Manager Broker Experience
Highmark Health job in Atlanta, GA
This job manages the development and execution of short-term and long-term objectives to standardize business practices and enhance system applications. Actively participates in and leads projects. Develops and implements appropriate controls and processing methods and manage adherence to. Manages staff responsible for addressing daily system and process issues. Provides leadership in the development, implementation, management and accurate maintenance of all contractually-based producer arrangements. Establishes and maintain all operational and system processes across the organization to support producer arrangements.
**This role can be remote or hybrid - If you are within 50 miles of an office you are required to be onsite 3 days a week - T, W, Th.**
**ESSENTIAL RESPONSIBILITIES**
+ Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
+ Lead the delivery and execution of projects by: analyzing, identifying and problem solving business and systems issues; presenting recommendations to senior management; managing development of requirements, standard operating procedures, functional roles and responsibilities, process flow and user guides. Serve in consulting/training role to direct reports to develop and execute comprehensive test scripts decreasing likelihood of defects to be corrected after implementation.
+ Identify, research, determine, implement and validate solutions, fostering an environment of continuous improvement across the organization. Oversee ongoing analysis and implementation of procedures and systems. Contribute to operational readiness, organizational change management, solution capability, packaging and estimating, planning and delivery management.
+ Lead the development and implementation of contractually-based producer arrangements by: interpreting and translating requests for enhanced business considerations; identifying operational capabilities and/or limitations in delivering requested enhanced business considerations; presenting and working through recommendations with senior management; defining operational process and necessary system development to implement and maintain agreed-to enhanced business communications. Communicate enhanced business considerations and operational processes across the organization. Establish and manage audit controls to ensure enhanced considerations are consistently and accurately adhered to.
+ Manages employees in the following analytical functions: 1) Analysis and approval of retroactive Producer changes, exception or advance payments, non-standard commissions, and requests for refunds from Producers; 2) Determination/ set-up of payment arrangements, data transfer, and licensure / appointment procedures for business partners; 3) Maintenance/dissemination of state requirements for producer appointment and licensing; 4) Production of complex reports for Sales, Producers, Business Partners, Regulators and other business areas and external parties; 5) Monitoring and internal auditing of various business partners relative to payment and producer of record accuracy, appointment compliance and other controls; 6) Maintenance of workflow procedures, form communications, and messaging.
+ Maintains master Producer contract forms, coordinates amendments and re-distribution of contracts, and works with the legal department on complex contractual issues and special language requests.
+ Acts as custodian/business owner of the payment processes and functional project manager of commission cycle.
+ Coordinates/approves payment system enhancements, relevant system requirements for corporate projects and business partner implementations.Works with other business areas to resolve complex system issues and payment problems.
+ Other duties as assigned or requested.
**EDUCATION**
**Required**
+ Bachelor's degree
**Substitutions**
+ 6 years related and progressive experience in lieu of Bachelor's Degree
**Preferred**
+ Master's Degree
**EXPERIENCE**
**Required**
+ 5 years in Healthcare, Technology or Project Management
+ 3 years in a leadership or management role
**Preferred**
+ 5 years performing or managing administrative and compliance processes related to Producer Relationships
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ None
**SKILLS**
+ Customer focus, results orientation, strategic thinking, change advocate, continuous improvement, talent development
+ Knowledge of Producer agreements, commission payment calculation and how it interfaces with company financial systems.
+ Demonstrated competency in project execution and management of organizational units
+ Excellent written and verbal communication skills
+ Excellent leadership and interpersonal skills
+ Proven ability to build and sustain internal and external customer relationships
+ Experience evaluating and implementing technology
+ Presentation experience
+ Strong strategic development capabilities with creative problem-solving skills
**Language (Other than English):**
None
**Travel Requirement:**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office-based
Teaches / trains others regularly
Constantly
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$78,900.00
**Pay Range Maximum:**
$147,500.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J273519
Director Reimbursement Design & Market Evaluation
Highmark Health job in Atlanta, GA
This job supports the matrixed strategic design and analytical approach to reimbursement. To be successful, the incumbent will work closely with stakeholders across the enterprise in the development and implementation of an integrated roadmap for the introduction and delivery of new and innovative reimbursement models across all of Highmark's markets and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry trends in both the commercial and government lines of business. This team will be responsible for supporting development and maintaining models that will drive both the return on investment (ROI) and other decisions on the payer partnership constructs. These new approaches require new operational capabilities, and this team is responsible for identifying those gaps, building requirements to drive the development of new capabilities, and tying them to Highmark's strategic capability roadmap. They will need to work effectively across teams to inform and influence change to drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting, Market and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan Operations.
