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EmblemHealth jobs in Farmington, CT - 292 jobs

  • Customer Service Representative

    Emblem Health 4.9company rating

    Emblem Health job in Farmington, CT

    * Must be able to commute to work location at 195 Scott Swamp Road, Farmington, CT 06302* We are seeking dynamic Call Center Professionals to join our Call Center in Farmington, CT starting 2026! Our Call Center professionals provide telephonic customer service support to members, providers and facilities. Handle incoming inquiries through multiple contact channels and effectively and efficiently communicate resolutions to members' requests ensuring high First Contact Resolution. The Call Center team advocates for our members in the event there are issues and follows up with the members once the issues are resolved. If you believe in extraordinary commitment to customer service, come join us! * All positions are on-site at 195 Scott Swamp Road, Farmington, CT 06302* Essential Job Information: * Up to 6 - 8 weeks of in-classroom training onsite * Primarily sedentary Compensation and Benefits: * Hourly Pay Rate is $22.50 * We offer competitive health and wellness benefits Job Responsibilities: * Create a connection and develop rapport with members to provide outstanding personalized service. * Identify customer needs and assist in providing complete resolution of customer concerns including claims, benefit and enrollment inquiries through health plan navigation and collaboration with other internal groups. * Serve as an expert in EmblemHealth products, services and technology platforms. * Champion efforts to solve the members request on the initial call; provide follow up if not solved on the initial call. * Inform and educate members on how to utilize self service capabilities and functionality with the portals and mobile application. * Act as a scheduling agent, working in collaboration with the member, to ensure appointments are scheduled, as necessary. * Proactively provide information and recommendations to maximize the customer experience: gather and provide feedback to stakeholders based on member feedback to further improve customer experience. Qualifications: * Bachelors' degree * 1 - 2+ years of relevant, professional work experience required * Healthcare experience including pharmacy background preferred * Additional experience/specialized training may be considered in lieu of educational requirements required * Proficient with MS Office (Word, Excel, Powerpoint, Teams, Outlook, etc.) required * Strong customer service skills and the ability to empathize with the customer's perspective required * Knowledge of health insurance industry required * Strong communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience required * Ability to clearly and effectively convey information and concepts to customers required * Dependability and adaptability required * Commitment to quality and continuous improvement required * Strong problem-solving skills to be applied to a wide array of business challenges required * High level of proficiency all applicable systems and processes required Additional Information * Requisition ID: 26004 * Hiring Range: $22.50 per hour
    $22.5 hourly 2d ago
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  • Senior Learning Design Professional

