through Friday **Travel:** occasional onsite as business needs require. **Work at Home Guidance** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **SSN Alert** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Interview Format** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $86,300 - $118,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-08-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $86.3k-118.7k yearly Easy Apply 4d ago
  • IHWA Data and Reporting Professional

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** The Data and Reporting Professional 2 generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The Data and Reporting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The In-Home Health and Wellbeing assessment team is seeking a Business Analyst who is adept in data analytics and possesses a keen eye for monitoring and troubleshooting KPIs. This role requires someone who can effectively perform ad-hoc analyses to support our business objectives. The ideal candidate will have insatiable curiosity and a strong aptitude for learning. **Key Responsibilities:** + Develop SQL queries for ad hoc data pulls, analysis, and identification of root cause + Utilize existing reports and dashboards to monitor and report out on key performance indicators (KPIs). + Conduct ad-hoc analyses to provide insights and support decision-making processes. + Collaborate with cross-functional teams to gather requirements and enhance reporting capabilities. + Refine business processes to improve efficiency and effectiveness. + This position will have a list of regular monthly and weekly to-do items on top of ad-hoc analysis requests and projects. **Use your skills to make an impact** **Required Qualifications** + Minimum one (1) year experience in a data and analytics-oriented role with monitoring of KPI's + In-depth experience in Microsoft Excel including formulas, pivots, charts, and graphs. + Strong analytical skills and attention to detail. + Excellent organizational skills. + Ability to read and understand raw data, reports and dashboards. + Excellent problem-solving abilities and a proactive approach to identifying and resolving issues. + Strategic thinker and skilled communicator. + Must be passionate about contributing to a team focused on continuous learning and improvement. + Ability to manage multiple projects simultaneously and meet deadlines. **Preferred Qualifications** + Bachelor's degree in business administration/information systems + Medicare Risk Adjustment background and knowledge. + 1 or more years of experience in SQL, databricks, or Power BI + Experience in designing, developing, and maintaining visually appealing reports and dashboards in Power Bi, Microsoft PowerPoint, or similar applications. + Automation experience. + Proficiency in understanding Healthcare related data. **Additional Information** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership. + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Workstyle** : Open for Hybrid or Remote Work at Home **Location:** U.S. **Schedule:** 8:00 AM - 5:00 PM Eastern Time Monday through Friday **Travel:** occasional onsite as business needs require. **Work at Home Guidance** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **SSN Alert** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Interview Format** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $60,800 - $82,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-08-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $60.8k-82.9k yearly Easy Apply 5d ago
  • National Dental Contracting Professional - Medicaid

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** The National Dental Contracting Professional - Medicaid is responsible for identifying, engaging, and contracting with qualified dentists to join the insurance carrier's Medicaid dental network. This role ensures the network meets accessibility, quality, and compliance standards as required by Medicaid regulations and company policies. The recruiter develops relationships with dental providers, manages the contracting process, and supports provider onboarding to enhance member access to dental care. Responsibilities of the National Dental Contracting Professional - Medicaid: + Proactively source and identify dentists and dental practices for participation in the Medicaid dental network. + Develop and implement outreach strategies to attract qualified dental providers, including cold calling, networking, and attending industry events. + Present the benefits of participating in the insurance carrier's Medicaid network and address questions or concerns from providers. + Facilitate the contracting process, including negotiating terms, collecting required documentation, and ensuring compliance with state and federal Medicaid guidelines. + Collaborate with internal teams (legal, credentialing, provider relations) to support a smooth onboarding experience for new providers. + Maintain accurate records of recruitment activities, contract status, and provider information in accordance with company and regulatory standards. + Monitor market trends and provider feedback to optimize recruitment efforts and network adequacy. + Participate in ongoing training related to Medicaid dental program requirements and provider network management. + Responsible for developing, coordinating, and delivering educational programs to dental providers participating in Medicaid. + Ensures providers understand Medicaid policies, compliance requirements, best practices, and program updates, thereby improving quality of care and adherence to regulatory standards. **Use your skills to make an impact** **Required Qualifications** + Minimum of 4 years of experience in dental provider Medicaid recruitment, provider service and retention. + Knowledge of Medicaid dental programs, provider contracting, fee negotiations, and regulatory compliance is highly desirable. + Excellent communication, public speaking and relationship-building skills. + Strong organizational and project management abilities. + Proficiency with Microsoft Office and salesforce platform. **Preferred Qualifications** + Bachelor's degree in business, healthcare administration, or related field preferred. **Additional Information** + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information 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. $65,000 - $88,600 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: 01-09-2026 **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 ***************************************************************************
    $65k-88.6k yearly 11d ago
  • Strategy Advancement Advisor - Distribution Strategy