**ESSENTIAL RESPONSIBILITIES**
+ Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
+ Develop the overall conceptualization, strategy alignment, financial models, and high-level design of new reimbursement models for both government and private payers. Programs will include but not be limited to fee for service, pay-for-value programs, episode payments, prospective bundled payments, gain share and risk share models across all lines of business with the goal of maximizing quality while reducing healthcare costs. Develops and maintains a 3-5 year strategic roadmap outlining current and future reimbursement designs across markets and lines of business with input from key executives across the organization. It will require that this team keeps abreast of new developments in both the public and private reimbursement space, including new innovative models developed by CMS to ensure seamless integration and that the organization is ahead of the curve with regard to our strategy.
+ Work in a Health Economist approach to build and maintain analytical models that performs evaluation of reimbursement models. Continuously evaluates models and seeks for innovative ways to make improvements based on data and market research. Working closely with Contracting and Provider Relation Leaders and others across the enterprise to develop targeted reimbursement models that support enterprise strategic initiatives that might fall outside of planned value-based reimbursement designs and/or to serve as a focus of innovation.
+ Develop and maintains strategic provider relationships to understand the current health care delivery state, readiness for change, test value based programming concepts and components, identify key partners, identify and proactively communicate market transformation concepts with provider and professional advocacy societies and key thought leaders. Serve as a subject matter expert working in concert with provider relations and clinical transformation consultants to explain new programs and results to key provider partners.
+ Other duties as assigned or requested.
**EDUCATION**
**Required**
+ Bachelor's Degree in Business, Finance, Healthcare Administration, or Related Field
**Substitutions**
+ 6 years of relevant work experience
**Preferred**
+ Master's Degree in Business or Healthcare Administration
**EXPERIENCE**
**Minimum**
+ 7 years Healthcare, Healthcare Insurance, Consulting or related area
+ 3 years Value-based reimbursement, through managed care contracting, provider reimbursement, consulting, population health delivery or related areas
+ 4 years Research and strategic planning around emerging trends in reimbursement, network, and payment model design. Demonstrate of the application of healthcare economic drivers and/or population health based analytics
To include
+ 1 year Experience working with technology vendors, and other service provider solutions to source key capabilities
+ 2 years Proven experience in working in a Health Economist capacity driving understanding of current health trends.
**Preferred**
+ 5 years Familiarity with alternative care model designs (e.g., patient centered medical home, ACO), alternative reimbursement models (e.g., bundled payments), and provider / health plan quality programs (e.g. pay for performance)
+ 5 years Familiarity with the delivery of health care services across the continuum and quality metrics.
+ 5 years Experience in running large cross organizational programs and projects
+ 5 years Familiarity with health plan and provider contracting or revenue management
+ 2 years Understanding of provider contract documents and overall contract management process
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ None
**SKILLS**
+ Excellent written and oral communication skills with the ability to present complex information clearly and persuasively. Including excellent leadership skills, with the ability to relate to all levels of management and staff as well as individuals external to the corporation
+ Highly effective oral and written communications skills
+ Ability to manage multiple, complex projects within prescribed timelines
+ Proficient in MS Office suite, including Word, Excel, PowerPoint and project management software
+ High level of autonomy and self-direction, to guide reimbursement model design from concept through to execution
+ Ability to successfully navigate complex organization, engaging multiple stakeholders to achieve reimbursement objectives
+ Strong financial background and analytical skills with a deep understanding of the economic drivers of healthcare
+ Comfort and with real-time calculations of cost, membership, etc. (i.e., "back of the envelope" estimations)
**Language: (Other than English)**
+ None
**Travel Requirement:**
+ 0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office-based
Teaches / trains others regularly
Frequently
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Does Not Apply
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$126,400.00
**Pay Range Maximum:**
$236,000.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J267196
Associate Architect
Highmark Health job in Atlanta, GA
Within area of expertise (application, solution, information, technology, business), assists in design, development, implementation, support, and optimization of architecture strategy to meet business capabilities and needs. Assists in ensuring completeness of architecture by adequately addressing all the pertinent concerns of its stakeholders. Assists in ensuring integrity of architecture by connecting various views of stakeholders, reconciling conflicting concerns, and showing the trade-offs made in so doing. Considers practicality and fitness for purpose in determining architecture to develop. Leverages business and technology knowledge to enable and/or alter business processes, practices, organizations and systems. Maintains knowledge of emerging technologies and best in class industry business trends and practices.