    Humana 4.8company rating

    Hartford, CT 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. IFG is a subsidiary of Humana The Senior Learning Design Professional uses instructional design, cognitive psychology and adult learning theory to determine the appropriate solution to a knowledge or performance gap. The Senior Learning Design Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. **Position Overview** The Senior Learning Design Professional leads the design and development of engaging, effective learning experiences that drive performance improvement for Medicare Advantage sales agents and agency partners. This role requires deep expertise in instructional design, eLearning development, and adult learning principles, combined with the ability to translate complex Medicare regulations and sales strategies into accessible, actionable training content. **Key Responsibilities** **Learning Solution Design & Development** + Analyze learning needsthrough stakeholder consultation, performance data analysis,and needsassessments to determineappropriate learninginterventions. + Design and develop multi-modal learning solutions including eLearning modules, instructor-led training materials(slide decks, facilitator guides), performance support tools(meeting-in-a-box, job aids), microlearning assets, and mobile learning experiences that reflect diverse representation and are accessible to all learners. + Write clear, measurable learningobjectives,and design performance assessments thatvalidatelearning transfer and business impact. + Create storyboards, scripts, and interactive eLearning courses using industry-standard authoring tools (Articulate Storyline, Rise,Vyond, Cornerstone). + Develop visual assets and multimedia content that enhance learner engagement and knowledge retention while meeting WCAG 2.1 AA accessibility standards. + Ensure all learning content meets compliance requirements for Medicare Advantage andmaintains CMS regulatory alignment. + Design content that accommodates multiple carriers' products, policies, and processes (Humana plus 10+ other insurance carriers). + Write authentic and valid knowledge assessments. **Learning Facilitation** + Facilitate engaging virtual instructor-led sales skills and leadership training as well as ad hoc team building exercises. **Stakeholder Partnership & Consultation** + Partner with subject matter experts, compliance leaders, sales managers, and agency principals to gather content requirements andvalidateaccuracy. + Conduct consultative needs analysis todeterminewhether learning solutions are necessary or if alternative performance interventions are moreappropriate. + Present design concepts and prototypes to stakeholders, incorporating feedback whilemaintaininginstructional integrity. + Educate stakeholders on adult learning principles andevidence-based instructional strategies. **Quality Assurance & Continuous Improvement** + With our organizationeffectivenessprogressional, track and analyze training program effectiveness through learner satisfaction surveys, knowledge assessments,completion rates,and performance metrics. + Conduct regular content audits to ensure materialsremaincurrent with Medicare regulations, product updates, and industry changes. + Implement iterative improvements based on learner feedback, performance data, and evolving business needs. + Maintain content version control and documentation in SharePoint andourlearning management system(Cornerstone). **Learning Technology & Innovation** + Leverage Cornerstone LMS capabilities to deliver personalized learning paths and track learner progress. + Utilize collaboration tools (Microsoft Teams, SharePoint, Zoom, Lucid Chart, PowerPoint) tofacilitatecontent review processes and knowledge sharing. + Explore and recommend emerging learning technologies. + Contribute to learning design standards, templates, and best practices documentation. **Use your skills to make an impact** **Required Qualifications** **Education & Experience** + Bachelor's degree in Instructional Design, Education, Psychology, Communications, or related field + 5+ years of learning design and eLearning development experience + Demonstrated experience designing learning solutions for complex,highlyregulated subject matter + Portfolioshowcasingdiverse learning deliverables (eLearning, blended learning, performance support) **Technical Skills** + **Expert** **proficiency** **in eLearning authoring tools:** Articulate Storyline 360, Rise 360, Vyond + **Strong** **proficiency** **in:** Learning Management Systems (Cornerstone preferred),Microsoft Office Suite (PowerPoint, Word, Excel), Microsoft Teams, SharePoint + **Working knowledge of** **:** SCORM/xAPIstandards, basic HTML/CSS + **Audio/visual production skills:** Audio editing (Adobe Audition), video editing (AdobeAfterEffects,Adobe Premiere), graphic design (Adobe Creative Suite basics) + **General tech-savviness:** Comfortable learning new platforms quickly, troubleshooting technical issues, and adapting to evolving technology landscape **Knowledge & Competencies** + Deep understanding of adult learning principles, instructional design models (LLAMA,SAM, Backwards Design, Kirkpatricklevels of evaluation,Cathy Moore'sAction Mapping, Bloom's Taxonomy), and evidence-based learning strategies + Ability to translate complex, technical subject matter (like Medicare Advantage plan structures, CMS regulations, sales methodologies) into clear, engaging learning content + Well-versed in psychometrics + Engagingfacilitator in virtual environments + **Business acumen:** Data-driven decision-making mindset; ability to connect learning solutions to business outcomes and ROI + Strong project management skills with ability to manage multiple concurrent projects and meet deadlines + Exceptional written and verbal communication skills + Collaborative mindset with ability to navigate competing stakeholder priorities + Experience with accessibility standards (WCAG, Section 508) + Familiarity with learning analytics and data visualization tools (Power BI) **Preferred Qualifications** + Master's degree in Instructional Design, Learning and Performance, Education, or related field + Experience in healthcare, insurance, or other highly regulated industry + Knowledge of Medicare Advantage products, sales processes, or insurance compliance **Additional Information** **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. **Team Culture & Working Environment** **About IFG** **and Our Team** Innovative Financial Group (IFG) is a subsidiary of Humana that operates as a field marketing organization (FMO), selling Medicare Advantage and supplemental insurance products from 10+ carriers-not just Humana. Our learning design team supports IFG's call center agents and agency partners, creating training that helps them navigate multiple carriers' products, regulations, and sales processes. We're a newly formed team building IFG University from the ground up-we've selected Cornerstone as our LMS, we're designing our content strategy based on comprehensive stakeholder research, and we're establishing processes that will scale. This is a unique opportunity to shape the foundation of a learning function and make a lasting impact. **What We Value** + **Collaboration over silos:** We break down barriers between Marketing, Training, Communications, and Learning Design. + **Learner-centricity:** We design back from what agents need, notwhat'seasiest for us. + **Data-informed decisions:** We measure what matters and continuously improve. + **Intellectual curiosity:** We embrace complex subject matter and find ways to make it accessibleanddigestible. + **Inclusive leadership:** We create space for diverse perspectives and challenge assumptions respectfully. + **Agility:** We move quickly, learn from experiments, and adapt based on feedback. + **Friendly and Fun:** Weinteract with others in a positive way and know that learning should be enjoyable! **Work Model** + **Remote work with up to 10% travel** for team meetings, training delivery, or stakeholder sessions + Collaborative team culture with regular synchronization and knowledge sharing + Opportunities for professional development and skill building + Supportive leadership committed to your growth and success **Our Commitment to Inclusion & Accessibility** Every member of our team is responsible for creating learning experiences that reflect diverse representation and are inclusive and accessible to all learners. This includes: + Designing content that features diverse learner personas and scenarios. + Ensuring all digital learning materials meet WCAG 2.1 AA accessibility standards (screen reader compatibility, captions, color contrast, keyboard navigation). + Using inclusive language,interrogating biases,and avoiding assumptionsabout learners' backgrounds, abilities, or experiences. + Creating multiple pathways for learners todemonstrateknowledge and accommodate differentabilitiesandlearning preferences. + Continuously seeking feedback from diverse learner populations to improve inclusivity. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-15-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $71.1k-97.8k yearly Easy Apply 4d ago
  • Medical Director - Nat'l UM Team 1wknd/mo

    Humana 4.8company rating

    Hartford, CT job

    **Become a part of our caring community and help us put health first** Become a part of our caring community and help us put health first The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, level of care, and/or site of service should be authorized. All work occurs within a context of regulatory compliance, and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements and will understand how to operationalize this knowledge in their daily work. Weekend work required one weekend per month with compensated days off during the work week The Medical Director's work includes reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert decisioning on the requested services. They will have regular discussions with external providers by phone to gather additional clinical information and discuss determinations. Medical directors are expected to understand Humana processes with a focus on collaborative professional relationships. The ideal candidate will have a high degree of integrity, professionalism, resourcefulness, and enjoy working in a team-based environment. Medical Directors support Humana value throughout all activities. **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are concordant with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. After completion of structured and mentored training, daily work is performed with minimal direction, but with ready support from other team members. The ideal candidate enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations and meets compliance timelines. + Conduct comprehensive, timely, and compliant medical necessity reviews for inpatient services + Maintain accountability for productivity, quality, and compliance metrics + Communicate determinations clearly both verbally and in writing + Demonstrate adaptability and willingness to learn evolving workflows, tools, and utilization management practices + **Weekend work required one weekend per month with compensated days off during the work week** **Use your skills to make an impact** **Use your skills to make an impact** **Required Qualifications** + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required. + No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. + Excellent verbal and written communication skills. + Evidence of analytic and interpretation skills, with prior experience working in a team environment **Preferred Qualifications** + Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, or other healthcare providers. + Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid, or Commercial health insurance. + Experience with national guidelines such as MCG or InterQual + Experience in hospital-based clinical practice, including specialties of Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine, and hospital-based clinical specialists + The curiosity to learn and the flexibility to adapt to changes in order to enhance efficiency, productivity, and organizational goals. + Ability to thrive in a dynamic fast-paced, team-oriented environment. + Commitment to a culture of innovation, including being facile with using technology to improve workflows + Participate in educational activities by attending required conferences and also create content to lead/teach/present for individual subject matter contribution + Passionate about contributing to an organization's focus on consistency in outcomes, consumer experiences and a highly engaged team culture **Additional Information** The medical director reports to a Lead Medical Director. Participation in weekend work on a rotational basis to ensure cases are decisioned in a timely manner May participate on project teams or organizational committees. \#physiciancareers Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 04-30-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $223.8k-313.1k yearly 60d+ ago
  • Pharmacy Stars Improvement Lead

