HCSC jobs in Springfield, IL

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** Responsible for an integrated member experience. Responsible for providing concierge guidance and answering questions from members and providers for medical, behavioral health and prescription benefits and claims. Assisting members in assessing tools, health partner options, and setting provider appts through their choice of communication whether it be phone, webchat, or written. The incumbent is a subject matter expert and may handle projects and assist in training others. They are responsible for navigating the healthcare system and helping the member reach optimal health by collaborating with clinicians from medical, behavioral or a pharmacist. Required Job Qualifications: * Associate with 2 years OR, a Bachelor's with 1 year, OR 3 years of concierge-oriented customer service experience * Experience emphasizing plan of care, assisting customers to select in-network providers, and train customers on tools. * Knowledge of medical terminology. * Experience building trust and providing concierge level of service. * Clear and concise verbal and written communication skills, including motivational interviewing to interact with the members and physicians. * Attention to detail and strong documentation skills. * Web and PC proficiency. Preferred Job Qualifications: * Associate degree in Health Science or Health Studies or Bachelor's degree. * Knowledge of HCSC customer service systems, processes, and products of the operational area. * 3 years of concierge-oriented customer service experience in an insurance environment. * Clinical or social work expertise. * Experience in coordinating medical services. * Knowledge with health benefit plans and the insurance industry. **This role will work onsite at the office address listed and the primary schedule will be Monday - Friday within 8am-6pm, based on business need. Pay will start at $24/hour.** **\#LI-TB1** **\#INKT** **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $18.10 - $37.10 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

**Become a part of our caring community and help us put health first** Humana's Transformation Program team is a high-performing team that works closely with senior leaders to help chart the course for the company's future. Transformation is critical to our core strategy: delivering great healthcare to seniors, providing a differentiated healthcare experience, and growing our reach and impact with members and patients. As a member of the Transformation team, you will support the complex and coordinated effort required to execute the enterprise strategy: accelerating our long-term vision by identifying opportunities, designing solutions, and implementing initiatives to fundamentally change the member, patient, provider, and associate experiences. The Transformation team is modeled after top-tier management consultancies. Team members work on fast-faced and high-visibility projects aligned with the enterprise's most important Transformation topics. Every day in the role is different, but activities often include developing industry analysis, building high-level financial/business models, conducting informational interviews, managing complex projects with numerous stakeholders, and synthesizing recommendations into executive-level deliverables that drive real-world results. Work assignments require a combination of strategic thinking, quantitative analysis, workstream management, cross-team collaboration, and storytelling. Team members can align with one of the enterprise's lines of business, supporting functions, or key Transformation capabilities to become a trusted thought partner for the Transformation agenda. **Key Responsibilities:** **Translate clinical, operational, and growth ideas into clear financial cases and scenario ranges** **Work with senior leaders to sequence initiatives, surface interdependencies, and ensure resources flow to the highest opportunities** **Design the framework that connects key performance indicators to the P&L and keeps leaders informed of near real-time progress** **Partner with analytics, technology and FP&A teams to deliver dashboards and tools executives use, not just read** **Package complex analysis into crisp narratives that secure sponsorship, funding, and enterprise adoption** **Guide a team of analysts and collaborate with finance, clinical, and technology partners to move initiatives from concept to booked impact** **Use your skills to make an impact** **Required Qualifications:** **8+ years in transformation, corporate finance, strategy consulting, or advanced analytics** **Fluency in financial modeling and scenario analysis (Excel plus SQL/Python or similar)** **Comfort navigating senior-executive conversations and cross-functional workshops** **Strong storytelling skills, able to distill complex data into decisive recommendations** **Bachelor's degree required; MBA, MHA, or MS Analytics preferred** **Preferred Qualifications** **Additional Information** Preferred working locations are Louisville, KY and Arlington, VA (Washington, DC metro area), with consideration for Chicago, IL, New York, NY, and alternative hub sites on a case-by-case basis. The Transformation team operates on a hybrid work arrangement (in office expectation of 3 days per week). **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. $168,000 - $231,000 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. **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the analysis of situations or data requires a case by case consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director will collaborate with clinicians and support staff to provide Humana members with optimal value based care in accordance with Medicare and Humana policy. All work occurs within a context of regulatory compliance and work is assisted by diverse resources, included but not limited to CMS policies, National and Local Coverage Determinations, CMS-recognized Compendia, NCCN, Humana Pharmacy Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements and will understand how to operationalize this