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor works on problems of diverse scope and complexity ranging from moderate to substantial. **Become a part of our caring community and help us put health first** The Strategy Advisor (Distribution) provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for the Enterprise Growth vertical. The Strategy Advisor's work involves complex assignments performed without direction where the analysis of situations or data requires an in-depth evaluation of variable factors. This work may require leading end-to-end strategy engagements. As part of the Strategy Advancement team, this role will lead MarketPoint's strategic investment portfolio, responsible building a new intake, evaluation, and measurement process that spans across range of cross-functional initiatives. The role requires comfort with ambiguity and creating new solutions in the "white space" where answers are not clear cut or readily available. A successful candidate will be someone who has worked for several years in large matrixed organization (e.g. a publicly traded corporation or large not profit organization) or has several years' experience with stakeholder management (strategy/operations at a top-tier consulting/professional services firm). They will have a demonstrated ability to synthesize large amounts of information into clear and concise outputs (PPT, Excel, PowerBI). This person must be comfortable working collaboratively with senior leaders and subject matter experts alike and should have a high degree of executive presence leading engagements with these stakeholders. This person also will be effective at multitasking and possess keen program and change management skills to balance an evolving set of priorities and deadlines. Healthcare experience is a plus, but not required, though must have a history of mastering an understanding of their prior industry. Other examples of the kind of work required from this role include leading the analysis of complex business problems and issues using data from internal and external sources. The candidate should bring expertise or identify subject matter experts in support of multi-functional efforts to identify, interpret, and produce strategic recommendations and plans. The candidate's work will substantially shape the thinking of distribution org. They will exercise independent judgment and decision making on complex issues to determine the best course of action and work under minimal supervision. **Use your skills to make an impact** About the team: Humana's distribution organization, MarketPoint, plays a key part in driving Humana's long-term vision to achieve leading growth in Medicare and individual products. The MarketPoint strategy team was created to help transform Humana's customer acquisition approach. The team functions with a mandate to think creatively, discover new opportunities and re-envision operations to drive growth and deliver a first-class experience to our members and agents. **Responsibilities:** + Develops and leads MarketPoint's investment and strategic initiatives intake, evaluation, and measurement process + Tracks and reports out on investment and initiative performance on a regular basis, partnering closely with analytics, finance, operations, to refine analyses + Develops high-quality analysis and deliverables that clearly frame organizational objectives, issues/challenges, and articulate compelling, insightful findings, value, and recommendations for senior leadership + Lead key portions of presentations at high-visibility meetings, including developing new meeting cadence with senior leadership to review portfolio performance + Assist MarketPoint leadership in communicating value and impact of MarketPoint initiatives to broader Humana organization + Coach junior team members to develop technical and professional skillsets **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + 3+ years of experience in strategy consulting, investment banking, corporate/business unit strategy, or finance + 2+ years of project/program leadership experience + Demonstrated ability for bringing structure to ambiguity / working in 'white space' to independently manage strategy engagements end-to-end from conception to final deliverables + Strong problem-solving skills and the ability to perform complex qualitative / quantitative analysis and modeling + Excellent verbal and written communication including familiarity with slide design and storytelling with data + Highly collaborative, flexible, takes coaching, team-oriented working style; builds social capital easily + Ability to quickly build and maintain trust with both senior business leaders and subject matter experts + Ability to operate in a fast-paced environment under tight deadlines + Demonstrated commitment to personal and professional growth **Preferred Qualifications** + Healthcare industry experience, preferably in the managed care or provider sector + MBA, MA/MS, PhD, or graduate degree in a management field, with outstanding academic credentials + Track record of setting and exceeding performance metrics, with a focus on delivering tangible and measurable results **Additional Information** **- Position does have the potential for up to 5% travel.** **- Position will be working Eastern (EST) hours.** **Virtual Pre-Screen** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a HireVue interview. In this interview, you will listen to a set of interview questions over your phone or text and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Work-At-Home Requirements** At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $115,200 - $158,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-27-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $115.2k-158.4k yearly Easy Apply 12d ago
  • Actuarial Principal - Financial Planning and Analysis

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** Join Humana's Financial Planning & Analysis team, part of the CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial strategy and analysis, with connections to enterprise-wide and total Insurance perspectives. The Actuarial Analytics/Forecasting Principal role offers flexibility in responsibilities, significant exposure to senior leadership, and strong potential for upward mobility. We seek candidates who are willing to think creatively, challenge assumptions, voice opinions on key drivers and ranges, and contribute to a culture of continuous improvement and healthy debate. The Actuarial Analytics/Forecasting Principal analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium, and long-term financial and competitive position. The Actuarial Analytics/Forecasting Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. The Actuarial Analytics/Forecasting Principal ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost-effective resolutions for data anomalies. Works with senior executives to develop and drive segment or enterprise-wide functional strategies. Advises one or more areas, programs, or functions and provides recommendations to senior executives on matters of significance, and as an advanced subject matter expert competent to work at very high levels in multiple knowledge and functional areas across the enterprise. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree, in some instances a Master's or Doctorate's degree + 10 or more years of technical experience + 2-5 years of project/people leadership + FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations + MAAA + Strong communication skills + Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending) + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Medicare Advantage pricing and forecasting experience + Experience working with aggregate financials across insurance products or enterprise-level financial planning + Demonstrated ability to challenge existing assumptions and propose creative solutions **Additional Information** Humana is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, or veteran status. For more information on Humana careers, please visit Humana Careers (******************************* . Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $156,600 - $215,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-30-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $156.6k-215.4k yearly 14d ago
  • RN Clinical Manager, Home Health

    Humana Inc. 4.8company rating

    Newberry, SC job

    Become a part of our caring community and help us put health first The Clinical Manager coordinates and oversees all direct care patient services provided by clinical personnel. * Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. * Conducts/delegates the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies. * Manages the assignment of caregivers. * Responsible for and oversees the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case, including disciplines required, to determine home health or hospice needs. Accountable to ensure patients meet admission criteria and make the decision to admit patients to service. Assigns appropriate clinicians to a case, as needed. * Instructs and guides clinicians to promote more effective performance and delivery of quality home care services, and is available at all times during operating hours to assist clinicians as appropriate. * Assists clinicians in establishing immediate and long-term therapeutic goals, in setting priorities, and in developing patient Plan of Care (POC). * Monitors cases to ensure documentation is in compliance with regulatory agencies and requirements of third-party payers. Ensures final audits/billing are completed timely and in compliance with Medicare regulations. * Coordinates communication between team members/attending physicians/caregivers to ensure the appropriateness of care and outcome planning. * Works in conjunction with the Branch Director and Company Finance Department to establish location's revenue and budget goals. * Participates in sales and marketing initiatives. * Supervises all clinical employees assigned to a specific location. Responsible for the overall direction, coordination, and evaluation of the location. Carries out supervisory responsibilities in accordance with Company policies and procedures. * Handles necessary employee corrective action and discipline issues fairly and objectively, in consultation with the Human Resources Department and the Executive Director/Director of Operations. * Participates in the interviewing, hiring, training, and development of direct care clinicians. Evaluates their performance relative to job goals and requirements. Coaches staff and recommends in-service education programs, when needed. Ensures adherence to internal policies and standards. * Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts regular staff education as needed. * Analyzes situations, identifies problems, identifies and evaluates alternative courses of action through the utilization of Performance Improvement principles. * Responsible for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, for appropriateness of care, delivery, and documentation requirements. * Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. Competently performs patient care assignments and staff management activities. * Provides direct patient care on an infrequent basis and only in times of emergency. * Acts as Branch Director in his/her absence. * Interprets Company standards and Company policies and procedures to ensure compliance with external regulatory authorities and ensures that caregiver clinical documentation meets internal standards. * Participates in performance improvement activities, maintains ongoing clinical knowledge through internal and external training programs. Provides interpretation of knowledge and direction to staff. * Maintains relationships with referral/community sources. Participates in professional organizations and conducts care-related programs. * Performs other related duties as assigned or requested. Use your skills to make an impact Required Experience/Skills: * Graduate of an accredited School of Nursing. * Current state license as a Registered Nurse. * Proof of current CPR. * Valid driver's license, auto insurance and reliable transportation. * Two years' experience as a Registered Nurse * Home Health experience required * Management experience preferred Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $77,200 - $106,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 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.
    $77.2k-106.2k yearly 41d ago
  • Senior Accountant - Tax Accounting