    Humana 4.8company rating

    Hartford, CT job

    **Become a part of our caring community and help us put health first** The Pharmacy Stars Improvement Lead will be a part of a collaborative Pharmacy Stars team which is accountable for Humana's Stars patient safety measure performance. The Pharmacy Stars Improvement Lead will autonomously develops, implements, and manages clinical program strategies to improve Medicare members' medication adherence and appropriate medication use with specific focus on telehealth and in-home methods of care delivery. The Pharmacy Stars Improvement Lead exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works under minimal supervision, and analyzes variable factors to determine the best course of action. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree in Business, Finance, Health Care or a related field + 2 or more years of project leadership experience + Prior Medicare/Medicaid experience + Strategic thinking and planning capabilities; organized and detail-oriented + Excellent communication skills + Enthusiasm and motivation essential; a confident change-agent; strong presentation skills (oral and written) + Ability to operate under tight deadlines + Successful track record in facilitating and consulting across teams and managing projects + Ability to learn quickly, work under pressure and timeline, work with ambiguity, and make complex decisions as necessary to meet business need + Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data + Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint **Preferred Qualifications** + Master's Degree in Business Administration, Health Administration or a related field + Provider relations experience + Prior managed care experience + Understanding of metrics, trends and the ability to analyze and identify gaps in care + Proven organizational and prioritization skills and ability to collaborate with multiple departments a plus + Understanding of CMS Stars and performance measure knowledge and experience a plus + Background working in quality improvements **Additional Information:** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **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 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. 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. $104,000 - $143,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-15-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $104k-143k yearly Easy Apply 17d ago
  • Associate Actuary, SPA-Rx

    Humana 4.8company rating

    Hartford, CT job

    **Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. _This a remote nationwide position_ The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + Associate of Society of Actuaries (ASA) designation + MAAA + Strong communication skills + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Prior Part D experience + Strong SAS skills + Prior Databricks experience **Our Hiring Process** As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you. If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. **Alert:** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. **_Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful._** \#LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $106,900 - $147,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-29-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $106.9k-147k yearly Easy Apply 24d ago
  • Aide - Almost Family

    Unitedhealth Group Inc. 4.6company rating

    Shelton, CT job

    Explore opportunities with Almost Family, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Home and Community Bases Services Aide, you will provide support, assistance with personal hygiene and household functions for an individual to be able to remain in their own home. Primary Responsibilities: * Provide personal care and assist with daily living activities such as bathing, grooming, dressing, ambulation, and medication reminders * Support household tasks, meal preparation, and accompany clients to appointments or errands as needed * Monitor and document client condition, vital signs, and incidents; maintain confidentiality and use EVV system * Ensure a safe environment, operate medical equipment properly, and respond promptly to client needs You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current driver's license, vehicle insurance, and reliable transportation or access to public transit * Current CPR certification * Ability to work flexible hours * Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client State-Specific Requirement * CT: 75-hour state-approved training program Preferred Qualifications: * 6 months+ of home care experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $14.00 to $24.23 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $14-24.2 hourly 7d ago
  • Data Scientist - Generative AI

    Humana 4.8company rating

    Hartford, CT job

    **Become a part of our caring community and help us put health first** The Data Scientist uses mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions. The Data Scientist work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Growth Analytics & AI within Humana is dedicated to transforming members' journeys and Humana's services using technology and analytics. We are looking for a Data Scientist who will be responsible for using mathematics, statistics, NLP, Generative AI, and machine learning to analyze complex data and deliver insights. In this multi-disciplinary team, you will have the opportunity to work closely with various partners, including IT, sales, and strategy partners, to positively identify potential opportunities using high volumes of complex data. This is a unique opportunity for a motivated individual to influence Humana's vision around member growth and experiences. Our goal is to create an impactful AI solution to improve healthcare experience and outcomes for our members. As a Data Scientist, you will develop advanced analytic solutions, engaging with customers, and creating reusable statistical models and generative AI solutions. You will create reports, projections, models, and presentations to support business strategy and objectives, and communicate insights with leaders (technical and non-technical). **Key Responsibilities** + Develop and validate machine learning and statistical analysis using Python, R, SQL, programming languages and packages + Design Generative AI solutions using Python, generative models like LLMs (API and open-source models), and frameworks (i.e., LangChain, LangGraph, Google Agent Development Kit) + Develop, maintain, and collect structured and unstructured data sets for analysis and reporting + Experience in creating reports, projections, models, and presentations to support business + Interpret and communicate analytic results to analytical and non-analytical business partners + Partner with business teams to understand challenges, co-create solutions, and communicate AI capabilities, especially generative AI **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree with at least 4 years of technical experience OR a Master's Degree in Math, Computer Science, Analytics, Quantitative Social Sciences, or related analytical field and 1 year of experience + Proficiency in SQL, Python, and data analysis/data mining tools + Experience with machine learning frameworks like Scikit-Learn, TensorFlow, or PyTorch + Experience with large language models, transformers, and model providers **Preferred Qualifications** + Ph.D. in a quantitative discipline, such as Computer Science, Data Science, Machine Learning, or related field + Prior experience in healthcare + Experience in Big Data environment, specifically PySpark and/or Databricks + Experience in cloud computing, Azure, AWS, or GCP + Clear and concise oral and written communication skills + Ability to communicate statistical concepts to broad audiences + Hands-on experiences deploying Generative AI solutions **Additional Information** + Visa sponsorship is not available for this position. 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. $97,900 - $133,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-15-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $97.9k-133.5k yearly 57d ago
  • Pharmacy Technician : Evening Shift - Home Delivery