in their daily work. The Medical Director's work includes computer based review of moderately complex to complex appeals for coverage for drugs using resources outlined above as well as inter- and intra-departmental resources. Work may include Peer to Peer discussions with prescribers, participation in hearings involving an Administrative Law Judge, support for CMS audits, cross-functional team activities, and other responsibilities as determined necessary to support optimal value based care in accordance with Medicare and Humana policy. **Use your skills to make an impact** **Required Qualifications:** + MD or DO degree + 5+ years of direct clinical patient care experience post residency or fellowship, preferably including some experience related to a Medicare type population (disabled or >65 years of age) + A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required + No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements + Excellent verbal and written communication skills + Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, or similar activities **Preferred Qualifications:** + Knowledge of the managed care industry, Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience in a medical management review organization such as Medicare Advantage, managed Medicaid, or Commercial health insurance + Current and ongoing Board Certification in Internal Medicine, Family Medicine, Emergency Medicine or Physical Medicine and Rehabilitation + Experience with national guidelines, such as MCG, InterQual, NCCN, Micromedex, Lexicomp, Elsevier's Clinical Pharmacology + Exposure to Public Health, Population Health, analytics, and use of business metrics + Curiosity to learn, flexibility to adapt, courage to innovate + Experience functioning as a Team member, providing support to reach a common goal **Additional Information** May participate on project teams or organizational committees. \#physiciancareers Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-31-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**Become a part of our caring community and help us put health first** Humana is a publicly traded, Fortune 100 health benefits company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in the 60's, to the largest US hospital corporation in the 80's, to a leading health benefits company beginning in the 90's. Today, Humana is a leader in consumer-focused health solutions and is one of the largest health benefits organizations in the country. Consumer Segment Team Identifying and delivering new avenues of growth is a critical company priority. The Consumer Segment team is an entrepreneurial, multi-functional team within Humana's Medicare and Medicaid business unit. The team is focused on driving industry leading membership growth, retention and health outcomes by identifying new consumer insights, developing growth strategies, and activating them across the enterprise to serve the unique needs of prioritized segments. Humana is seeking an experienced team member with meaningful strategy consulting or healthcare strategy experience to join this team. As Strategy Advancement Advisor, you will support development and implementation of consumer segment strategies that drive growth and retention while optimizing member experience and outcomes. You'll collaborate with teammates and cross-functional partners to frame up business questions, conduct analyses, and recommend solutions. You will help answer key strategic business questions that arise during the annual product/sales cycle across multiple domains, including product design, plan footprint, marketing and sales performance, membership analytics, customer/provider satisfaction and more. You will proactively identify new consumer insights and create business cases to support new pilots and initiatives to address critical unmet consumer needs. **Key Responsibilities Include** : + Managing analysis and/or work streams within high-profile, high-impact strategy projects + Conducting industry, market, competitor, and financial analysis and deliverables that clearly frame objectives, issues/challenges, and articulate compelling, insightful findings, conclusions, and recommendations + Conducting interviews, working sessions, and report-outs with associates and leaders across the company + Own development and presentation of key deliverables for leadership and cross-functional partners + Innovate new pilots and member experiences to drive growth and improved retention + Support business case development for key initiatives **Use your skills to make an impact** **Required Qualifications** + 7+ years of full-time relevant strategic work experience, ideally post-MBA + Strategy management consulting experience + Experience leading broad initiatives with cross-functional collaboration + Strong problem-solving skills and the ability to perform complex qualitative and quantitative analysis + Experience leveraging consumer insights to design and implement new products/services/solutions + Proficiency in verbal/written communication to senior and executive leadership + Proficient in delivering engaging and informative presentations to diverse audiences **Preferred Qualifications** + MBA, MPH, PhD, or graduate degree in a management field + Prior healthcare industry experience, preferably in the managed care or provider sector Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $115,200 - $158,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-18-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. ***NOTE: This is a hybrid remote role with occasional local travel (up to 10%) for home visits and team meetings. Preference will be given to individuals who (1) **reside in the following Illinois Counties: Perry, Jackson, Union, Alexander, Pulaski, Johnson, Williamson, Franklin, Jefferson, Wayne, Hamilton, Saline, Pope, Hardin, Gallatin, White, Edwards, Wabash;** (2) have worked in the child welfare or foster care or post adoption family space, (3) who have a combination of experience in service coordination, case management, community advocacy, behavioral health while using varius office software such as outlook, excel, electronic medical record platforms proficiently.