**ESSENTIAL RESPONSIBILITIES**
+ Assists in providing strategic consultation to business customers in defining or designing less complex business processes, functions and organizational structures, as well as in researching, identifying and internally marketing enabling technologies based on customer capability requirements. Facilitates development of enterprise business solutions that combine knowledge of particular business processes and issues, general technological options, and process facilitation techniques. Participates in enterprise strategy development, including environmental analysis, opportunity identification, value cases and business innovation portfolio development.
+ Assists in specifying and designing less complex systems, solutions, networks, infrastructure elements, or processes. Selects appropriate design standards, methods and tools and ensures that they are applied effectively. Reviews others' system design to ensure selection of appropriate technology, efficient use of resources and integration of multiple systems and technology. Establishes policy for selection of architecture components. Evaluates and undertakes impact analysis on major design options. Ensures that the system architecture balances functional, service quality and systems management requirements.
+ Assists in using appropriate tools, including models of components and interfaces, to contribute to the development of architectures. Produces detailed component requirements, specifications and translates these into detailed solutions/designs for implementation using selected products. Provides advice on technical aspects of system development, integration (including requests for changes, deviations from specifications, etc.) and processes. Ensures that relevant technical and business strategies, policies, standards and practices are applied correctly.
+ Assists in selecting and using tools and methods to establish, clarify, and communicate the functional and non-functional requirements of system users, their characteristics, and tasks. Identifies the technical, organizational, and physical environment in which less complex products or systems will operate. Identifies, proposes, initiates, and leads improvement programs, taking responsibility for the quality and appropriateness of the work performed and the realization of measurable business benefits. Modifies existing process improvement approaches and/or develops new approaches to achieving improvement.
+ Assists in ensuring the resolution of a variety of architecture and business problems and serves as a technical or business resource for less complex project initiatives.
+ Communicates effectively with all levels of organization
+ Manages expectations of customers, partners and management
+ Participates in customer walkthroughs and plans; design and technical walkthroughs; and problem resolution and decision making
+ Interacts with departments across the organization as necessary, including the development and interpretation of less complex requirements for peers and other staff.
+ Maintains an in-depth knowledge of specific technical aspects in area of expertise and provides advice regarding their application. The area of specific expertise may be any aspect of information or communication technology, technique, method, process, product, or application area.
+ Provides leadership in the areas of expertise and architecture to their peers, developers, management and business users including technical expertise, coaching, and ad-hoc training by:
+ Preparing presentations on less complex issues on the area of expertise
+ Presenting to their peers to ensure consistency to Highmark's strategic direction.
+ Other duties as assigned or requested.
**EDUCATION**
**Required**
+ Bachelor's Degree in Information Technology or related field
**Substitutions**
+ 6 years of related experience in lieu of a 4 year degree
**Preferred**
+ Master's Degree
**EXPERIENCE**
**Required**
+ None
**Preferred**
+ Health insurance industry business knowledge
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ Industry certifications
**SKILLS**
An Architect is not required to have experience in all of these, but is required to have those needed to support applications they are responsible for supporting. Current skill set are reviewed every other year, new skills may be required to meet changing business needs.
+ Skills:
+ IMS, DB2, Oracle and Teradata Databases, Data Warehousing
+ COBAL, Visual Basic, C C++, SAS
+ Java/JavaScript Framework
+ PEGA, CSS3, Mobile, JSON, Cognos, Hadoop, SQL, J2EE, HTML5/XML
+ Project Management Tools:
+ Waterfall
+ Agile
+ Certification in application areas such as:
+ Java Developer
+ DB2, Cogno, PEGA, Enterprise Architect(SCEA), Project Management
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Never
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$57,700.00
**Pay Range Maximum:**
$107,800.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J273535
Strategy Advancement Advisor
Atlanta, GA job
**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 ***************************************************************************
Associate Actuary
Atlanta, GA job
**Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
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 ***************************************************************************
Learning Facilitation Professional
Atlanta, GA job
Become a part of our caring community and help us put health first The Learning Facilitation Professional conducts or facilitates training courses for organization employees or external audiences. The Learning Facilitation Professional work assignments are often straightforward and of moderate complexity.