    Unitedhealth Group Inc. 4.6company rating

    Berlin, CT job

    Explore opportunities with PharmScript, part of the Optum family of businesses. PharmScript is one of the nation's leading pharmacies, partnering with long-term and post-acute care facilities to supply medications to thousands of residents and patients. Be part of our team that's dedicated to delivering safe, accurate and timely medication to those who need it most. PharmScript is a place where you can thrive and contribute. Join us to start Caring. Connecting. Growing together. We're looking for a Pharmacy Technician I to join our PharmScript team within our Floor Technician department. As a Pharmacy Technician I, you'll support the onsite pharmacist to prepare prescription orders for facilities. You'll be responsible for ensuring that pharmacy standards are maintained, policies are carried out and objectives are accomplished. The ideal candidate is a people person who enjoys troubleshooting and resolving problems and is dedicated to helping customers. * This position is an evening shift, Monday- Friday 3:30pm to 12am with rotating weekends every 3-4 weeks. * Location: 80 Clark Dr. Unit 2BC, East Berlin, CT Primary Responsibilities: * Provides exceptional customer service to all consumers and members of the clinic staff * Fills prescription orders and makes them available for verification under direct supervision of the Registered Pharmacist * Orders, receives and stores incoming pharmacy supplies * Receives and processes wholesaler medication orders * Verifies medication stock and enters data in computer to maintain inventory records * Works with the Pharmacist to assist in the pharmacy functions and keeping the pharmacy in compliance with all federal and state requirements * Performs various clerical duties relating to the department * Communicates with solid professional verbal and written communication skills You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * High school diploma/GED or equivalent experience * Active and unrestricted Pharmacy Technician license in applicable state or ability to get certification within 60 days of hire * Able to work Monday- Friday 3:30pm to 12am with rotating weekends every 3-4 weeks. Preferred Qualifications: * National Pharmacy Technician Certification * Pharmacy and prescription data entry experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $16-27.7 hourly 14d ago
  • Phlebotomist

    Unitedhealth Group Inc. 4.6company rating

    Meriden, CT job

    Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Phlebotomist performs venipuncture and capillary puncture on adults and pediatric patients; collects urine specimens; participates in the instruction of new personnel; works with computers; communicates in a manner that promotes laboratory professionalism as well as a comfortable experience. The Phlebotomist also processes lab specimens. May be asked to cover another practice if/when needed. Schedule: This is a 40-hour work week Monday through Friday, 8am - 4:30pm. Location: 816 Broad St. Ste 24 Meriden, CT 06450 Primary Responsibilities: * Perform routine phlebotomy procedures * Ability to distinguish sample types and draw requirements with order of draw for lab testing * Navigate laboratory computer system with minimal to no errors * Perform pediatric and adult phlebotomy * Obtain finger stick collection * Verify patient demographics accurately with two patient identifiers * Adhere to safety and scientifically accepted infection control practices and standards * Blood collection: from adult and pediatric patients using vacutainer, syringe and butterfly techniques; capillary puncture using heel and fingerstick techniques * Identifies and labels specimens appropriately * Instruct patients regarding urine and stool collection procedures * Enters accessing data into the computer * Prepares specimens for sending out testing * Inventories supply and prepare phlebotomy stations to effectively collect blood * Attends required meetings * Function as an effective team member * Work cooperatively alongside physicians, nurses and other ancillary staff * Display effective communication * Maintain pace of over 4-6 patients per hour * Enhances professional growth and development through in service meetings and education programs * Maintains patient confidentiality * Performs related work as required * Provide quality customer service to the patients and visitors courteously and promptly * Must possess solid interpersonal skills to communicate effectively with co-workers, Management Staff, and Physicians * Must be able to work effectively and cooperatively as a team member, balancing both the support of the physician(s) and following the financial policies established by Optum * Demonstrate professionalism in appearance and actions with patients, staff, Physicians and Administrators always * Maintains confidentiality of patient information * Travel to all other draw stations and perform all tasks * Troubleshoot problems within LIS and partner with LIS team to resolve outstanding issues * Including but not limited to: * Follow handwashing protocols * Practice aseptic techniques * Utilize protective barriers * Utilize personal protective equipment, e.g. gloves, lab coats * Maintain proper disposal of hazardous materials * Demonstrate knowledge of role in emergency disaster * Maintain pace of over 4-6 patients per hour * Travel to all other draw stations and perform all tasks * Performs other duties as assigned What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: * Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays * Medical Plan options along with participation in a Health Spending Account or a Health Saving account * Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage * 401(k) Savings Plan, Employee Stock Purchase Plan * Education Reimbursement * Employee Discounts * Employee Assistance Program * Employee Referral Bonus Program * Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) * More information can be downloaded at: ************************* You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * High School Diploma/GED (or higher) * Phlebotomy certified * 1+ years of experience of drawing blood * Beginner level of proficiency in Microsoft Office and demonstrates solid computer skills * Access to reliable transportation and valid US driver's license Preferred Qualifications: * 1+ years of EPIC experience * Previous laboratory experience * Pediatrics Phlebotomy experience * Bilingual Spanish Soft Skills: * Ability to work independently and maintain good judgment and accountability * Ability to acclimate working on a small or large team * Demonstrated ability to work well with health care providers * Strong organizational and time management skills * Ability to multi-task and prioritize tasks to meet all deadlines * Ability to work well under pressure in a fast-paced environment * Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #RED
    $16-27.7 hourly 10d ago
  • Associate Claims Representative