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** The Senior Tax Accountant analyzes and interprets tax laws, regulations, GAAP, and Statutory tax accounting principles, and prepare technical reports on how they impact the organization's operations. The Senior Tax Accountant work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Tax Accountant focuses on Federal and State Income, GAAP and Statutory Tax Accounting, Sales and Use, Property and Premium taxes. Maintains tax information and records, prepares tax returns and other required reports, and pay tax declarations so that compliance obligations are submitted accurately and on time. Prepares correspondence with external tax agencies (for example, auditors). 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: in accounting/finance + 4+ years of relevant tax experience + Experience with predicting liabilities for Federal and/or State tax + Excellent written and verbal communication skills + Strong organization skills - able to manage tax processes, develop work plans, meet deadlines and coordinate with others + Experience with computerized tax software and research programs + Knowledge of federal and state tax law and current developments + Strong Excel proficiency **Preferred Qualifications** + Certified Public Accountant + Master's Degree in Business Administration or a related field + GAAP ASC 740 tax accounting experience or knowledge + Statutory SSAP 101 tax accounting experience or knowledge + Good working knowledge of OneSource Tax Provision software **Additional Informa** **tion** Preferred location is Louisville office/hybrid but would consider remote depending on skills/quals in Eastern or Central time zones. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $86,300 - $118,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-08-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $86.3k-118.7k yearly 60d ago
  • Senior Product Owner

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** The Senior Product Owner is responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog. The Senior Product Owner work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Product Owner maximizes value of product created by Agile team. Liaises with stakeholders and the development team ensuring the right product is being built, in the right order, within budget and by the deadline. Serves as the Agile team's primary contact for information, work prioritization, and decision-making. 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. + Communicate the **product vision and goals** aligned with business strategy. + Own and manage the **product (team) backlog** , ensuring it is prioritized based on business value. + Write clear and actionable **user stories, acceptance criteria, and requirements** . + Collaborate with **stakeholders** (business, IT, UX, operations) to gather and refine requirements. + Serve as the **primary liaison** between business stakeholders and development teams aligned at team layer. + Make **scope and priority decisions** to maximize value delivery within constraints. + Ensure the team understands **business context and customer needs** . + Participate in **sprint planning, backlog refinement, and daily stand-ups** . + Accept or reject completed work based on **definition of done** and quality standards. + Monitor and report on **progress, risks, and dependencies** to stakeholders. + Drive **continuous improvement** in product development processes. + Align product features with **regulatory, security, and compliance requirements** . + Track and analyze **product performance metrics** to inform future decisions. + Support **release planning and go-to-market activities** in collaboration with Product Management. + Manage **stakeholder expectations** and communicate changes effectively. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree or equivalent and 5+ years of technical experience + Scaled Agile Framework (SAFe) familiarity and certifications + Scrum and Kanban framework + Lean portfolio management Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $94,900 - $130,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-08-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $94.9k-130.5k yearly 5d ago
  • Licensed Practical Nurse, Home Health

    Humana Inc. 4.8company rating

    Columbia, SC job

    Become a part of our caring community and help us put health first Make a meaningful impact every day as a CenterWell Home Health nurse. You'll provide personalized, one-on-one care that helps patients regain independence in the comfort of their homes. Working closely with a dedicated team of physicians and clinicians, you'll develop and manage care plans that support recovery and help patients get back to the life they love. As a Home Health LPN, you will: * Provide professional nursing services under the direction of a RN in compliance with the state's Nurse Practice Act, any applicable licensure/certification requirement, applicable healthcare standards, governmental laws and regulations, and CenterWell Home Health policies and procedures. * Provide skilled nursing interventions in the treatment of the patient/clients illness, rehabilitative needs and preventative care. Utilize a holistic approach in the provision of problem specific therapeutic interventions, teaching and training activities in accordance with the plan of care. * Apply knowledge and skills in accordance with accepted standards of clinical practice to facilitate problem resolution and achieve individualized patient goals and outcomes. * Confer with the RN Supervisor regarding needed changes in the Plan of Treatment. Accept verbal orders from physician were permitted by state law/regulations/Nurse Practice Act and communicate these orders to the RN Supervisor. * Utilize a systematic, individualized goal/outcome driven approach in implementing the nursing plan of care. * Maintain contact with patients, physicians, clinical manager(s), other members of the healthcare team in a timely manner regarding patient/family needs and status changes. Participate in care coordination activities and discharge planning as appropriate. * Maintain the highest standards of professional conduct in relation to information that is confidential in nature. Share information only when the recipient's right to access is clearly established and the sharing of such information is dearly in the best interests of the patient. * Appropriately communicate to ensure adherence to professional standards in the provision of and availability of supplies, materials and equipment needed to safely and effectively implement the plan of care. * Prepare, submit and maintain documentation as required by the Company and/or facility. Visit/shift notes documented on day services are rendered. Use your skills to make an impact Required Experience/Skills: * Graduate of an accredited Licensed Practical Nursing Program or accredited School of Vocational Nursing. * Current nursing license in the practicing state. * Valid drivers license, auto insurance and reliable transportation. * Current CPR certification. * Two years experience as an LPN/LVN in a clinical setting, preferably in a home health or hospice setting. Pay Range * $28.00 - $40.00 - pay per visit/unit * $44,600 - $61,400 per year base pay Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,000 - $73,000 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 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.
    $53k-73k yearly 60d+ ago
  • Lead Citrix Systems Engineer - Network/Virtualization