The Learning Facilitation Professional plans, coordinates, and implements all aspects of training programs for participants throughout the organization, including but not limited to instructor-led and virtual instructor-led training. Selects appropriate materials. Creates an environment that is conducive to learning and exchanging information, engages the learner, and produces the desired outcomes. Monitors training personnel records to ensure that employees have met all company training requirements for company, quality, and regulatory compliance. Analyzes course evaluations in order to judge effectiveness of training sessions and to implement suggestions for improvements. Evaluates the relevance of online resources to complement the facilitated experience in the fields as appropriate. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.
Use your skills to make an impact
Required Qualifications
* Bachelor's degree
* Less than 3 years of training or learning development experience
* Proficiency in Microsoft Office applications including Outlook, PowerPoint, Microsoft Project
* Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
* Experience using a wide variety of training tools to effectively facilitate to a wide audience.
* Experience managing projects or processes
Additional Information
This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. 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.
Alert
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
#LI-MD1
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$48,900 - $66,200 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Easy ApplyCardiac and Vascular Sonographer
Decatur, GA job
Become a part of our caring community and help us put health first Cardiac and Vascular Sonographer Job Functions: * Be able to interact and communicate effectively - both orally and in writing - with healthcare providers, including other Sonographers, Physicians, and Nurses
* Be well-versed in Medical Terminology
* Be capable of explaining the purpose of the Echocardiographic examination to the patient and answering patients' questions
* Be aware of proper infection control, including precautionary procedures
* Be familiar with, and in compliance with, relevant laws regarding patient confidentiality and privacy
* Be competent in first aid and certified in Basic Life Support
* ARDMS and/or CCI certifications are maintained and up to date
* Performs 2D echo with color flow Doppler exam in ≤ 45 minutes
* Sonographer consistently demonstrates good judgment with regard to use of echo contrast
* Consistent patient preparation, including evaluation of requisition or medical record
* Preparation of exam room, identification of patient, infection control procedures (i.e., Standard Precautions), patient assessment, and instruction concerning the procedure
* Follows Exam protocol listed in Partners in Integrated Care echo lab guidelines consistently
* Performs clinical assessment and Cardiac sonography examinations for requested sonographic examinations as ordered by the provider(s).
* Uses cognitive sonographic skills to identify, record and adapt procedures as appropriate to anatomical, pathological, diagnostic information and images.
* Uses independent judgment during the sonographic exam to accurately differentiate between normal and pathological findings.
* Addresses problems with patients as they arise and makes decisions appropriately to resolve the problems.
* Analyzes sonograms, synthesizes sonographic information and medical history, and communicates findings to the appropriate provider.
* Prepares preliminary reports and contacts referring provider(s) when required, according to established procedures.
* Assists in coordination of work schedule with leader to assure workload coverage with maximizing schedule(s).
* Assumes responsibility for the safety, mental and physical comfort of patients while they are in the sonographer's care.
* Maintains ultrasound equipment, work area and adequate supplies. Reports equipment failures to the appropriate leader.
* Participates in the maintenance of any laboratory accreditation.
* Establishes and maintains ethical working relationships with good rapport with all interrelating facilities.
* Coordinates with other staff to assure appropriate patient care is provided.
* Provide in-service to other staff members as requested by management.
* Performs other work-related duties as assigned.
Use your skills to make an impact
Required Qualifications
* Certification in Vascular and Echo
* ARDMS and/or CCI certifications are maintained and up to date
* Completion of Ultrasound Technology Training at an accredited school
* Certification as an Ultrasound Technician (or equivalent) with 1+ years' experience in a diagnostic facility or hospital as an Ultrasound Technician, however, willing to accept New Graduates who are eager to learn
* Must have good knowledge of Ultrasound equipment and techniques
* If selected for this role, you will be required to be screened for TB
* Must be a team player with excellent communication skills
Preferred Qualifications
* Experience with MS Outlook along with basic computer knowledge
* Bilingual in English and Spanish
Cardiac and Vascular Sonographer Working hours:
Monday to Friday 8AM - 5PM
Scheduled 40 hours per week
Note: Mileage is reimbursed for travel between clinics.
Alert
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
Interview Format - HireVue
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Benefits
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:
Blue Cross and Blue Shield Health benefits effective day 1
Paid time off, holidays, volunteer time and jury duty pay
Recognition pay
401(k) retirement savings plan with employer match
Tuition assistance
Scholarships for eligible dependents
Parental and caregiver leave
Employee charity matching program
Network Resource Groups (NRGs)
Career development opportunities
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.