    Unitedhealth Group 4.6company rating

    Hartford, CT job

    _This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges._ **Optum Insight** is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start **Caring. Connecting. Growing together.** If putting a smile on someone's face puts one on yours, you belong on our team. Here at Optum and UnitedHealth Group, we've brought together teams of incredibly compassionate and absolutely positive people to help serve our members when they call us with questions regarding their health care coverage, eligibility or reimbursement. Your helpful personality combined with our support, training and development will ensure your success. This is no small opportunity. This is where you can bring your compassion for others while building a career. This role is equally challenging and rewarding. You'll be called on to research complex issues across multiple databases. It requires fluency in computer navigation and toggling while you confidently and compassionately engage in dialogue with the caller. Be assured that our training will provide you with knowledge of the various products, plans and levels of benefits available to members and you'll soon find yourself creating positive experiences and earning the gratitude of callers on an hourly basis. This position is full-time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm CST. It may be necessary, given the business need, to work occasional overtime. We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule. **Primary Responsibilities:** + Making outbound calls to care providers and minimal inbound calls + Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems + Contact care providers (hospitals) on behalf of the customer to assist with claims related issues or concerns + Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma / GED + Must be 18 years of age OR older + 1+ years of customer service experience + Administrative experience (i.e. office, administrative, clerical, customer service, etc.) + Experience with Microsoft Excel (ability to create, edit, filter and sort through spreadsheets) + Experience with Microsoft Word (ability to create and edit spreadsheets) + Experience with Microsoft Outlook (ability to send/receive emails and calendar invites) + Proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications + Experience in a fast paced or production environment + Ability to work Monday - Friday, 08:00am - 05:00pm CST. **Preferred Qualifications:** + Experience processing medical, dental or prescription claims + Familiarity with UB04's + Understand and maintain HIPAA confidentiality and privacy standards when completing assigned work **Telecommuting Requirements:** + Ability to keep all company sensitive documents secure (if applicable) + Required to have a dedicated work area established that is separated from other living areas and provides information privacy. + Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. **Soft Skills:** + Demonstrated ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner + Detail orientated - maintain a high level of quality + Strong telephone skills + Proficient conflict management skills to resolve issues in a stressful situation *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $16.00 - $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
    $16-27.7 hourly 3d ago
  • Senior IT Product Manager - Information Marketplace & Data Governance Platform

    Humana 4.8company rating

    Hartford, CT job

    **Become a part of our caring community and help us put health first** The Senior IT Product Manager - Information Marketplace & Data Governance is responsible for the strategic vision, roadmap, and execution of the Information Marketplace and its ecosystem of integrated enterprise capabilities. This role owns the end-to-end product lifecycle for the Information Marketplace as well as integrations with its supporting capabilities, data discovery, data quality and observability, metadata management, data cataloging, semantic enablement, and governed data usage processes such as the Protected Information Review Council (PIRC). The Information Marketplace serves as the front door and starting off point for finding and understanding Humana's data. It serves a large role in day-to-day data usage and management processes and that role will continue to expand and evolve. The Senior IT Product Manager partners closely with data governance leadership, architecture, engineering, security, compliance, and business stakeholders to ensure these capabilities operate as a cohesive, scalable product that enables trusted data use, risk reduction, and business value realization. They will create, prioritize and manage product backlogs with a focus on iteration and scalability. They will directly influence department strategy and make decisions on moderately complex to complex issues regarding technical and non-technical approaches for project components. Work will be performed without direction and considerable latitude will need to be exercised in determining objectives and approaches. Detailed Responsibilities **Product Strategy & Vision** + Define and own the long-term product vision and roadmap for the Information Marketplace and its integration to supporting capabilities and processes. + Translate enterprise data governance, compliance, and analytics strategies into actionable product capabilities and prioritized initiatives. + Act as the product authority for how data discovery, quality, observability, metadata management, and semantic layers work together as a unified experience. **Information Marketplace Ownership** + Own the Information Marketplace as a core enterprise product, including user experience, adoption, scalability, and extensibility. + Ensure the Marketplace enables intuitive discovery of curated and un-curated data assets. + Drive continuous improvement of Marketplace capabilities based on usage analytics, stakeholder feedback, and emerging governance trends. **Platform Integrations & Ecosystem Management** + Lead integration strategy and execution across platforms supporting: + Data quality and observability + Data cataloging and metadata management + Data lineage and impact analysis + Semantic layers and business term enablement + Workflow and approval processes (e.g., PIRC) + Partner with architecture and engineering teams to ensure integrations are scalable, secure, resilient, and aligned with enterprise standards. + Manage dependencies across internal platforms, vendor tools, and custom-built solutions. **Stakeholder Engagement & Leadership** + Serve as the primary product interface between data governance leadership and stakeholders. + Facilitate prioritization decisions. + Communicate product strategy, roadmap progress, and outcomes to executive and senior leadership audiences. **Delivery & Execution** + Own and manage the product backlog, ensuring clear articulation of epics, features, and acceptance criteria. + Partner with agile delivery teams to ensure timely, high-quality execution of product initiatives. + Define and track success metrics related to adoption, data trust, operational efficiency, and risk reduction. **Use your skills to make an impact** **Required Qualifications** + 8+ years of experience in product management, technology product ownership, or platform leadership roles. + Proven experience managing complex, enterprise-scale platforms with multiple integrations and stakeholders. + Demonstrated success owning products across the full lifecycle, from strategy and vision through delivery and adoption. + Ability to work effectively with architects and engineers on integration patterns, APIs, metadata flows, and platform interoperability. + Experience operating in hybrid or multi-platform environments, including vendor tools and custom-built solutions. + Exceptional stakeholder management skills, with the ability to influence without direct authority. **Preferred Qualifications** + Strong understanding of data governance concepts, including metadata management, data quality, data lineage, and data stewardship. + Experience with data discovery, data cataloging, or information marketplace-style platforms. + Familiarity with compliance-driven data usage processes (e.g., privacy reviews, data access approvals, risk assessments). + Strong understanding of how semantic layers, business glossaries, and metadata drive analytics and AI enablement. + Strong executive communication skills, including the ability to translate complex technical concepts into business outcomes. + Experience supporting regulated industries (e.g., healthcare, financial services, insurance). + Exposure to data observability platforms, data quality automation, or AI-enabled governance capabilities. + Experience operationalizing governance processes through workflow tools or custom platforms. 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. $104,000 - $143,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 03-26-2026 **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 ***************************************************************************
    $104k-143k yearly 2d ago
  • Billing Representative