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** The Lead Systems Engineer is responsible for design, analysis, configuration and maintenance of complex systems software solutions in a virtual environment, based on a thorough knowledge of systems engineering and programming concepts and techniques. Systems software engineering/programming is a specialized area of software engineering/programming focused on software that operates/controls computer hardware and provides a platform for running end user applications. Includes operating systems, device drivers, utilities, and software; development tools (e.g., assemblers, compilers, etc.). The Lead Systems Engineer works on problems of diverse scope and complexity ranging from moderate to substantial. + The Lead Virtualization Engineer is responsible for architecting, implementing, and maintaining enterprise-grade virtual environments that support the organization's critical applications and services. This role requires broad expertise in virtualization technologies, including but not limited to desktop and application virtualization, server virtualization, cloud-based virtual infrastructure, and remote access solutions. The Lead Engineer will guide technical teams, ensure optimal performance, security, and scalability of all virtualized resources. **Key Responsibilities:** + Design, deploy, and manage complex virtual environments using industry-leading platforms (e.g., VMware, Hyper-V, Citrix, Microsoft Azure Virtual Desktop, and others). + Oversee the lifecycle management of virtual systems, including provisioning, patching, upgrading, and decommissioning. + Develop and maintain technical standards, procedures, and best practices for virtual infrastructure and remote access solutions. + Collaborate with cross-functional teams to assess business requirements and deliver scalable, secure, and resilient virtual solutions. + Lead troubleshooting and incident resolution efforts for virtual platforms, ensuring minimal disruption to business operations. + Conduct capacity planning, performance analysis, and optimization of virtual resources. + Mentor junior engineers and serve as a subject matter expert on virtualization technologies. + Ensure compliance with relevant security policies, regulatory requirements, and audit controls. + Research emerging trends and recommend adoption of new technologies to improve operational efficiency. **Use your skills to make an impact** **Required Qualifications** + **Our Department of Defense contract requires U.S. citizenship for this position.** + **Successfully receive approval for government security clearance (eQIP - electronic questionnaire for investigation processing). Employment with Humana Government Business is contingent upon your having access to government information and systems** + 7+ years of hands-on experience in virtualization engineering and infrastructure management. + Strong expertise in enterprise virtualization technologies (e.g., VMware vSphere/ESXi, Microsoft Hyper-V, Citrix Virtual Apps and Desktops, cloud virtualization platforms). + Solid understanding of networking, storage, and security concepts in virtual environments. + Excellent problem-solving, communication, and documentation skills. + Experience with Citrix NetScaler in the Gateway configuration and load balancing. **Preferred Qualifications:** + Bachelor's degree in Computer Science, Information Technology, or related field; + Relevant certifications such as VCP, CCA, MCSE, or equivalent. + Experience with hybrid cloud or multi-cloud virtual infrastructure. + Familiarity with DevOps practices and Infrastructure as Code (IaC). + Proficiency with scripting and automation tools (e.g., PowerShell, Python, or similar). **Additional Information** This role will also provide support for Humana Government Business and will require a clear background investigation performed by the Defense Counterintelligence and Security Agency. Location/Work Style: Remote US. Must be able to work Eastern Standard Time (EST) hours beginning at 9:00 A.M. EST. **Why Humana** Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: + Health benefits effective day 1 + Paid time off, holidays, volunteer time and jury duty pay + 401(k) retirement savings plan with employer match once eligible + Tuition assistance + Scholarships for eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Social Security Task** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **_*This is a remote position._** **_**Must be able to work EST hours._** \#LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $117,600 - $161,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-25-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $117.6k-161.7k yearly Easy Apply 12d ago
  • Medical Assistant Float

    Humana Inc. 4.8company rating

    Columbia, SC job

    Become a part of our caring community and help us put health first The Medical Assistant is the first point of contact for patient care. Responsible for administrative duties in addition to patient care. The Medical Assistant performs varied activities and moderately complex administrative, operational, and customer support assignments. Typically works on semi-routine assignments. This is a FLOAT position and will require you to work between offices as business needs require in the Columbia area. Mileage will be reimbursed for travel between clinics. The Medical Assistant performs clinical duties such as discussing symptoms, obtaining vital signs, medication/vaccine administration, phlebotomy, collecting specimens, performing diagnostic screening tests, sterilizing/cleaning equipment, maintaining examination rooms, and documenting information into the electronic medical records system. Collaborates closely with Physicians and Advanced Practice Providers. Delivers direct patient care dependent on what active certification allows. Decisions typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has latitude over prioritization/timing, and works under minimal direction. Follows standard policies and procedures that allow opportunity for interpretation/deviation and/or independent discretion. Use your skills to make an impact Required * Successful completion of MA school/training program or a Certified/Registered Medical Assistant or 5+ years of experience and approval from Provider * High school diploma or equivalent * CPR Certified * This role is considered patient facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB Preferred * Certified or Registered - (Arizona, Indiana, & South Carolina candidates require Medical Assistant Certification or Registration) * Phlebotomy experience• Medication/vaccine administration experience * 1+ years MA experience * Value Based Care experience including knowledge of HEDIS, CPT/ICD coding, and CAHPS/HOS Patient Experience. * Bilingual proficiency in English and Spanish - must pass proficiency exam prior to foreign language communication 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. $40,000 - $52,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 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.
    $40k-52.3k yearly 60d+ ago
  • Associate Director, Cloud Solutions Engineering