$70,700 - $96,400 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Easy ApplySenior Manager, MarketPoint Sales - Raleigh Durham, NC.
Atlanta, GA job
**Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does.
Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact your own income potential? If so, we are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate beneficiaries on our services in a field setting. Our teams also sell Life, Annuity, Indemnity, Dental, Vision, Prescription plans, and more.
Humana has an inclusive and diverse culture welcoming candidates with multilingual skill sets to service our consumers.
**This role is** **field** **based, and you will be out and about in the field in the Raleigh** **Durham, NC.** **area working with your team and meeting members face to face. You must reside in Raleigh** **Durham, NC.** **area or be willing to relocate to the area.**
In this **field** position, you will; coach, mentor, educate, motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a solid understanding of the market they serve, how to resolve operational problems and provide creative solutions to increase sales while following CMS guidelines. This role also involves cultivating, maintaining, and building relationships with Humana's customers, both internal and external business partners, along with the community we serve through telephonic, virtual, and face-to-face interactions with individuals and groups. Other responsibilities include developing marketing budgets, and looking for branding opportunities.
**Use your skills to make an impact**
**Required Qualifications**
+ **Must reside in the** **Raleigh** **Durham, NC.** **area or be willing to relocate**
+ **Active Health & Life Insurance Licenses**
+ 2 or more years of sales leadership experience
+ 6 or more years of experience working in the insurance industry
+ Must be able to travel up to 50% of the time
+ Ability to lead a team of sales associates and train them in successful sales techniques, educational presentation skills, utilizing technology tools as well as building relationships with communities and medical providers
+ Strong aptitude for technology with proficiency in MS Office products, various CRM platforms, and various iPhone app capabilities
+ Must be a strong leader, strong producer
+ Strong organizational, interpersonal, communication and presentation skills
+ Ability to adapt and overcome when necessary
+ Community Engagement/Grassroots experience in marketing Medicare plans in the community
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
+ This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits
**Preferred Qualifications**
+ Bachelor's Degree
+ Prior experience working in Medicare and the health solutions industry
+ Engaged with the community through service, organizations, activities and volunteerism
+ Project management background or certification a plus
+ Bilingual with the ability to speak, read and write without limitations or assistance
**Humana Perks:**
Full time associates enjoy:
+ Base salary with a competitive commission structure
+ Medical, Dental, Vision and a variety of other supplemental insurances
+ Paid time off (PTO) & Paid Holidays
+ 401(k) retirement savings plan
+ Tuition reimbursement and/or scholarships for qualifying dependent children.
+ And much more!
**Social Security Task:**
Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website.
**Virtual Pre-Screen:**
As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a HireVue interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes.
\#MedicareSalesManager \#MedicareSalesReps
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$77,000 - $105,100 per year
This job is eligible for a commission incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 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 ***************************************************************************
Easy ApplyMedical Assistant
Atlanta, GA job
Become a part of our caring community and help us put health first The Medical Assistant is the first point of contact for patient care. Responsible for administrative duties in addition to patient care. The Medical Assistant performs varied activities and moderately complex administrative, operational, and customer support assignments. Typically works on semi-routine assignments.
The Medical Assistant performs clinical duties such as discussing symptoms, obtaining vital signs, medication/vaccine administration, phlebotomy, collecting specimens, performing diagnostic screening tests, sterilizing/cleaning equipment, maintaining examination rooms, and documenting information into the electronic medical records system. Collaborates closely with Physicians and Advanced Practice Providers. Delivers direct patient care dependent on what active certification allows. Decisions typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has latitude over prioritization/timing, and works under minimal direction. Follows standard policies and procedures that allow opportunity for interpretation/deviation and/or independent discretion.
Use your skills to make an impact
Required
* High school diploma or equivalent
* Certified/Registered Medical Assistant with successful completion of MA school/training program or a Certified/Registered Medical Assistant or 5+ years of experience
* CPR Certified
* This role is considered patient facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB
Preferred
* Phlebotomy experience• Medication/vaccine administration experience
* 1+ years MA experience
* Value Based Care experience including knowledge of HEDIS, CPT/ICD coding, and CAHPS/HOS Patient Experience.
* Bilingual proficiency in English and Spanish - must pass proficiency exam prior to foreign language communication
Additional Information
As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. 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.
