Claims Assistant
Corvel Career Site job in Portland, OR
The Claims Assistant will support the claims staff in the set-up and administration of workers' compensation claims/case management and other tasks depending on the specific customer needs.
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ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Sets up new claims
Process mail, handle files (until paperless), and input notes/diary entries in the claims system
Process payments, as needed
Process form letters, state forms and reports
Assist claims examiners with telephone calls including provider, claimant and customer calls
Additional duties as assigned
KNOWLEDGE & SKILLS:
Excellent written and verbal communication skills
PC literate, including Microsoft Office (Word, Excel)
Ability to work independently and in a team environment
Strong organizational skills
EDUCATION & EXPERIENCE:
High school diploma, college degree preferred
Six (6) months of service oriented office experience preferred
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: $13.08 - $22.89 per hour
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
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.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Onsite
Medical Only Claims Specialist
Corvel Career Site job in Portland, OR
The Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers' compensation claims under close supervision, supporting the goals of the Claims Department and of CorVel.
is open to remote or hybrid.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Receives claims, confirms policy coverage and acknowledgement of the claim
Determines the validity and compensability of the claim
Establishes reserves and authorizes payments within established reserving authority limits
Communicates claim status with the customer, claimant and client
Adheres to client and carrier guidelines and participates in claims review as needed
Assists other claims professionals with more complex or problematic claims as necessary
Additional duties as assigned
KNOWLEDGE & SKILLS:
Excellent customer service skills
Excellent written and verbal communication skills
Fast learner; develops knowledge and understanding of claims practice, relevant statutes, and medical terminology
Ability to identify, analyze and solve problems
Computer proficiency and technical aptitude to utilize Microsoft Office, including Excel spreadsheets
Strong interpersonal, time management, and organizational skills
Ability to work both independently and within a team environment
EDUCATION & EXPERIENCE:
Bachelor's degree or a combination of education and related experience
Minimum of 1 year industry experience and claim handling
WC experience required
Licensed as required jurisdictionally
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: $16.36 - $26.31 per hour
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:
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.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
Claims Specialist
Corvel Career Site job in Portland, OR
The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers' compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.
This position is open to remote or hybrid.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Receives claims, confirms policy coverage and acknowledgment of the claim
Determines validity and compensability of the claim
Establishes reserves and authorizes payments within reserving authority limits
Manages non-complex and non-problematic medical only claims and minor lost-time workers' compensation claims under close supervision
Communicates claim status with the customer, claimant and client
Adheres to client and carrier guidelines and participates in claims review as needed
Assists other claims professionals with more complex or problematic claims as necessary
Additional duties as assigned
KNOWLEDGE & SKILLS:
Excellent written and verbal communication skills
Ability to learn rapidly to develop knowledge and understanding of claims practice
Ability to identify, analyze and solve problems
Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets
Strong interpersonal, time management and organizational skills
Ability to meet or exceed performance competencies
Ability to work both independently and within a team environment
EDUCATION & EXPERIENCE:
Bachelor's degree or a combination of education and related experience
Minimum of 1 year of industry experience and claims management preferred
State Certification as an Experienced Examiner
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: $51,807 - $83,551
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
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.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
Sr. Program Delivery Professional IWHA-Interoperability
Salem, OR 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 ***************************************************************************
Easy ApplyImplementation Coordinator I
Corvel job in Portland, OR
An Implementation/Technical Project Coordinator is an integral team member, serving as the primary point of contact for CorVel's Enterprise Comp Solution implementations. They oversee all onboarding details for new customers and are responsible for driving action items critical to timely and accurate account setups. This is a highly visible role that requires a great deal of communication and coordination between different groups. The Implementation Coordinator works with all offices of the organization including Account Management, Customer Configurations, Software Development, Business Operations, and Executive Management, communicating requirements and deliverables with an exceptional level of customer service and professionalism.