*** Additional Details: - Line of Business: Illinois Health Plan - Department: MED-Medical Management (Case Management) - Caseload: Youth Care/Foster Care (ages 0-21) - Schedule: Monday through Friday, 8am-5pm central **Position Purpose:** Works with senior care management team to support care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for members and interacts with members by performing member outreach telephonically or through home-visits. + Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate + Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed + Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plans + Develops in-depth knowledge of care management services including responding to some complex or escalated issues + Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care + Performs service assessments/screening for members with some complex needs and documents the member's care needs. + Documents and maintains member records in accordance with state and regulatory requirements and distribution to providers as needed + Works with care management team with triaging, adjusting, and escalating complex requests to management + Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards + Ability to identify needs and make referrals to Care Manager, community cased organizations, and Disease Manager + Provide education on benefits and resources available + May assist with training and development needs + Performs other duties as assigned. + Complies with all policies and standards. **Education/Experience:** Requires a High School diploma or GED. Requires 2 - 4 years of related experience **License/Certification:** + For Illinois Youth Care plan only: Bachelor's degree in nursing, social sciences, social work, or related field; One (1) year of supervised clinical experience in a human-services field. Must reside in IL Pay Range: $20.00 - $34.03 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

**Become a part of our caring community and help us put health first** The 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 Actuary, Analytics/Forecasting works on problems of diverse scope and complexity ranging from moderate to substantial. The 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. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations. + MAAA + Strong communication skills + Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending) + Proficiency with at least one software coding language. + 3+ years of SQL experience, preferably in SSMS. **Preferred Qualifications** + Medicare Advantage experience. + Experience with SQL and VBA highly preferred. + Experience with Power Platform / Azure Synapse / Databricks / Python or similar software coding experience preferred. + Strong desire to engage and learn new innovative technologies to transform traditional financial and Actuarial work. + Experience with building and owning Actuarial pricing methodologies. **Additional Information** + This role is part of a team that owns the Medicare Advantage pricing methodology and supporting tools in the ecosystem. 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. $129,300 - $177,800 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: 12-30-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**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. Our brokerage business is poised to advance the industry in how digital can be used to drive customer acquisition in the Medicare Advantage space. Within this business area, we are aggressively driving new digital capabilities, new ways of working, and employing next-gen technology to revolutionize how Medicare Advantage is sold. This role is part of this expanding Digital organization, and will be critical in our growth plans. **Key Responsibilities:** + Develop the vision and roadmap for the platform and capabilities for this exciting new product, including functionality, performance, results criteria, evolution, and lifecycle, all towards innovatively and aggressively growing our eCommerce acquisition channel. + Provide strategic thought-leadership as a subject matter expert within Enterprise Growth and with partner organizations in the enterprise, on approaches to best-practices in Product Management. Be a leader in how Product Management at the company should be done. + Assess the business and consumer impact of various options and collaborate with the engineering, design, marketing, and sales teams to build business cases, requirements/services, and determine the best prioritization, technical implementation method, and schedule. + Establish hypotheses that enable us to test, learn, and iterate with high speed, enabling supercharged business growth. + Be customer and data obsessed - maintain a deep understanding of the needs and goals of consumers and business to develop requirements, data and features needed to deliver on a best-in-class digital experience. + Create business cases to be prioritized on the roadmap and collaborate with the engineering, design, marketing, and sales teams to build business cases, requirements/services, and determine the best technical implementation method and schedule. + Establish success measures/product/feature KPIs and maintain a deep understanding of the needs and goals of consumers and business to develop requirements, data and features needed to deliver on a best-in-class digital experience. + Proven ability to lead cross-functional teams through influence versus direct management; excellent interpersonal skills. + Structure and lead meetings, clearly communicate expectations, and ensure that stakeholders are adequately updated on progress and milestones. **Use your skills to make an impact** **Required Qualifications** + Expert Digital experience (web, mobile, social and ecommerce) + 7+ years of product management experience, with a focus on technical products and platform experience + Deep user empathy and strong user experience sensibilities + Ability to work well with designers and engineers in an agile environment + An entrepreneurial work style, you're a self-starter + Excellent written and verbal communication skills + Ability to facilitate collaborative decision-making in a workshop setting + An analytical and metrics-driven work style + Natural leadership instincts with proven ability to innovate and influence + Comfort in a fast-paced and dynamic environment 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. $126,300 - $173,700 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: 12-13-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **THIS POSITION IS REMOTE WITH 10% TRAVEL INTO OFFICE FOR MANDATORY MEETINGS AND/OR TOWN HALLS AT THIS TIME. THE WORK SCHEDULE IS MONDAY - FRIDAY, 8AM - 5PM CENTRAL TIME ZONE WITH FLEXIBILITY TO MEET BUSINESS NEEDS.