    Unitedhealth Group 4.6company rating

    Hartford, CT job

    _This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges._ **Optum Insight** is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start **Caring. Connecting. Growing together.** As part of the **UnitedHealth Group** family of businesses, we're a dynamic new partnership formed by **Dignity Health** and **Optum** . We'll count on your professionalism, expertise, and dedication to help ensure that our patients receive the quality of care they need. So, if you're looking for a place to use your passion, your ideas and your desire to drive change, this is the opportunity for you. The **Billing Representative** is responsible for accurate and timely billing of UB-04 claims for acute hospital services. This role works closely with internal teams and hospital facilities to resolve claim edits, ensure compliance with CMS, State, and Payer regulations, and follow established billing matrices and workflows to support clean claim submission and optimal reimbursement. This position is full-time (40 hours/week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 3:30pm PST. It may be necessary, given the business need, to work occasional overtime. We offer on-the-job training. The hours of training will be aligned with your schedule. **Primary Responsibilities:** + Prepare, review, and submit UB-04 claims for acute inpatient and outpatient hospital services + Review and resolve claim edits by sending and responding to tasks in accordance with established processes + Work directly with hospital facilities to obtain required documentation, clarify billing issues, and resolve discrepancies + Follow detailed billing matrices, payer-specific instructions, and internal workflows + Ensure all billing activities remain compliant with payer guidelines and internal compliance standards + Identify and correct billing errors prior to claim submission to prevent denials + Assist with claim follow-up, rebilling, and correction requests as needed + Document all account activity clearly and accurately in billing systems + Collaborate effectively with team members to meet department goals and deadlines + Maintain productivity and accuracy standards in a high-volume acute care environment You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma / GED + Must be 18 years of age OR older + 1+ years of hospital billing experience + Working knowledge of medical terminology + Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications + Experience with Microsoft Word (create correspondence and work within templates), Microsoft Excel (data entry, sort / filter, and work within tables) and Microsoft Outlook (email and calendar management) + Ability to work Monday - Friday, 7:00am - 3:30pm PST **Preferred Qualifications:** + Experience with UB-04 billing + Residing within PST time zone + Experience with Federal or State billing **Telecommuting Requirements:** + Ability to keep all company sensitive documents secure (if applicable) + Required to have a dedicated work area established that is separated from other living areas and provides information privacy. + Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. **Soft Skills:** + Experience with identifying root causes to determine appropriate actions and outcomes + Ability to completely and concisely summarize important details in account notes + Ability to multitask, handling multiple software's at a time + Ability to conduct professional conversations with internal and external teams *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 - $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
    $18-32.1 hourly 1d ago
  • Business Intelligence Lead

    Humana 4.8company rating

    Hartford, CT job

    **Become a part of our caring community and help us put health first** We're seeking a Business Intelligence Lead to join our team. This role is ideal for a strategic thinker and hands-on thought leader who thrives at the intersection of data, business strategy, and cross-functional collaboration. You'll be responsible for transforming raw data into actionable insights that directly influence executive decision-making and drive enterprise-wide initiatives. **What You'll Do:** + **Lead Strategic BI Initiatives:** Design, develop, and deliver business intelligence tools and analyses that support key organizational priorities across sales, operations, and customer experience. + **Partner with Senior Leadership:** Serve as a trusted advisor to executives and business leaders, translating complex data into clear, actionable insights that inform strategic decisions. + **Drive Analytical Excellence:** Perform deep-dive analyses to uncover trends, relationships, and opportunities to inform decision-making. + **Ensure Data Quality and Governance:** Collaborate with data engineering and governance teams to ensure BI solutions are scalable, reliable, and aligned with enterprise standards. **What We're Looking For** + Proven experience in business intelligence, analytics, and/or strategy advancement, ideally in a lead or senior role. + Expertise in BI tools (e.g., Power BI, Tableau, etc), SQL, and modern data platforms (e.g., Snowflake, DataBricks, etc). + Strong business acumen and the ability to communicate complex data concepts to executive leadership and non-technical stakeholders. + Demonstrated success in leading cross-functional projects and influencing strategic outcomes. + A passion for uncovering insights and driving measurable impact through data. **Why Join Us** + Work directly with senior executives on high-visibility initiatives. + Be part of a team that values depth of thought, precision, and innovation. + Help shape the future of data-driven decision-making in a dynamic and evolving organization. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree and 8 or more years of technical experience in business intelligence, analytics, and/or strategy advancement, ideally in a lead or senior role. + Expertise in BI tools (e.g., Power BI, Tableau, etc), SQL, and modern data platforms (e.g., Snowflake, DataBricks, etc). + 2 or more years of project leadership experience + Advanced experience working with big and complex data sets within large organizations + Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction + Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs **Preferred Qualifications** + Advanced Degree in a quantitative discipline, such as Mathematics, Economics, Finance, Statistics, Computer Science, Engineering or related field + Advanced in SQL, SAS and other data systems + Expertise in data mining, forecasting, simulation, and/or predictive modeling + Experience creating analytics solutions for various healthcare sectors 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: 01-16-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $117.6k-161.7k yearly 6d ago
  • Algorithm and Analytics Consultant

    Unitedhealth Group 4.6company rating

    Hartford, CT job

    _This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges._ Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you'll provide consultative support to our business units and external vendor organizations. You'll handle requests, define business requirements and coordinate resolutions incorporating State/Federal regulations. Join us and build your career with an industry leader. This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm EST). It may be necessary, given the business need, to work occasional overtime. We offer 8 weeks of on the job training. Schedule will be 8:00am to 5:00pm EST. **Primary Responsibilities:** + Define and document/communicate business requirements + Analyze scope and resolution of medium to large size Operations Management (OM) and development requests + Serve as a key resource on complex and/or critical issues and help develop innovative solutions + Perform complex conceptual analyses + Serve as a key resource on complex and/or critical issues and help develop innovative solutions This is a challenging role with serious impact. You'll be assisting, educating, problem-solving and resolving challenging situations to the best possible outcomes. You'll need to understand and interpret clients' needs and ensure service and delivery excellence supporting the Fraud, Waste, Abuse, and Error product suite. This involves working with a high complexity solution set and cross functional teams to proactively review, research and resolve highly escalated inquiries. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma/GED OR equivalent work experience + Must be 18 years of age OR older + 2+ years of experience working in negotiations, mediations, and / or arbitrations; preferably in the health insurance business + 2+ years of experience analyzing and solving problems + 2+ years of experience using claims platforms such as UNET, Pulse, NICE, Facets, Diamond, etc. + Proficiency using MS Excel (data entry, sorting/filtering, pivot tables) and PowerPoint + Ability to work fulltime, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm EST). It may be necessary, given the business need, to work occasional overtime. **Preferred Qualifications:** + Understanding of medical coding methodologies + 1+ years of experience in health care claims recovery **Telecommuting Requirements:** + Ability to keep all company sensitive documents secure (if applicable) + Required to have a dedicated work area established that is separated from other living areas and provides information privacy. + Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 - $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the 2health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $71.2k-127.2k yearly 29d ago
  • Accounts Receivable Clerk