This role will have a major impact on the success of our software development team as it strives to deliver applications that are vital to the services that CorVel provides. In addition to project management skills and some knowledge of the software development process, the coordinator will need to develop and maintain a strong working knowledge of CorVel's business.
Qualified candidates for this position are recent graduates / early-career individuals with a strong drive to learn and grow as a member of the CorVel family. They are highly organized, detail-oriented, adaptable to frequently changing priorities and able to work independently as well as part of multiple teams. They must have outstanding communication and critical thinking skills, and the ability to build positive, cooperative relationships across the organization.
This is a remote role with occasional requirement to come into our Portland, OR office for customer data delivery.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
* Coordinate multiple implementations while maintaining accurate details at all times
* Maintain accurate project schedule using established tools
* Communicate project scope, schedule, status, and deliverables to all levels of the organization
* Lead weekly/bi-weekly customer onboarding meetings with field and setup teams, stakeholders, technical resources and management
* Facilitate data file transfers between multiple vendors, field teams and IT groups via network drives, customer FTP sites, and other secure media devices
* Review, understand and interpret claim data submitted in varying formats from prior vendors
* Develop knowledge of CorVel systems as they relate to Enterprise Comp Solutions
* Identify process improvement opportunities to automate and enhance team responsibilities
* Communicate technical data, issues, solutions and process-related information to non-technical teams
* Maintain all project implementation documentation including meeting notes, timelines, requirements, and stakeholders
* Serve as the central communications and documentation contact for implementations
* Execute queries for data analysis, claim inventory, validation issues etc.
* Lead and coordinate schedules and activities for assigned software development projects and project teams
* Lead daily project team meetings
* Identify and remove impediments to software development teams' progress
* Participate in requirements gathering process and create product backlog items for development team, in conformance with process guidelines
* Participate in product backlog item prioritization
* Monitor the project backlog to ensure project priorities and deadlines are effectively met
* Facilitate communication between end users, stakeholders, product managers and software development project teams
* Manage, in collaboration with UAT coordinator and IT staff, the software release process for assigned projects
* Prioritize work effectively to assure maximum efficiency and productivity as well as quick and timely response to customer issues
* Effectively and consistently communicate with team members, supervisor and other parties
KNOWLEDGE & SKILLS:
* Demonstrable skills with Agile / Scrum, Kanban, Waterfall methodologies
* Demonstrable ability to read and write simple to moderate SQL queries.
* Demonstrated ability to manage details and timelines for multiple, simultaneous, complex implementations
* Adept at thriving in a fast-paced environment with firm deadlines
* Strong organizational skills and attention to detail
* Strong professional interpersonal and communications skills (verbal or written) including effective and appropriate use of email, chat, etc.
* Ability to work with technical and non-technical team members across the organization with varying communication styles
* Strong analytical problem-solving and problem-resolution skills
* Technical aptitude for learning new systems and technical processes
* Knowledge of the full software development life cycle
* Familiarity with Microsoft Azure DevOps or other development platforms
* Knowledge of project management tools and practices
* Basic understanding of relational database architecture
* Advanced abilities in Microsoft Excel, Word, Outlook
* Accurate typing skills, 65 WPM or higher
Preferred Skills:
* Knowledge of claims administration
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: $22.63 - $33.77 per hour
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:
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.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
Medical Director - Pharmacy Appeals
Salem, OR job
**Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the analysis of situations or data requires a case by case consideration of the Medicare rules, Humana policies and medical necessity.
The Medical Director will collaborate with clinicians and support staff to provide Humana members with optimal value based care in accordance with Medicare and Humana policy. All work occurs within a context of regulatory compliance and work is assisted by diverse resources, included but not limited to CMS policies, National and Local Coverage Determinations, CMS-recognized Compendia, NCCN, Humana Pharmacy Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements and will understand how to operationalize this in their daily work.