** **APPLICANTS MUST RESIDE IN THE STATE OF ILLINOIS.** **THIS ROLE WILL WORK WITH MEDICAID SERIOUSLY MENTALLY ILL ADULTS INCLUDING SUBSTANCE USE DISORDER BEHAVIORAL HEALTH MEMBERS.** **Position Purpose:** Supervises the care management team and the care coordination of behavioral health members to promote quality and efficacy of care management delivery related to mental and behavioral health needs. Supervises day-to-day escalations and care management issues related to members or providers. + Monitors and reviews care management required documentation to maintain compliance with federal and state regulations and contractual agreements + Assigns caseloads to care management staff based on state requirements, care management staff experience, and member needs + Works with senior management on escalated and complex care cases related to BH and provides guidance to junior team members to address member concerns + Educates and provides resources for care management team on key initiatives and member outreach + Evaluates care management team performance and provides feedback regarding performance, goals, and career milestones + Provides coaching and guidance to care management team and providers to ensure members are receiving high quality care and information regarding service / care plan options, procedures, referrals, and healthcare benefits + Monitors and review reports on a regular basis ensuring quality and productivity metrics are met and for case assignments, and may perform audits of staff on a regular basis + Assists with onboarding, hiring, and training care management team members + Performs other duties as assigned. + Complies with all policies and standards. **Education/Experience:** Requires a Master's degree or Graduate from an Accredited School of Nursing and 4+ years of related experience. **License/Certification:** + Licensed Clinical Behavioral Health Professional or RN based on state contract requirements e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience required Pay Range: $85,300.00 - $158,100.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

**Explore opportunities with CPS,** part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind **Caring. Connecting. Growing together.** The Specialty Pharmacist will provide high-touch support to patients with complex, specialty diseases, helping them achieve better outcomes through personalized care and consistent engagement. You'll enroll and retain patients, deliver exceptional service, and act as a trusted resource throughout their therapy journey to maximize their access to pharmacy care. Responsibilities include resolving drug-related issues, educating patients and healthcare providers, coordinating clinical and billing projects, and contributing to formulary and compliance efforts. You'll also serve as a specialty medication expert, continuously expanding your knowledge through research and writing. **Primary Responsibilities:** + Enrolling patients into the program, by assisting with recruitment to ensure the most possible benefits for the patients + Delivering "VIP level" service to each patient in every interaction, ensuring they perceive our customer site pharmacy as the pharmacy of choice and ultimately impacting their level of success in their therapy + Retaining patients throughout the life of their therapy to achieve the best possible clinical outcomes by supporting them at each step in their therapeutic journey + Working to prevent and or resolve drug-related issues, and providing drug information to patients and families, physicians, nurses, and other healthcare professionals + Coordinating clinical projects, assisting with formulary decisions and, ensuring billing compliance and revenue capture and helping to lead other projects as needed + Serving as a resource and drug expert in specialty medications and increasing knowledge through research and writing activities You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + ACPE- accredited PharmD degree + Active applicable state pharmacist license in good standing **Preferred Qualifications:** + ASHP Accredited Residency + Work in a specialty pharmacy or clinic + Experience with specialty dispensing software 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 $89,900 to $160,600 annually 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._

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Portfolio Manager will perform various analytic and strategic tasks in order to support the Risk Adjustment team within the IL Health Plan Division. The Portfolio Manager will analyze portfolio data, documentation, and processes and consolidate this information for reporting to senior leadership. The role will be responsible for the collection, aggregation, and analysis of risk adjustment data (e.g., department / business area data for the portfolio of projects and initiatives managed by the area) across the enterprise. The data will be focused on risk gaps/scores, claims measures, chart chase outcomes, provider engagement metrics, chart review findings, risk adjustment impact, risk improvement opportunities. + Collect, aggregate, and analyze portfolio management data leveraging industry standard guidance such as, PMI standards, process and controls guidance, and best practices for project governance. + Collaborates with program and portfolio managers to define reporting metrics and performance data including: financial and project