    Unitedhealth Group 4.6company rating

    Hartford, CT job

    _This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week._ Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start **Caring. Connecting. Growing together.** This position is responsible for the management of activities relative to third party payer billing. Ensures timely and accurate filing of claims, performs accounts receivable management, and follows up on denials and non-payments. May assist in the training and mentoring of other team members. This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 4:30pm CST. We offer 4 weeks of training. The hours of training will be 8:00am - 4:30pm CST. **Primary Responsibilities:** + Insurance billing follow-up in compliance with government rules and regulations + Submits, processes, and resolves claim rejections and denials + Verifies patient insurance eligibility for denial resolution + Completes the appeal process + Monitors and follows up on unpaid balances + Resolves issues and resubmits for payment + Utilizes resources to reconcile accounts + Performs demographic and insurance coverage updates on accounts and bills new insurance + Contacts insurance companies to obtain the status of outstanding claims and submitted appeals + Provides professional billing support + Assists in training and mentoring to ensure compliance of established processes + Provides education or feedback to operational sites and other departments within Revenue Cycle Management (RCM) + Participates in process improvement initiatives to improve efficiency and customer service expectations + Monitors, identifies, and communicates trend analysis + Other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma / GED + Must be 18 years of age OR older + 2+ years of experience in revenue cycle operations (ie: patient access) + Ability to work full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 4:30pm CST. **Preferred Qualifications:** + 2+ years of experience with medical terminology and medical coding + 1+ years of experience in billing follow up and denials + 1+ years of experience with NextGen + 1+ years of experience with cash reconciliation **Telecommuting Requirements:** + Ability to keep all company sensitive documents secure (if applicable) + Required to have a dedicated work area established that is separated from other living areas and provides information privacy. + Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 - $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
    $17.7-31.6 hourly 3d ago
  • Medical Assistant MA, Newington Pediatrics

    Unitedhealth Group Inc. 4.6company rating

    Newington, CT job

    Opportunities with ProHealth Physicians, part of the Optum family of businesses. When you work at ProHealth Physicians, your contributions directly sustain the health and well-being of our community. Discover high levels of teamwork, robust medical resources and a deep commitment to exceptional care and service. Join a leading community-based medical group and discover the meaning behind Caring. Connecting. Growing together. Are you ready to make a positive impact in health care? If so, you're the missing piece in our care team. As part of the Optum and UnitedHealth Group family, ProHealth Physicians offers new opportunities for growth. Here, you'll experience: * Exceptional teamwork * Robust medical resources * Passionate professionals with a focus on patient-centered care Position Details: * Location: 141 Willard Avenue, Newington, CT 06111 * Department: Pediatrics * Schedule: Full time, 40 hours/weekly, Monday through Friday, hours between 7:45AM - 6:30PM The Medical Assistant supports the Care team and its patients through patient care, clinical and administrative tasks including patient intake, receiving and responding to patient phone calls, and documenting patient interactions. The MA performs duties within the Connecticut scope of practice. Primary Responsibilities: * Provide patient care, clinical summary and direction on next steps or follow up * Perform phlebotomy for patients as needed * Act as a member of the care team, including preparing patients to be seen by collecting and recording clinical information as per protocol * Manage patients according to approved protocols and consistent with appointment and scheduling guidelines * Carry out standing orders consistent with practice policies and procedures * Document all patient interactions and other clinical activities accurately and in a timely manner in the electronic health record (EHR) * Schedule tests, treatments and follow up visits on behalf of patients; assist patients with identifying suitable outside resources for disease management and other services; refer patients when appropriate * Answer and document patient phone calls; take complete messages and route to providers as needed using the EHR * Monitor task pools in order to respond to tasks in a timely manner, follow up on overdue orders/worklists and monitor status of critical referrals * In coordination with Regional Nurse Managers, maintain oversight of temperature monitoring * Assist care team to assure smooth office operation and delivery of excellent service through teamwork * Provide attention to patients in a manner that builds confidence, trust and loyalty * Demonstrate respect for patients and ProHealth staff by presenting a friendly, courteous manner at all times and maintaining patient confidentiality * Maintain open lines of communications with care team and Regional Management team * Maintain knowledge of current coding, OSHA and CLIA regulations and company policies * Adhere to all patient safety initiatives and infection control regulations * Perform other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualification: * Graduate of Accredited Medical Assistant program OR Completed relevant medical assisting training by any branch of the armed forces of the United States OR 2+ years of aide or tech level work experience in healthcare Preferred Qualifications: * Graduate from an accredited MA program * Certified / Registered Medical Assistant from AAMA, NHA, NCCT, or AMT * CPR/BLS Certification * Completed relevant medical assisting training by any branch of the armed forced of the United States * 1+ years of pediatrics experience * 1+ years of MA experience * Experience working with Epic * Experience working in a primary care office * Intermediate level of computer proficiency Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $24.23 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $16-24.2 hourly 3d ago
  • Home Care Business Manager

    Unitedhealth Group Inc. 4.6company rating

    Danbury, CT job

    Explore opportunities with Patient Care, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. The Home Health Business Manager is responsible for managing, coordinating, and directing the administrative support and non-clinical operations of the agency, and for ensuring that all duties are performed in a timely manner. The Business Manager is also responsible for ensuring that all administrative support to the Executive Director and/or Clinical Director functions are operating effectively and efficiently. Primary Responsibilities: * Overseeing and maintaining contracts, binders, and HR/medical files for all agency employees and contract staff in accordance with policy and applicable regulations * Reviewing, reconciling, and submitting invoices to Home Office in accordance with LHC Group policy. This also includes ensuring payment is issued timely, following up on concerns, and maintaining a positive relationship with all vendors * Performs and or manages billing audits per policy and follows-up with corrections * Manages clerical staff and manages all non-clinical workflow and process in the office. This includes timely completion of all clerical tasks, as well as providing input into hiring, disciplinary, and separation decisions You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Must possess at least one of the following: * 3+ years of healthcare experience * 3+ years of experience in an office administration role * Bachelor's Degree * Computer proficiency, including Microsoft Office suite Preferred Qualifications: * Demonstrated solid organizational, written, verbal communication, and time management skills * Demonstrated computer proficiency, including Microsoft Office suite * Demonstrated ability to work independently * Demonstrated solid process and people leadership abilities * Experience with payroll process, supply management, and basic financial knowledge Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $20.4-36.4 hourly 8d ago
  • Associate Patient Care Coordinator