The Medical Director's work includes computer based review of moderately complex to complex appeals for coverage for drugs using resources outlined above as well as inter- and intra-departmental resources. Work may include Peer to Peer discussions with prescribers, participation in hearings involving an Administrative Law Judge, support for CMS audits, cross-functional team activities, and other responsibilities as determined necessary to support optimal value based care in accordance with Medicare and Humana policy.
**Use your skills to make an impact**
**Required Qualifications:**
+ MD or DO degree
+ 5+ years of direct clinical patient care experience post residency or fellowship, preferably including some experience related to a Medicare type population (disabled or >65 years of age)
+ A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required
+ No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements
+ Excellent verbal and written communication skills
+ Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, or similar activities
**Preferred Qualifications:**
+ Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or clinical group practice management
+ Utilization management experience in a medical management review organization such as Medicare Advantage, managed Medicaid, or Commercial health insurance
+ Current and ongoing Board Certification in Internal Medicine, Family Medicine, Emergency Medicine or Physical Medicine and Rehabilitation
+ Experience with national guidelines, such as MCG, InterQual, NCCN, Micromedex, Lexicomp, Elsevier's Clinical Pharmacology
+ Exposure to Public Health, Population Health, analytics, and use of business metrics
+ Curiosity to learn, flexibility to adapt, courage to innovate
+ Experience functioning as a Team member, providing support to reach a common goal
**Additional Information**
May participate on project teams or organizational committees.
\#physiciancareers
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$223,800 - $313,100 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-31-2026
**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 ***************************************************************************
National Dental Contracting Professional - Medicaid
Salem, OR 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 ***************************************************************************
Home Health Account Executive
Vancouver, WA job
Become a part of our caring community and help us put health first As a Home Health Sales Executive, you will: * Call on physicians, hospitals, skilled nursing facilities' management, discharge planners, and case managers within an assigned territory to promote our homecare services.
* Build and maintain client relationships.
* Prepare business plans and maintain target lists. Prioritize accounts in accordance with the market sales plan.
* Gather and organize account-related information and provide input on key customer opportunities, service line extensions and proposal or contract pricing.
Use your skills to make an impact
Required Experience/Skills:
* Bachelor's degree in Marketing, Business, or a health related science (e.g., nursing, pharmacy, etc.) or the equivalent plus a minimum of two years health care or related industry sales experience generally required.
* Clinical license (RN, LPN, SLP, PT,PTA) preferred.
* Excellent selling, organization, problem-solving skills and the ability to appropriately represent the Company service capabilities to the targeted referral source audience is required.
* Previous healthcare sales experience preferred such as selling in skilled nursing facilities (SNFs), DME, ortho, cardio, etc OR previous experience as a clinical liaison preferred
* Excellent interpersonal communication and presentation skills required. Microsoft Office proficiency required.
* Ability to travel within assigned territory and to sales meetings as 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.
$58,700 - $78,500 per year
This job is eligible for a commission incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
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.
Contract Administrator I
Corvel Career Site job in Portland, OR
The Contract Administrator is responsible for reviewing contract terms, interpreting agreement terms, identifying potential issues, reviewing agreement amendments and modifications, and incorporating changes.
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Main Job Tasks and Responsibilities
Ensure accuracy of company contracts, with a focus in pricing
Ensure compliance by auditing contracting policies and procedures
Responsible for obtaining, verifying, and maintaining records relevant to the contract such as new customer setups and pricing changes
Responsible for tying out pricing in contracts to customer pricing set up within CorVel's internal systems
Responsible for communication and coordination of account managers and customer configuration team
Attention to detail and the ability to spot errors and inconsistencies
Excellent reading and language comprehension
Coordinate actions with internal procurement and legal teams, if needed
Report status of current contract processes to management
Resolve any existing contract conflicts
Analyze potential risks that contract changes may pose to the organization
Qualifications and Key Competencies
Bachelor's degree with concentration in Economics, Mathematics or Business Administration (with an emphasis in Accounting)
Excellent communication and organizational skills
Ability to complete projects in a timely and accurate manner
Ability to effectively set priorities
Attention to detail and accuracy
Able to work productively independently and as part of a team
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: $49,399 - $73,800
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:
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.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Remote
Strategy Advancement Advisor - Distribution Strategy
Salem, OR 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 ***************************************************************************
Easy ApplyCapture Center Specialist
Corvel job in Milwaukie, OR
The Capture Center Specialist is responsible for quality and process management of our processing of invoices and medical bills for our customers. Depending on the department, this processing might include picking up, receiving, and preparing customer mail for scan; scanning documents on high speed scanners; performing quality checks on the data record associated with documents; interacting with electronic documents in line with our product line expectations; ensuring our final processed work is delivered successfully to our customers; and/or making outbound phone calls to medical providers' front desks to perform provider demographics verifications.