level performance + Prepares detailed analytic packages for reporting and review by key stakeholders + Participates and leads workgroups in the design and analysis of the portfolio management and reporting + Performs research and analysis on leading practices for the design and implementation of portfolio management standards + Perform other duties as assigned **Education/Experience:** Bachelor's Degree in Management, Information Systems, Data Analytics or Finance or equivalent experience is required. Minimum 3 years of experience in project and program management is required. Analytical skills, including Data Sciences and Business Intelligence Reporting is required. Some experience functioning as a lead is required. Up to 20% travel will be expected in this position **License/Certification:** A certification in one of the following is preferred: PfMP, CAPM, PMP, CGEIT, CISA, Data Sciences Certification **Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.** Pay Range: $86,000.00 - $154,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **Must currently reside in one of the following Illinois counties to be considered:** Mason, Cass, Greene, Jersey, Macoupin, McLean, Montgomery, Morgan, Piatt, Pike, Schuyler, Shelby, Vermilion, Adams, Brown, Calhoun, Champaign, Christian, Clark, Coles, Cumberland, De Witt, Douglas, Edgar, Ford, Hancock, Iroquois, Livingston, Logan, Macon, Menard, Moultrie, Sangamon, or Scott. Previous experience working with DCFS (Department of Children and Family Services) and/or in case management is plus **Position Purpose:** Works with senior care management team to support care management activities and the teams assigned to members to ensure services are delivered by the healthcare providers and partners and continuity of care/member satisfaction is achieved. Serves as a liaison alongside care managers and providers to ensure proper coordination of care for members and interacts with members by performing member outreach telephonically or through home-visits. + Provides outreach to members via phone or home visits to engage members and discuss care plan/service plan including next steps, resources, questions or concerns related to recommended care, and ongoing education for the member throughout care/service, as appropriate + Coordinates care activities based on the care plan/service plan and works with healthcare and community providers and partners, and members/caregivers to accommodate changes or progress, as needed + Serves as support on various member and/or provider inquiries, requests, or concerns related to care plan/service plans + Develops in-depth knowledge of care management services including responding to some complex or escalated issues + Communicates with care managers, practitioners, and others as needed to facilitate member services and to ensure continuity of care + Performs service assessments/screening for members with some complex needs and documents the member's care needs. + Documents and maintains member records in accordance with state and regulatory requirements and distribution to providers as needed + Works with care management team with triaging, adjusting, and escalating complex requests to management + Follows standards of practice and policies compliant with contractual requirements and regulatory guidelines and standards + Ability to identify needs and make referrals to Care Manager, community cased organizations, and Disease Manager + Provide education on benefits and resources available + May assist with training and development needs + Performs other duties as assigned. + Complies with all policies and standards. **Education/Experience:** For Illinois Youth Care plan only: Bachelor's degree in nursing, social sciences, social work, or related field; One (1) year of supervised clinical experience in a human-services field. Must reside in IL **License/Certification:** + For Illinois Youth Care plan only: Bachelor's degree in nursing, social sciences, social work, or related field; One (1) year of supervised clinical experience in a human-services field. Must reside in IL Pay Range: $20.00 - $34.03 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Remote Available. **Position Purpose:** Perform and lead various analysis and interpretation to link business needs and objectives for assigned function and implement process improvements. + Lead the support of business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems + Lead the identification and analysis of user requirements, procedures, and problems to improve existing processes + Resolve issues and identify opportunities for process redesign and improvement + Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations, including improvements and revisions to business processes and requirements + Evaluate risks and concerns and communicate to management + Coordinate with various business units and departments in the development and delivery of training programs + Develop, share, and incorporate organizational best practices into business applications + Oversee all changes to departmental policies and procedures, including communicating and implementing the changes + Serve as the subject matter expert on the assigned function product to ensure operational performance + Ability to travel **Education/Experience:** Bachelor's degree in related field or equivalent experience. 