Alert
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
#LI-MD1
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$40,000 - $52,300 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Easy ApplyTechnical Engineer (Starburst)
Highmark Health job in Atlanta, GA
*****CANDIDATE MUST BE US Citizen (due to contractual/access requirements)***** **Candidates within a 50-mile radius of a Highmark office (Pittsburgh or Mechanicsburg) are required to work on-site Tuesdays, Wednesdays, and Thursdays, from 8:00 AM to 5:00 PM EST. Those residing outside this 50-mile radius will be required to travel to Pittsburgh for an annual meeting.**
This job is an integral member of one of our teams responsible for supporting the design, development, and maintenance of our technical solutions, ensuring their efficient and reliable operation. This position will be responsible for the system administration of the Starburst Enterprise Platform (SEP) within the organization. Eligible candidates must have a strong knowledge and proven work experience with the infrastructure components of SEP and its supporting technologies. They will work closely with other technical professionals, analysts, and engineers to build and optimize solutions, ensuring quality, integrity, and performance. The ideal candidate is adaptable, solution-oriented, and capable of collaborating across multiple teams to support a broad range of technical initiatives. The incumbent, and team, may be involved in every aspect as a part of the technical process from idea generation, analysis, design, build, and support using various technologies and design patterns.
**ESSENTIAL RESPONSIBILITIES**
+ Responsible for one or many of the following tasks: analyzing, designing, coding, testing andimplementingtechnical solutions, as well as providing general production monitoring and support, meeting defined scope, target dates and budgets with minimal or no defects.
+ Collaborate with stakeholders across IT, product, analytics, and business teams to gather requirements and provide technical solutions that meet organizational needs
+ Monitor work against production schedule andprovide progress updates and report any issues or technical difficulties to leadership on a regular basis.
+ Document technical processes and procedures, and participate in technical reviews and knowledge sharing sessions
+ Collaborate on the design and implementation of with architecture to ensure solution alignment to enterprise goals and standards
+ Perform technical analysis and provide insights to support decision-making across various departments
+ Stay up-to-date with the latest relevant technologies and industry best practices
+ Other duties as assigned or requested.
**EXPERIENCE**
**Required**
+ 3 years of experience in one or many of the following tasks: analyzing, designing, coding, testing and implementing technical solutions, as well as providing general production support, meeting defined scope, target dates and budgets with minimal or no defects
+ 3 years of technical problem solving, solution implementation, team/project collaboration experience
+ 3 years of basic computer science concepts and principles, common operating systems, development languages/scripting
**Preferred**
+ 3 years experience installing, configuring, deploying, upgrading and managing Starburst Enterprise Platform (SEP) with a thorough knowledge of Starburst / Trino's distributed architecture, including coordinators, workers, and connectors.
+ 5 years experience in managing software applications using Infrastructure-as-Code (IaC) techniques and tools including Gitlab, Terraform, Ansible, Helm Charts, .yaml code, config properties, etc
+ 5 years experience with SEP security features, including authentication using LDAP, Kerberos, or OAuth and Role-Based Access Control
+ 5 years experience with various SEP data source connectors (e.g., Oracle, DB2, Teradata, S3, PostgreSQL, MySQL, etc) and their configuration within Starburst.
+ 5 years experience with monitoring, scaling, and troubleshooting SEP clusters.
+ 5 years experience identifying key metrics for Starburst platform health and performance, set up alerts, and analyze logs for root cause analysis.
+ Strong SQL skills, particularly with Trino's dialect and optimization techniques with the ability to analyze query plans, identify bottlenecks, and apply optimizations (e.g., query tuning, resource allocation, caching strategies).
+ Experience with the Google Cloud Platform and it associated services a plus.
**SKILLS**
+ Demonstrated ability to achieve stretch goals in a highly innovative and fast-paced environment
+ Adaptability: Ability to take on diverse tasks and projects, adapting to the evolving needs of the organization
+ Analytical Thinking: Analytical skills with a focus on detail and accuracy
+ Interest and ability to learn other technologies as needed
+ Technical Proficiency: Comfortable with a range of data tools and technologies, with a willingness to learn new skills as needed
+ Track record in designing, implementing, and/or supporting large-scale technical solutions
+ Sense of ownership, urgency, and drive
+ Demonstrated passion for user experience and improving usability
+ Team Collaboration: A team player who can work effectively in cross-functional environments
**EDUCATION**
**Required**
+ Bachelor's degree in Computer Science, Information Systems, Computer Engineering or relevant experience and/or education as determined by the company in lieu of bachelor's degree.