This is an Onsite role. This role requires driving a 2026 Isuzu 18 Foot box truck locally.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
* Identifies and indexes all incoming faxes to the appropriate file, on a daily and timely basis
* Scans paper documents and completes imaging process
* Follows document destruction procedures
* Adheres to HIPPA and other sensitive data regulations, policies, and procedures
* Processes information by compiling, coding, categorizing, and verifying information and data
* Photocopying of original two-sided documents to convert to one sided documents
* Opens and sorts incoming paper mail
* Identifies and classifies documents or other electronic content according to characteristics such as document type, function, or other classification
* Retrieves images
* Operates data capture equipment safely
* Operates data capture technology to import digitized documents into document management system
* Searches electronic sources, such as databases or repositories, or manual sources for information
* Follows clearly established and defined procedures and knows when to escalate for higher review
* Challenges include the completion of high volumes of work while meeting quality, productivity, and timeliness standards
* Must be able to lift and carry up to 50 pounds as needed
* Safely operate a company vehicle to transport mail between USPS and the company office, ensuring timely and accurate delivery while following local traffic laws and safe driving practices.
* Represent the company professionally when interacting with USPS staff and other third parties, demonstrating courtesy and clear communication.
* Additional duties as assigned
KNOWLEDGE & SKILLS:
* Excellent written and verbal communication
* Intermediate Microsoft Office suite skills
* Ability to work independently and in a team environment
* Attention to detail, organizational ability, and time management skills
* Learning agility: able to learn, adapt, unlearn, and relearn to keep up with changing conditions
* Ability to manage time effectively and prioritize tasks to meet scheduled delivery deadlines.
EDUCATION & EXPERIENCE:
* High school diploma or GED
* Six months experience in a service type office or customer service preferred
* For Document Control department: valid driver's license and clear DMV background check
* For Intracompany Services department: comfort making regular outbound business phone calls to administrative professionals for provider demographics verification
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: $13.08 - $22.89 per hour
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 SYMBEO
Symbeo, a wholly owned subsidiary of CorVel Corporation and certified Great Place to Work Company, provides digital mailroom and automated accounts payable services to the world's largest and most recognized companies. Symbeo is passionate about connecting enterprise organizations with technology solutions that bring deep value and operational cost savings to our customers. Since our founding in 1983, we have grown to over 200 people working in our downtown Portland and Milwaukie, OR offices. Our investment and blend of people, process and technology drives our innovation and blazes new trails in AP automation and scanning services. We 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.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
#LI-Onsite
Medicare Sales Field Agent - Portland, OR
Portland, OR 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 MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll help bring Humana's strategy to life: Deliver on the fundamentals, differentiate through exceptional service, and grow by expanding our reach and impact.
What You'll Do in This FIELD Based Role:
Deliver: Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental, Vision, and Prescription coverage.
Differentiate: Create meaningful, face-to-face connections through grassroots marketing, community events, and in-home visits-providing a personalized experience that sets Humana apart.
Grow: Drive self-generated sales, meet performance goals, and expand Humana's presence in the market by becoming a valued resource in your community.