6+ years of business process or data analysis preferably in healthcare or 5+ years of HEDIS analysis. Advanced knowledge of Microsoft Applications, including Excel and Access preferred. Project management experience preferred. Pay Range: $86,000.00 - $154,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Manage all aspects of vendor activity, including but not limited to dental, ancillary, pharmacy, and vision vendors for Meridian Illinois Health Plan. ***The Manager, Vendor Management position is primarily remote with 10% travel expectation. Since it supports Illinois Health Plan, candidates must reside in the state of Illinois to be considered for the position. *** Responsibilities: Manage vendor utilization including workflows for coordinating services with the Illinois Health Plan Analyze vendor data and complete required reports for the health plan, Corporate and state Create and manage vendor scorecard and associated ratings/correction plans Perform as a key account manager for the Illinois Health Plan to coordinate with high priority providers and vendors Coordinate with Corporate Vendor Management team regarding vendor expectations, performance, and procedures Coordinate with Medical Management, Member Services and Provider Services to educate and communicate expectations, performance and procedures to vendors Conduct monthly meetings and document discussions, issues, attendees, action items, research and resolve claim disputes with vendor, member or provider issues and route to appropriate person(s) for resolution Receive and respond to provider related database information requests and concerns Ensure operation integrity, including compliance with all policies and procedures for the Illinois Health Plan including adherence to state contracts and guidelines Request and/or assist in the development of correction action plans for standards that are not met by the vendor Education/Experience: Bachelor's degree in public health, business or related field or equivalent experience. 4+ years of healthcare management experience, preferably in vendor managed care or the health insurance field. Experience with reporting and analyzing data preferred. Strong Excel skills and working with a variety of software data programs preferred. Project management experience a plus. Pay Range: $86,000.00 - $154,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

**Become a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical documentation to ensure capture of all relevant coding. Applies clinical and coding experience to conduct a clinical validation review of the inpatient medical record to validate billed diagnoses. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **Use your skills to make an impact** **WORK STYLE:** Remote/Work at Home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. Associates are expected to start each day between 6AM and 9AM in their home time zone. **Required Qualifications** + Active Registered Nurse (RN) license in the state they reside. + Minimum of 2 consecutive years acute inpatient hospital care experience in critical, intensive care setting within the last 5 years (Not pediatrics or neonatal). For example: ICU, CCU, PCU, med-surg/adult units or a minimum of 2 years DRG Inpatient auditing. NOTE: Inpatient experience does **not** refer to any other levels of care such as ER, OR, Pre-op, PACU,L&D, mother-baby, behavioral health, SNF, care manager/discharge manager, LTC, rehab, outpatient or office/clinic visits such as wound care, oncology, radiology, interventional radiology, lab, hospice, or home health. + In depth knowledge and critical understanding of complex medical diagnoses including, but not limited to, Sepsis (including end-organ failure), Pneumonia, Acidosis, Renal Failure, Encephalopathy, CVA, DKA, MI, etc. + Advanced knowledge of MS Office (Word, Excel, etc) + Excellent writing, editing, interpersonal, planning, teamwork, and communications skills + Demonstrated ability to exercise solid judgment and discretion in handling and disseminating information + Ability to work independently and manage workload + Customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession **Preferred Qualifications** + Bachelor's Degree in relevant field preferred + Inpatient coding certification (AHIMA or AAPC - ex: RHIA, RHIT, CCS, CIS, CIC) + Inpatient coding claim experience + Prospective payment methodologies, DRG auditing experience + Clinical documentation improvement knowledge (CDE, CDEI certification) **Additional Information** **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 **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. 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. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. **THIS POSITION IS REMOTE, WILL WORK FROM ASSIGNED HOSPITALS: ST. LOUIS UNIVERSITY AND CARDINAL/GLENNON. APPLICANTS SHOULD RESIDE WITHIN A 20 MILE RADIUS OF THESE HOSPITALS.** **ROLE WILL SUPPORT THE HOSPITAL CARE MANAGER/CASE MANAGER TO SUPPORT OUR MEMBERS; WILL HANDLE DISCHARGE PLANNING BASED ON MEMBER ADMISSIONS.** **WORK SCHEDULE WILL BE MONDAY - FRIDAY 8AM - 5PM DURING THE TRAINING TIME FRAME.** **Position Purpose:** Assesses, plans, and implements complex care management activities based on member activities to enable quality, cost-effective healthcare outcomes. Develops a personalized care plan / service plan for care members, addresses issues, and educates members and their families/care givers on services and benefit options available to receive appropriate high-quality care. + Develops and continuously assesses ongoing care plans / service plans and collaborates with providers to identify providers, specialist, and/or community resources needed to address member's unmet needs + Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services + Monitors care plans / service plans and/or member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs + May identify problems/barriers for care management and appropriate care management interventions for escalated cases + Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations + Reviews referrals information and intake assessments to develop appropriate care plans/service plans + May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources + Collaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed + Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators + Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits + Partners with leadership team to improve and enhance care and quality delivery for members in a cost-effective manner + May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness + Provides guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice + Engages and assists New Hire/Preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination success + Engages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readiness + Other duties or responsibilities as assigned by people leader to meet business needs + Performs other duties as assigned + Complies with all policies and standards **Education/Experience:** Requires a Degree from an Accredited School or Nursing or a Bachelor's degree in Nursing and 4 - 6 years of related experience. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required. Pay Range: $73,800.00 - $132,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

**Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor works on problems of diverse scope and complexity ranging from moderate to substantial. **Become a part of our caring community and help us put health first** The Strategy Advisor (Distribution) provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for the Enterprise Growth vertical. The Strategy Advisor's work involves complex assignments performed without direction where the analysis of situations or data requires an in-depth evaluation of variable factors. This work may require leading end-to-end strategy engagements. As part of the Strategy Advancement team, this role will support MarketPoint's investment rationalization and strategic planning efforts. The role requires comfort with ambiguity and creating new solutions in the "white space" where answers are not clear cut or readily available. A successful candidate will be someone who has worked for several years in large matrixed organization (e.g. a publicly traded corporation or large not profit organization) or has several years' experience with stakeholder management (strategy/operations at a top-tier consulting/professional services firm). They will have a demonstrated ability to synthesize large amounts of information into clear and concise outputs (PPT, Excel). This person must be comfortable working collaboratively with senior leaders and subject matter experts alike and should have a high degree of executive presence leading engagements with these stakeholders. This person also will be effective at multitasking and possess keen program and change management skills to balance an evolving set of priorities and deadlines. Healthcare experience is a plus, but not required, though must have a history of mastering an understanding of their prior industry. Other examples of the kind of work required from this role include leading the analysis of complex business problems and issues using data from internal and external sources. The candidate should bring expertise or identify subject matter experts in support of multi-functional efforts to identify, interpret, and produce strategic recommendations and plans. The candidate's work will substantially shape the thinking of distribution org. They will exercise independent judgment and decision making on complex issues to determine the best course of action and work under minimal supervision. **Use your skills to make an impact** About the team: Humana's distribution organization, MarketPoint, plays a key part in driving Humana's long-term vision to achieve leading growth in Medicare and individual products. The MarketPoint strategy team was created to help transform Humana's customer acquisition approach. The team functions with a mandate to think creatively, discover new opportunities and re-envision operations to drive growth and deliver a first-class experience to our members and agents. **Responsibilities:** + Leads multiple short- and long-term work streams sometimes across engagements, including hypothesis development, working sessions, and report-outs with leaders across the company, and documenting key ideas and actions to drive follow-up actions + Partners closely with finance, analytics, and operators to optimize, track, and report out on internal and external compensation strategy and results + Develop high-quality analysis and deliverables that clearly frame organizational objectives, issues/challenges, and articulate compelling, insightful findings, conclusions, and recommendations + Lead multiple cross functional investment sizing workstreams and provide high-level support for senior leaders to make informed decisions + Identify new growth avenues of opportunity through independent analysis and presents actionable findings + Lead key portions of presentations at high-visibility meetings + Assist MarketPoint leadership in communicating value and impact of MarketPoint initiatives to broader Humana organization + Coach junior team members to develop technical and professional skillsets **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + **3+ years** of progressive experience consulting in finance, strategic planning, or related roles. + Proven track record in **building compensation models** and **incentive design frameworks** . + Advanced proficiency in **financial modeling and Excel** + Demonstrated experience **managing large, complex budgets** and guiding senior leadership through **trade-off decisions** . + Strong background in **business case development** , including **value sizing** , ROI analysis, and scenario modeling. + Ability to influence and partner with senior executives to drive strategic decisions. + Exceptional analytical and problem-solving skills with a focus on **data-driven decision-making** . + Strong communication skills to present complex financial concepts clearly to non-financial stakeholders. **Preferred Qualifications** + Healthcare industry experience, preferably in the managed care or provider sector + Experience in **compensation strategy** within large organizations. + Exposure to **enterprise-level budgeting and resource allocation** . **Additional Information** **- Position does have the potential for up to 5% travel.** **- Position will be working Eastern (EST) hours.