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** The Associate Director of Cloud Infrastructure Operations is responsible for leading Humana's enterprise cloud strategy-focused on the design, implementation, and optimization of cloud compliance, operational excellence, and cost efficiency in a complex multi-cloud environment. This position serves as a strategic advisor and operational leader, collaborating with Application and Product Teams, Cloud Engineering, FinOps, Finance, Legal and Supply Management Services to ensure secure, efficient, and scalable cloud operations. This position offers a unique opportunity to lead Humana's transformation at the intersection of operations, technology, and AI innovation. The Associate Director of Cloud Infrastructure Operations will drive the evolution of Humana's intelligent infrastructure-enhancing system reliability, security, and compliance while enabling the business to deliver exceptional, patient-centered care. This leader will also drive the integration of Artificial Intelligence (AI) and Generative AI (GenAI) capabilities into Humana's Infrastructure Operations, blending traditional IT management with next-generation, AI-driven automation and predictive analytics. The role serves as a bridge between operations and innovation-advancing digital transformation, improving system reliability, and ensuring compliance with healthcare regulations such as HIPAA and PHI. **Key Responsibilities:** + Provide senior-level leadership and decision-making in developing Humana's overall cloud operations strategy, governance framework, and optimization initiatives. + Establish short-, mid-, and long-term roadmaps for Cloud Production Operations aligned with Humana's enterprise and digital transformation goals. + Oversee operational planning, staffing, and budget management across multi-cloud environments (Azure, GCP, AWS). + Partner with internal stakeholders and Managed Service Providers (MSPs) to ensure operational excellence, service continuity, and adherence to SLAs. + Define and implement ITIL/ITSM frameworks for Incident, Problem, Change, Event, Access, and Knowledge Management, promoting continuous improvement. + Foster collaboration across Humana's technology ecosystem to align cloud operations with business priorities and compliance standards. + Lead and mature the Incident and Problem Management functions to minimize Mean Time to Detect (MTTD) and Mean Time to Resolve (MTTR). + Drive proactive monitoring and operational readiness through the implementation of automated tools and event correlation systems. + Ensure 24/7 operational uptime of mission-critical systems by guiding operational teams, defining SLAs, and improving incident response capabilities. + Lead the MSP teams responsible for daily cloud operations and infrastructure support across Azure, GCP, and AWS. + Partner with Engineering and DevOps teams to integrate CI/CD, automated deployment, and self-healing systems into the operational model. + Maintain operational compliance with security, privacy, and regulatory requirements in healthcare environments. + Develop and execute strategies for cloud compliance, reporting, and cost optimization across all environments. + Deliver tooling, metrics, and dashboards to automate cloud financial management, consumption tracking, and operational reporting. + Partner with FinOps and Finance to provide chargeback, showback, budgeting, and forecasting capabilities, driving financial transparency and accountability. + Identify and standardize processes suitable for automation; collaborate with platform engineering teams to implement solutions that enhance efficiency and reliability. + Drive continuous improvement initiatives that reduce total cost of ownership and improve operational consistency across vendors and service providers. + Maintain relationships with key partners and service providers to identify and implement continuous improvement opportunities in operational performance and cost savings. + Lead research, evaluation, and deployment of AI and GenAI technologies within Humana's Infrastructure Operations. + Explore and prototype AI-driven solutions that automate incident response, predict failures, summarize telemetry data, and assist operations teams through intelligent copilots. + Develop and lead the AI adoption roadmap, integrating predictive analytics, LLMs, and self-healing capabilities into the infrastructure ecosystem. + Integrate AI/ML models into monitoring platforms to enable proactive, data-driven decision-making. + Lead R&D efforts for AI-assisted infrastructure automation, anomaly detection, and capacity forecasting, aligning innovation with operational goals. + Design and maintain automated systems to collect and analyze usage, forecast, and cost data across cloud platforms. + Provide visibility into key performance metrics (SLAs, KPIs, utilization, consumption) that inform operational and strategic decision-making. + Develop and deliver executive-level reports and insights, highlighting operational efficiency, performance trends, and risk indicators. + Identify and address operational gaps by analyzing trends, patterns, and outliers in infrastructure and application performance data. + Create and maintain comprehensive operational documentation, including playbooks, dashboards, and analytical summaries. **Use your skills to make an impact** **Required Qualifications:** + Bachelor's or Master's degree in Computer Science, Healthcare Informatics or a related field. + 10+ years of experience in infrastructure operations or engineering, including 2+ years of leadership in AI/ML or GenAI R&D. + Proven record managing NOC or Command Center teams with responsibility for 24/7 availability and mission-critical systems. + Advanced knowledge of public cloud platforms (Azure, GCP, AWS) and hybrid infrastructure architectures. + Expertise in cloud observability, monitoring, and incident response tools and practices. + Hands-on experience with automation and scripting tools (Terraform, Ansible, PowerShell, Python, Bash, or similar). + Proficiency in cloud cost management tools (Cloudability, Azure Pricing Calculator, AWS Cost Explorer, Power BI). + Strong understanding of ITIL/ITSM principles and practical experience applying them in complex enterprise environments. + Excellent analytical, organizational, and communication skills, with the ability to engage and influence at all levels. + Ability to operate in a lean, agile, and fast-paced organization while balancing long-term strategic goals. + Availability to support off-hours operations as required in a 24/7 enterprise setting. **Preferred Qualifications:** + Advanced understanding of cloud platforms, consoles, and services (Azure, Google and AWS). + Deep understanding of the key concepts and practices of cloud observability, coupled with experience implementing robust systems that leverage metrics, logs, and traces to provide holistic state of the cloud operations. + A technical business acumen that ensures the organization is operating efficiently and effectively in a hybrid cloud environment. + Solid understanding of infrastructure and operation landscape with a focus on public cloud (Azure, GCP and AWS) technology and how it differs from traditional computing. + Ability to work with minimal supervision, making decisions based upon priorities, schedules and an understanding of business initiatives. + Passion for and skills in resource optimization to improve cloud efficiency. + Ability to apply critical thinking to all aspects of the position. + Detail oriented with excellent documentation skills/methodologies, who is able to successfully manage multiple priorities. + Proficiency in developing repeatable and efficient automation to codify and simplify end-to-end processes and methods in public and private cloud landscapes. + You have a deep understanding how to apply best practices around monitoring, alerting, and logging, and have implementation experience with one or more monitoring, alerting, and logging systems (Azure Monitor, Log Analytics, Splunk, Dynatrace, SentryOne, etc...). + Deep understanding of core public & private cloud billing, cost management, and data visualization tools (e.g. Cloudability, Azure Pricing Calculator, AWS Cost Explorer). + Senior experience in Ansible, API queries, and Power BI is a plus. + Knowledge scripting using Python, as well as Perl, PowerShell, JavaScript, or similar scripting languages. + Strong analytical and reporting skills. + Leader and a team player with transformation mindset. + Strong organizational, task, and project management skills. + Self-driven and able to work across diverse technical and non-technical teams. + Strong written, verbal and interpersonal communication skills. + Ability to operate successfully in a lean, agile, and fast-paced organization. + Ability to communicate at all levels within an organization and influence leadership. + Azure and/or AWS certifications preferred **Additional Information** **Work-At-Home Requirements** + WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. + A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information \#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. $156,600 - $215,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-20-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $156.6k-215.4k yearly 12d ago
  • SNF Utilization Management RN - Compact Rqd