    Unitedhealth Group 4.6company rating

    Farmington, CT job

    Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** ProHealth is seeking an **Associate Patient Care Coordinator** to join our growing **Family Medicine** team. This position will support the care team and its patients by greeting and checking in patients, scheduling appointments, answering telephone inquiries, collecting payments and maintaining demographic information. Additionally, they will routinely use the electronic health record (HER) according to ProHealth policies. **Hours (40 hours):** 8-hour shift Monday - Friday between 7am - 6:15pm EST; may need to provide coverage for other nearby locations **Location** : 599 Farmington Avenue, Suite 101, Farmington, CT **Primary Responsibilities:** + Schedule and triage appointment requests for urgency according to approved protocols consistent with ProHealth's Appointment and Scheduling Guidelines + Use call processing and other applicable functionality in the EHR to take messages and communicate with clinicians + Greet patients and conduct check-in process + Monitor daily reminder call logs to reschedule appointments as needed + Scan and index documents into the EHR; ensure that necessary documents, lab results, etc. are available in advance of patient visits + Close payment batch(es) at the end of each shift, assemble and balance batch(es) according to ProHealth cash control procedures + Maintain knowledge of current OSHA, HIPAA, and ProHealth policies + Assist coworkers as needed to ensure smooth office operation and delivery of excellent service through teamwork + Provide coverage at other ProHealth locations on an ad hoc basis + Perform other duties as assigned **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma/GED (or higher) + 1+ years of customer service, healthcare, and/or administrative experience + Intermediate level of computer proficiency in Microsoft Office + Ability to work flexible schedule between 7:00am - 6:15pm EST + Access to reliable transportation and active valid US driver's license to provide coverage as needed to other office locations **Preferred Qualifications:** + Experience working in a primary care setting + Experience working with Epic + Experience working with an electronic health record + Knowledge of medical terminology + Office Administrative / Receptionist / Clerical experience in a medical environment + Customer service experience in retail, hospitality, etc. + Knowledge of ICD - 10 and CPT coding **Soft Skills:** + Ability to work independently and maintain good judgment and accountability + Demonstrated ability to work well with health care providers + Strong organizational and time management skills + Ability to multi-task and prioritize tasks to meet all deadlines + Ability to work well under pressure in a fast-paced environment + Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.15 to $28.80 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #RED
    $16.2-28.8 hourly 1d ago
  • Health Information Management Representative

    Unitedhealth Group 4.6company rating

    Hartford, CT job

    _This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges._ Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start **Caring. Connecting. Growing together.** This position is full time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 4:30pm CST. We offer 3 weeks of on-the-job training. The hours of the training will be aligned with your schedule. **Primary Responsibilities:** + Reviews electronic chart documentation ensuring correct patient, location, and no duplicate information + Processes release of information (ROI) requests + Manages requests for documentation and information + Scans and edits documents in the electronic medical record + Locates, logs, retrieves, files, and delivers medical records stored in various mediums and systems + May train and mentor co-workers + Analyzes documentation and tracks completion to meet regulatory requirements + Promotes principles of health information accuracy, transparency, currency, accessibility, relevancy, and reliability + Work with Microsoft Word, Microsoft Excel (create, edit, save documents and spreadsheets) and Microsoft Outlook (email and calendar management) + Other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma / GED OR equivalent work experience + Must be 18 years of age OR older + 1+ years of customer service experience within a hospital or healthcare environment + 1+ years of Health Information Management (HIM) or Release of Information (ROI) experience + Experience with Microsoft Office products + Ability to work Monday - Friday, 8:00 am to 4:30 pm CST **Preferred Qualifications:** + 2+ years of customer service experience + RHIT or RHIA certification + EPIC experience + Knowledge of medical terminology + Health Information Management (HIM) experience + Clerical or administrative support background + Experience working within the health care Industry and with health care insurance + Experience working in a hospital, physician's office or medical clinic setting + Experience working in a call center + Experience communicating with patients & staff with various educational & socio-economic backgrounds **Telecommuting Requirements:** + Ability to keep all company sensitive documents secure (if applicable) + Required to have a dedicated work area established that is separated from other living areas and provides information privacy + Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 - $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **_Application Deadline:_** _This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $18-32.1 hourly 1d ago
  • Pharmacy Technician

    Unitedhealth Group Inc. 4.6company rating

    Mansfield Center, CT job

    "A Day in the Life" video Opportunities with Genoa Healthcare. A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start Caring. Connecting. Growing together. We seek a Pharmacy Technician to support all functions of the Genoa mental health and specialty pharmacy primarily through dispensing medical prescriptions and performing necessary clerical duties while under the direct supervision of a Registered Pharmacist. Hours: Monday - Friday 8:00am - 4:30pm (Lunch 12pm - 12:30pm) Location: 140 North Frontage Road, Room 171, Mansfield Center, CT, 06250 Primary Responsibilities: * Provides exceptional customer service to all consumers and members of the clinic staff * Fills prescription orders and makes them available for verification under direct supervision of the Registered Pharmacist * Orders, receives and stores incoming pharmacy supplies * Receives and processes medication orders * Verifies medication stock and enters data in computer to maintain inventory records * Works with the Pharmacist to assist in the pharmacy functions and keeping the pharmacy in compliance with all federal and state requirements * Performs various clerical duties relating to the department * Communicates with strong professional verbal and written communication skills * Other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Active and unrestricted Pharmacy Technician license in the state of Connecticut * Access to reliable transportation and valid US driver's license Preferred Qualifications: * 6+ months of Pharmacy Technician experience * National Pharmacy Technician Certification * Bilingual in English and Spanish Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #RED
    $16-27.7 hourly 14d ago

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