** **Virtual Pre-Screen** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a HireVue interview. In this interview, you will listen to a set of interview questions over your phone or text and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Work-At-Home Requirements** At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $115,200 - $158,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-28-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**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. We are seeking a Lead Product Manager to drive the vision, strategy, and execution of our Sales and Marketing Technology initiatives. This role will be pivotal in aligning product capabilities with business objectives, ensuring seamless integration across platforms, and delivering innovative solutions that empower our sales and marketing teams to achieve growth targets. The Lead Product Manager Conceives of, develops, delivers, and manages products for customer use. The Lead Product Manager works on problems of diverse scope and complexity ranging from moderate to substantial. **Key Responsibilities:** + Define and own the product roadmap for Sales Technology solutions and their intersection with Humana's Marketing organization. + Collaborate with cross-functional teams including Sales, Marketing, Engineering, and Data Analytics to deliver impactful products. + Lead discovery sessions to identify pain points and opportunities for process optimization. + Manage vendor relationships and evaluate third-party tools for integration. + Establish KPIs and measure product performance to ensure continuous improvement. + Advocate for best practices in CRM, marketing automation, and sales enablement technologies. **Use your skills to make an impact** **Qualifications:** + Bachelor's degree in Business, Marketing, Computer Science, or related field; MBA preferred. + 7+ years of product management or product ownership experience, with at least 3 years in Sales/Marketing Technology. + Experience with sales platforms (ie.Salesforce, Highspot and Sproutloud). + Proven track record of delivering enterprise-level solutions in CRM, marketing automation, and analytics platforms. + Strong leadership and stakeholder management skills. + Excellent communication and analytical abilities. **Preferred Skills:** + Familiarity with data-driven marketing and personalization strategies. + Agile methodology experience. **Why Join Us?** + Opportunity to lead strategic initiatives impacting revenue growth. + Collaborative and innovative work environment. + Competitive compensation and benefits package. 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. $126,300 - $173,700 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: 12-30-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **In addition, the Associate Actuary will:** + Support long term projects aimed at advancing technical maturity, process efficiency, and forecasting accuracy. We are looking for creativity, curiosity, and a desire to explore and influence uncharted territory. + Conduct independent research, collaborate across many teams/departments, and require strong communication skills to be successful in the job. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + Associate of Society of Actuaries (ASA) designation + Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP) + MAAA + Strong communication skills + Demonstrated ability to communicate technical information with audiences not in the actuarial space + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + 3+ years health industry experience with ASA, or 1+ years health industry experience with FSA + 2+ years SQL experience, or equivalent skillset **Preferred Qualifications** + Medicare Advantage background + Creative, high degree of self-accountability + Experience in Python, PowerApps, and PowerBI Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $106,900 - $147,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-30-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Explore opportunities with CPS, part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind **Caring. Connecting. Growing together.** The Specialty Pharmacy Liaison will engage directly with patients to coordinate pharmacy services through the health system's specialty and retail pharmacy. Acting as a bridge between patients, providers, and the pharmacy, this role focuses on improving prescription capture, providing follow-up counseling, and ensuring smooth communication. Key duties include processing prior authorizations, assisting with financial aid, updating clinical data, and supporting administrative tasks. The liaison collaborates closely with the CPS Patient Care Services team and works under the direct supervision of a pharmacist. **Primary Responsibilities:** Initializing and leading ongoing work in clinics and ensuring that the patient/CPS engagement is appropriate and consistent with their preferences. This includes: + Ensuring that every patient who can benefit from specialty pharmacy services is identified and met in clinic upon arrival + Explaining the benefits of our specialty pharmacy, without impeding patient choice of pharmacy, and achieving patient participation + Successfully enrolling patients into the program + Performing all benefits investigation, prior authorization, and financial assistance work needed to ensure patients have access to the medication they need + Overseeing services provided to enrolled patients - ensuring that everything from order entry to final verification is completed quickly, accurately, and in accordance with patients' needs Providing direct support to enrolled patients to ensure that they are supported throughout their therapy regimen and achieve their intended outcome. This includes: + Conducting outbound phone calls for patient support, adherence checks, and refill reminders + Accepting inbound calls from patients, as needed and sharing in on call coverage to ensure 24/7 patient support + Appropriately triaging any clinical questions to an appropriate clinician (pharmacist, nurse, or provider) 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 or equivalent + Active Pharmacy Technician license in good standing in applicable state + PTCB certification or ability to acquire within 24 months of hire **Preferred Qualifications:** + College degree + Experience in a health system specialty pharmacy as an in-clinic liaison + Experience working with various disease states 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 to $31.63 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._