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **Use your skills to make an impact** **Use your skills to make an impact** **Required Qualifications** + ** Licensed Registered Nurse (RN)** in the (appropriate state) with no disciplinary action. + **MUST have Compact License** + Greater than one year of clinical experience in a RN role in acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc. + Comprehensive knowledge of Microsoft Word, Outlook and Excel + Ability to work independently under general instructions and with a team + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Education: BSN or Bachelor's degree in a related field + Three or more years of clinical experience in an acute care setting with preference for specialty areas such as critical care, emergency room, trauma units, etc. + Experience as an MDS Coordinator or discharge planner in an acute care setting + Previous experience in utilization management/utilization review for a health plan or acute care setting + Compact license PLUS a single state RN Licensure in any of the following non-compact states: California, Hawaii, Nevada, Oregon + Health Plan experience + Previous Medicare/Medicaid Experience a plus + Call center or triage experience + Bilingual is a plus **Additional Information** + Scheduled Weekly Hours: 40 + Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Work-At-Home Requirements** + Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). + A minimum standard speed for optimal performance is 25mbs download x 10mbs upload is required. + Check your internet speed at ***************** + A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $71.1k-97.8k yearly 60d+ ago
  • Associate Medical Director

    Humana Inc. 4.8company rating

    Columbia, SC job

    Become a part of our caring community and help us put health first The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care (VBC) principles. This market/center-specific role requires flexibility to adapt responsibilities as needed and demands a unique blend of clinical management, financial/business acumen, and strategic partnership to optimize patient care and business outcomes. KEY RESPONSIBILITIES Leadership & Organizational Management: * Understand organizational & market priorities, trends, and goals, to develop a clinical strategy to advance clinical talent and performance * Interview, hire, and supervise clinical teams to staff and develop a high-quality clinical team with strong engagement, patient-first culture, and talent retention * Closely engage and communicate with clinicians and care teams, conducting weekly onsite center visits, holding regular individual 1:1s and clinician pod meetings, and actively participating in monthly leadership meetings * Deeply understand, support, and improve primary care clinician performance through understanding of individual & care team context, effective use of data, and effective coaching of clinicians and care teams * Engage in regular market performance (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical initiatives * Champion our senior-focused primary care strategic vision and initiatives and foster stakeholder relationships, including health plan partners, healthcare providers (e.g. specialists, hospitals) and social services, to improve our community of care locally * Represent CenterWell/Conviva brands in local communities and related media activities while collaborating with the recruitment team to build and network a pipeline of high-quality primary care clinicians (physicians, APPs, MAs, and other clinical professionals) * Utilize clinical performance dashboards and data tools to support stack ranking, performance analysis, and targeted strategy development * Foster a culture of continuous learning and professional growth among clinical teams Clinical/Patient Management: * Foster a robust patient-centered and value-based clinical vision, strategy, and culture locally that orients care teams around excellence in patient care, teamwork, outcomes * Deliver leading clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization * Periodically review clinician charts to identify opportunities in care, ensuring clinical assessments are accurate and that performance improvement and coaching initiatives are precise * Identify critical issues for high-risk patients during case reviews & other forums, and model and drive clinical excellence * Conduct root cause analysis of care opportunities from both individual, team, and systems perspectives and partner with clinical and operational colleagues to improve high-reliability care as a team * Ensure clinicians effectively co-manage high-risk episodes of care and patients with partnered Care Integration Team (CIT) resources and programs for transitions of care management (TCM), high-risk patient management (HRPM), and social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization * Monitor and manage daily patient care and initiatives to improve team-based key performance indicators (KPIs), such as patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals * Personally deliver high-quality primary care and demonstrate a high degree of patient care ownership and clinical excellence in age-friendly senior primary care including health promotion & prevention, disease management, effective specialist & hospital co-management, and complex care management * Spend 20-50% of time on direct patient care, with remaining time dedicated to administrative responsibilities. The percentage of time may vary by market needs and by staffing levels throughout the year * Support clinical quality performance improvement in areas such as MRA, Stars, and prevention of unnecessary utilization through provider education and coaching * Promote team-based care delivery and foster collaboration across interdisciplinary teams Dyad Partnership: * Collaborate with operational leaders (Associate Operations Director and/or Market President) and Shared Services partners to align on clinical and operational goals, strategic planning, and budgeting * Maintain regular communication to align on performance, strategies, and team communication and management, ensuring unified decision-making and consistent messaging for cohesive leadership * Work together towards common goals that support the mission, vision, values, and overall patient experience outcomes, managing clinic/market dynamics and engagement * Partner on strategic and operational insights, including capital and operational budgeting, and monitor clinical & financial performance and metrics * Review clinician schedules and incentive plans to align with patient care access and management goals Use your skills to make an impact Required Qualifications: * Graduate of an accredited medical school (MD/DO) with a current medical license, maintaining licensure requirements of the state of jurisdiction * Board Certification in Family Medicine, Internal Medicine or Geriatric Medicine * Minimum five years of experience in outpatient practice, with clinical experience in primary care, senior health, and value-based care (VBC) * Minimum three years of experience successfully leading clinicians in a leadership role with demonstrated impact on clinician talent, culture, and performance, and effective partnership with operations and supporting teams * Skilled in use of clinical technology platforms and resources, such as EMR systems (e.g. athenahealth, Epic, eClinicalWorks), voice documentation tools (e.g. Dragon, Abridge), and clinical evidence & pathway resources (e.g. UpToDate) * This role is considered patient-facing and is part of CenterWell's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB * Candidates selected for this job will be required to adhere to Humana's flu vaccine policy Additional Information Social Security Task Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. #LI-CB2 #physiciancareers 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. $246,100 - $344,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 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.
    $246.1k-344.2k yearly Easy Apply 60d+ ago
  • Senior Manager, MarketPoint Sales - Raleigh Durham, NC.