You'll engage with customers in the FIELD through a mix of in-person, virtual, and phone interactions. Face-to-face visits in prospective members' homes are a key part of this role.
Why Join Humana?
People-first culture that supports your personal and professional growth.
Inclusive and diverse environment that values multilingual talent and cultural understanding.
Autonomy and flexibility to manage your schedule and success.
Purpose-driven mission to help people achieve their best health-and transform healthcare along the way.
Benefits include:
Medical, Dental, Vision, and a variety of other supplemental insurances
Paid Time Off (PTO) and Paid Holidays
401(k) retirement savings plan with a competitive match
Tuition reimbursement and/or scholarships for qualifying dependent children
And much more!
Use your skills to make an impact
Required Qualifications
Active Health Insurance License or ability to obtain.
Must reside in the designated local territory to effectively serve the community.
Comfortable with daily face-to-face interactions in prospective members' homes and engaging with the community through service, organizations, volunteer work, or local events.
Valid state driver's license and proof of personal vehicle liability insurance meeting at least 25/25/10 coverage limits (or higher, based on state requirements).
Preferred Qualifications
Active Life and Variable Annuity Insurance License.
Prior experience selling Medicare products.
Experience in public speaking or delivering presentations to groups.
Associate's or Bachelor's degree.
Experience using Microsoft Office tools such as Teams, Excel, Word, and PowerPoint.
Bilingual in English and Spanish, with the ability to speak, read, and write fluently in both languages.
Additional Information
This position is in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and MVR review.
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.
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.
Schedule: Meeting with members requires appointments and/or event times that may vary on nights and weekends. Flexibility is essential to your success.
Training: The first five weeks of employment and attendance is mandatory.
Interview Format:
As part of our hiring process for this opportunity, we are 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.
If you are selected to move forward in the process, you will receive a text message inviting you to participate in a HireVue prescreen. In this prescreen, you will receive a set of questions via text and given the opportunity to respond to each question. You should anticipate this prescreen taking about 15 minutes. Your responses will be reviewed and if selected to move forward, you will be contacted with additional details involving the next step in the process.
Pay Range
The range below reflects a good faith estimate of total compensation for full time (40 hours per week) employment at the time of posting. This compensation package includes both base pay and commission with guarantee. The pay range may be higher or lower based on geographic location. Actual earnings will vary based on individual performance, with the base salary and commission structure aligned to company policies and applicable pay transparency requirements.
$80,000 - $125,000 per year
#medicaresalesrep
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
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.
Auto-ApplyAssociate Director, Cloud Solutions Engineering
Salem, OR 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 ***************************************************************************
Lead Citrix Systems Engineer - Network/Virtualization
Salem, OR 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 ***************************************************************************
Easy ApplyCertified Nursing Assistant, Home Health
Portland, OR job
Become a part of our caring community and help us put health first A Home Health Aide ( HHA ): * Provides direct patient care to patient under direction of the RN and according to the Aide Plan of Care (POC). * Correctly assists the patient with self-administered medications by opening bottle caps for the patient, reading medication labels to the patient, checking the dose being self-administered against the prescribed dose on the container label and observing the patient takes the medication
* Consistently takes accurate temperature, pulse and blood pressure measurements and recognizes and reports abnormal results to supervisor
* Helps patient maintain good personal hygiene by performing or supervising bathing, grooming, skin care, shaving, oral care, nail/foot care and other activities
* Assists in feeding patients. Is able to communicate basic principles of nutrition, observe and record food and fluid intake when necessary. Safely positions patient for meals and feeds or assists in self feeding
* Assists with patient toileting including use of bed pan/urinal, change and position catheter bags and bag change procedures on well-regulated ostomies
* Provides necessary skills to safely assist the patient with patient mobility, exercises, positioning/turning, transfers and ambulation per Plan of Care and CenterWell Home Health policy
* Provides necessary skills to appropriately report changes and document pertinent information and care rendered to patient to ensure continuity of care. Documents interactions with patients, caregivers, doctors and other staff members appropriately, legibly, thoroughly and in the amount of time allowed
* Practice acceptable infection control principles. Provide a clean, safe and comfortable environment
* Willingly assists with other household duties including light laundry, bed changing and bed making, light meal preparation, light housekeeping and shopping (if no other assistance is available and an MD order is present).