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact your own income potential? If so, we are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate beneficiaries on our services in a field setting. Our teams also sell Life, Annuity, Indemnity, Dental, Vision, Prescription plans, and more. Humana has an inclusive and diverse culture welcoming candidates with multilingual skill sets to service our consumers. **This role is** **field** **based, and you will be out and about in the field in the Raleigh** **Durham, NC.** **area working with your team and meeting members face to face. You must reside in Raleigh** **Durham, NC.** **area or be willing to relocate to the area.** In this **field** position, you will; coach, mentor, educate, motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a solid understanding of the market they serve, how to resolve operational problems and provide creative solutions to increase sales while following CMS guidelines. This role also involves cultivating, maintaining, and building relationships with Humana's customers, both internal and external business partners, along with the community we serve through telephonic, virtual, and face-to-face interactions with individuals and groups. Other responsibilities include developing marketing budgets, and looking for branding opportunities. **Use your skills to make an impact** **Required Qualifications** + **Must reside in the** **Raleigh** **Durham, NC.** **area or be willing to relocate** + **Active Health & Life Insurance Licenses** + 2 or more years of sales leadership experience + 6 or more years of experience working in the insurance industry + Must be able to travel up to 50% of the time + Ability to lead a team of sales associates and train them in successful sales techniques, educational presentation skills, utilizing technology tools as well as building relationships with communities and medical providers + Strong aptitude for technology with proficiency in MS Office products, various CRM platforms, and various iPhone app capabilities + Must be a strong leader, strong producer + Strong organizational, interpersonal, communication and presentation skills + Ability to adapt and overcome when necessary + Community Engagement/Grassroots experience in marketing Medicare plans in the community + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits **Preferred Qualifications** + Bachelor's Degree + Prior experience working in Medicare and the health solutions industry + Engaged with the community through service, organizations, activities and volunteerism + Project management background or certification a plus + Bilingual with the ability to speak, read and write without limitations or assistance **Humana Perks:** Full time associates enjoy: + Base salary with a competitive commission structure + Medical, Dental, Vision and a variety of other supplemental insurances + Paid time off (PTO) & Paid Holidays + 401(k) retirement savings plan + Tuition reimbursement and/or scholarships for qualifying dependent children. + And much more! **Social Security Task:** Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. **Virtual Pre-Screen:** As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a HireVue interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes. \#MedicareSalesManager \#MedicareSalesReps Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $77,000 - $105,100 per year This job is eligible for a commission incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-30-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $77k-105.1k yearly Easy Apply 15d ago
  • National Dental Contracting Professional - Medicaid - VSP

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** The National Dental Contracting Professional - Medicaid is responsible for identifying, engaging, and contracting with qualified dentists to join the insurance carrier's Medicaid dental network. This role ensures the network meets accessibility, quality, and compliance standards as required by Medicaid regulations and company policies. The recruiter develops relationships with dental providers, manages the contracting process, and supports provider onboarding to enhance member access to dental care. Responsibilities of the National Dental Contracting Professional - Medicaid: + Proactively source and identify dentists and dental practices for participation in the Medicaid dental network. + Develop and implement outreach strategies to attract qualified dental providers, including cold calling, networking, and attending industry events. + Present the benefits of participating in the insurance carrier's Medicaid network and address questions or concerns from providers. + Facilitate the contracting process, including negotiating terms, collecting required documentation, and ensuring compliance with state and federal Medicaid guidelines. + Collaborate with internal teams (legal, credentialing, provider relations) to support a smooth onboarding experience for new providers. + Maintain accurate records of recruitment activities, contract status, and provider information in accordance with company and regulatory standards. + Monitor market trends and provider feedback to optimize recruitment efforts and network adequacy. + Participate in ongoing training related to Medicaid dental program requirements and provider network management. + Responsible for developing, coordinating, and delivering educational programs to dental providers participating in Medicaid. + Ensures providers understand Medicaid policies, compliance requirements, best practices, and program updates, thereby improving quality of care and adherence to regulatory standards. **This role is Variable Staffing Pool( VSP), Variable Staffing Pool Humana associates work specific hours to meet business needs on a limited term basis.** **Use your skills to make an impact** **Required Qualifications** + Minimum of 4 years of experience in dental provider Medicaid recruitment, provider service and retention. + Knowledge of Medicaid dental programs, provider contracting, fee negotiations, and regulatory compliance is highly desirable. + Excellent communication, public speaking and relationship-building skills. + Strong organizational and project management abilities. + Proficiency with Microsoft Office and salesforce platform. **Preferred Qualifications** + Bachelor's degree in business, healthcare administration, or related field preferred. **Additional Information** + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 1 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $65,000 - $88,600 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. Application Deadline: 01-09-2026 **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 ***************************************************************************
    $65k-88.6k yearly 11d ago
  • Licensed Practical Nurse, Home Health