Use your skills to make an impact
Required Experience/Skills:
* High school diploma or equivalent
* Completion of Certified Nursing Assistant or Certified Home Health Aide Program within the last 24 months
* Must meet applicable state certification requirements
* A valid driver's license, auto insurance, and reliable transportation are required
* Must be in good standing on the HHA Registry (if applicable) and have completed HHA/CNA course to work for a Medicare certified agency.
* At least one year experience in the last 24 months as a Home Health Aide or Certified Nursing Assistant in a hospital, nursing home, home health/hospice agency.
Scheduled Weekly Hours
20
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$37,440 - $43,800 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 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.
IHWA Data and Reporting Professional
Salem, OR 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 ***************************************************************************
Easy ApplyLicensed Practical Nurse, Home Health
Portland, OR 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
* $41.00 - $57.00 - pay per visit/unit
* $60,200 - $82,900 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.
$63,600 - $87,600 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
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.
Social Worker Home Health
Lake Oswego, OR job
Become a part of our caring community and help us put health first The Medical Social Worker participates in the interdisciplinary care provided to home health patients. The Medical Social Worker functions to evaluate and develop a plan of care personalized to fit the patient's emotional and social needs. The Medical Social Worker provides direction and supervision of the Social Worker Assistant as required and when involved in the patient's plan of care. The Medical Social Worker works within CenterWell Home Health's company-specific policy and procedures, applicable healthcare standards, governmental laws, and regulations.
* Assesses the patient's social and emotional state as it relates to his or her illness or injury, needs for care and his or her response to such treatment, and adjustments to care.
* Assesses any relationships of the patient's medical and nursing needs in the home setting, financial resources, and available community resources.
* Provides any appropriate action to obtain available community resources to assist in resolving issues that may be impeding the patient's recovery.
* Instructs patients and families in treating and coping with social and emotional response connected with Provides ongoing assessment of patient and family needs and responses to teaching
* Assists the physician and other health team members in understanding the significant social and emotional factors related to the patient's health Participates in the development and periodic re-evaluation of the physician's Plan of Care for the patient.
* Observes, records, and reports changes in patients' condition and response to treatment to the Clinical Manager and the Participates in the discharge planning process
* Participates as a member of the interdisciplinary care team in care coordination activities and acts as a resource to other health team members in the identification and resolution of patient needs
* Supervises instructs and evaluates the performance of the Social Work Assistant (BSW) to assure that all medical social services are provided to patients in compliance with Company, government, and professional standards
* Maintains and submits documentation as required by the company and/ or facility including any case conferences, patient/physician community contacts, visit reports progress notes, and confers with other health care disciplines in providing optimum patient care.
Use your skills to make an impact
Required Skills/Experience
* Masters or doctoral degree from a school of social work accredited by the Council on Social Work Education.
* Social Worker licensure in the state of practice; if required by state law or regulation.
* A valid driver's license, auto insurance, and reliable transportation are required.
* Proof of current CPR certification
* Minimum of one year of experience as a social worker in a health care setting, home health, and/or hospice.
* Knowledge of and the ability to assist with discharge planning needs, and to obtain community resources (housing, shelter, funeral/memorial service arrangements, legal, information and referral, state/federal financial and medication programs, and eligibility.
* Excellent oral and written communication and interpersonal skills.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$53,700 - $72,600 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
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.
Senior Manager, MarketPoint Sales - Raleigh Durham, NC.
Salem, OR 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 ***************************************************************************
Easy ApplySNF Utilization Management RN - Compact Rqd
Salem, OR 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 ***************************************************************************