    Humana Inc. 4.8company rating

    Orangeburg, SC job

    Become a part of our caring community and help us put health first Coverage Area: : Elloree, Santee, Holly Hill, Eutawville, Vance and Cross Make a meaningful impact every day as a CenterWell Home Health nurse. You'll provide personalized, one-on-one care that helps patients regain independence in the comfort of their homes. Working closely with a dedicated team of physicians and clinicians, you'll develop and manage care plans that support recovery and help patients get back to the life they love. As a Home Health LPN, you will: * Provide professional nursing services under the direction of a RN in compliance with the state's Nurse Practice Act, any applicable licensure/certification requirement, applicable healthcare standards, governmental laws and regulations, and CenterWell Home Health policies and procedures. * Provide skilled nursing interventions in the treatment of the patient/clients illness, rehabilitative needs and preventative care. Utilize a holistic approach in the provision of problem specific therapeutic interventions, teaching and training activities in accordance with the plan of care. * Apply knowledge and skills in accordance with accepted standards of clinical practice to facilitate problem resolution and achieve individualized patient goals and outcomes. * Confer with the RN Supervisor regarding needed changes in the Plan of Treatment. Accept verbal orders from physician were permitted by state law/regulations/Nurse Practice Act and communicate these orders to the RN Supervisor. * Utilize a systematic, individualized goal/outcome driven approach in implementing the nursing plan of care. * Maintain contact with patients, physicians, clinical manager(s), other members of the healthcare team in a timely manner regarding patient/family needs and status changes. Participate in care coordination activities and discharge planning as appropriate. * Maintain the highest standards of professional conduct in relation to information that is confidential in nature. Share information only when the recipient's right to access is clearly established and the sharing of such information is dearly in the best interests of the patient. * Appropriately communicate to ensure adherence to professional standards in the provision of and availability of supplies, materials and equipment needed to safely and effectively implement the plan of care. * Prepare, submit and maintain documentation as required by the Company and/or facility. Visit/shift notes documented on day services are rendered. Use your skills to make an impact Required Experience/Skills: * Graduate of an accredited Licensed Practical Nursing Program or accredited School of Vocational Nursing. * Current nursing license in the practicing state. * Valid drivers license, auto insurance and reliable transportation. * Current CPR certification. * Two years experience as an LPN/LVN in a clinical setting, preferably in a home health or hospice setting. Pay Range * $28.00 - $40.00 - pay per visit/unit * $44,600 - $61,400 per year base pay Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,000 - $73,000 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. 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.
    $53k-73k yearly 55d ago
  • Care Manager, Telephonic RN

    Humana 4.8company rating

    Columbia, SC job

    **Become a part of our caring community and help us put health first** The Compact licensed telephonic Care Manager works from home in a call center environment. They assess and evaluate members' needs and requirements to achieve or maintain optimal wellness by providing care coordination and facilitating member or family interaction with resources appropriate for the care and wellbeing of the member. **Job Description** Humana Care Support is a division of Humana dedicated to helping adults remain independent in their homes. Our nurses are called Care Managers, because our case management services are centered on the person rather than the condition. The Care Manager uses a range of strategies and techniques to manage a member's physical, environmental, and psycho-social health issues. They identify and resolve barriers to effective care and continuously monitor progress through assessments and evaluations to ensure members achieve their desired health outcomes. **Role Overview** + The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system. + This role operates in a fast-paced environment, requiring the ability to quickly engage with members while navigating multiple computer applications simultaneously. To maintain compliance and support the auto-dialer process critical to our operations, care managers follow structured daily schedules, which limits day-to-day flexibility **.** + All our RN Care Managers are work at home associates, working from a dedicated home office space (see Work at Home Guidance below). + Remote Care Managers are expected to achieve established outcomes, quality, and productivity benchmarks and demonstrate advanced communication and interpersonal skills. **Duties Include** + Telephonically working with Medicare members with transitional needs and complex chronic conditions. + Assessing members' physical, environmental, and psychosocial health needs, collaborating with a multidisciplinary team, and implementing timely clinical interventions to manage risks, coordinate care, and help prevent avoidable hospitalizations. + Collaboration with members who face multiple chronic conditions, along with financial and functional challenges, to support them in achieving and sustaining optimal health. + May develop individualized member care plans. Success in this position requires that you + Understand department, segment, and organizational strategies and objectives, and how they connect to related areas. + Exercise judgement regarding own work methods, even in ambiguous situations, with minimal direction and occasional guidance where needed. + Demonstrate flexibility and ability to promptly adapt to new processes and workflows. + Adhere to established guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Registered Nurse (R.N.) license with **no** disciplinary action on any license. + **Must hold an active Compact nursing license and reside in the state that holds your compact license.** + 3+ years of clinical acute care experience with case management, discharge planning, and patient education for adult acute care + Demonstrated clinical expertise in managing chronic conditions through individualized care planning, supported by strong assessment and critical thinking skills + Proficiency in Microsoft Office applications including Word, Excel, and Outlook. + Demonstrated proficiency in navigating multiple systems using dual monitors, with strong computer skills and the ability to quickly learn new applications. Skilled in autonomous decision-making, troubleshooting, and problem-solving system-related issues **Preferred Qualifications** + BSN or MSN degree + Case Management experience + Managed care experience + Certified Case Manager (CCM) + Bilingual in English and Spanish (see Language Proficiency Testing below) **Training and Work Schedule** + The first 4 weeks of training work hours will be from 8:30AM to 5:00PM EST. No time off is permitted during the first month of training. + Following training, work hours are: + **If you live in the Eastern Time Zone (EST):** Work hours are 9:00 AM to 5:30 PM EST. + **If you live in the Central Time Zone (CST):** work hours are 10:00 AM to 6:30 PM EST **Work at Home Guidance** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is also required. Satellite, cellular and microwave connection is not allowed. + On occasion, the personal level of internet service a Home or Hybrid Home/Office associate provides-despite meeting the minimum requirement above-proves to be insufficient to maintain an optimal connection through Humana's VPN and thereby interferes with the Home or Hybrid Home/Office associate's ability to work effectively. When this happens, Humana reserves the right to require the associate to upgrade the level of his/her personal internet service as a condition of employment. Based on system requirements, you may need a download speed of up to 200 Mbps and an upload speed of 20 Mbps. + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Language Proficiency Testing** Any Humana associate who wishes to communicate with members in a language other than English must complete a language proficiency assessment, administered by an approved external vendor, to ensure fluency and competency in that language Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. **Interview Format** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **Please note during the screening process, you will be asked to provide your Compact Nursing license number and your internet upload and download speeds from** ********************* . **These items will be required prior to scheduling an interview.** **Social Security Task** Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $71.1k-97.8k yearly Easy Apply 10d ago

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