**Preferred**
+ Master's degree in Computer Science, Information Systems,Computer Engineering or related field.
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ None
**Language (Other than English):**
None
**Travel Requirement:**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office- or Remote-based
Teaches / trains others
Occasionally
Travel from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J271372
Patient Services Coordinator - LPN, Home Health
Atlanta, GA job
Become a part of our caring community and help us put health first The Patient Services Coordinator-LPN is directly responsible for scheduling visits and communicating with field staff, patients, physicians, etc. to maintain proper care coordination and continuity of care. The role also assists with day-to-day office and staff management
* Manages schedules for all patients. Edits schedule for agents calling in sick, ensuring patients are reassigned timely. Updates agent unavailability in worker console.
* Initiates infection control forms as needed, sends the HRD the completed "Employee Infection Report" to upload in the worker console.
* Serves as back up during the lunch hour and other busy times including receiving calls from the field staff and assisting with weekly case conferences. Refers clinical questions to Branch Director as necessary.
* Maintains the client hospitalization log, including entering coordination notes, and sending electronic log to all office, field, and sales staff.
* Completes requested schedule as task appears on the action screen. Ensures staff are scheduled for skilled nurse/injection visits unless an aide supervisory visit is scheduled in conjunction with the injection visit.
* Completes requested schedules for all add-ons and applicable orders:
* Schedules discharge visit / OASIS Collection or recert visit following case conference when task appears on action screen.
* Schedules TIF OASIS collection visits and deletes remaining schedule.
* Reschedules declined or missed (if appropriate) visits.
* Processes reassigned and rescheduled visits.
* Ensures supervisory visits are scheduled.
* Runs all scheduling reports including Agent Summary Report and Missed Visits Done on Paper Report.
* Prepares weekly Agent Schedules. Performs initial review of weekly schedule for productivity / geographic issues and forwards schedule to Branch Director for approval prior to distribution to staff.
* Verifies visit paper notes in scheduling console as needed.
* Assists with internal transfer of patients between branch offices.
* If clinical, receives lab reports and assesses for normality, fax a copy of lab to doctor, make a copy for the Case Manager, and route to Medical Records Department. Initiate Employee / Patient Infection Reports as necessary.
* If clinical, may be required to perform patient visits and / or participate in on-call rotation.
Use your skills to make an impact
Required Experience/Skills:
* Be a Licensed Professional Nurse or a Licensed Vocational Nurse licensed in the state in which he / she practices
* Have at least 1 year of home health experience.
* Prior packet review / QI experience preferred.
* Coding certification is preferred.
* Must possess a valid state driver's license and automobile liability insurance.
* Must be currently licensed in the State of employment if applicable.
* Must possess excellent communication skills, the ability to interact well with a diverse group of individuals, strong organizational skills, and the ability to manage and prioritize multiple assignments.
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.
$48,900 - $66,200 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Director Data Services - Data Governance
Highmark Health job in Atlanta, GA
This job is responsible for developing the strategy, planning and delivery of all aspects related to data governance, data warehousing, data management and related efforts for the organization. Directs the coordination of involvement of all business area Subject Manager Experts (SMEs) and other staff members. Promotes the proliferation of a data driven organization in end-user processes and the integration of applications; as well as the promotion of enterprise-wide thinking among business and technical areas. Responsible for defining, documenting, and making available data sources of truth throughout the enterprise. Participation in project management and budgeting to assure data related projects are included in the organizational roadmap and produce tangible results. Champions the use of data as an asset across the enterprise. Improvement and maturity of data sources to move through the life cycle of data, information, and knowledge.
**ESSENTIAL RESPONSIBILITIES**
+ Perform management responsibilities including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority.
+ Assure all related projects or initiatives are delivered on time, within the specified budget and in accordance with the agreed upon scope.
+ Define, build, and maintain a data warehouse/big data platform and associated data stores that maintain an enterprise focus and meet the needs of its varied stakeholders.
+ Ensure that decisions are made reflecting that position and carefully managing on the part of the incumbent to satisfactorily resolve situations with competing priorities or different perceptions, particularly among senior management.
+ Communicate and act as the ambassador for data management and data governance within the organization, which includes upward and downward communication of the outcomes produced through the efforts of the team and driving the organization to a data-driven operating approach.
+ Accountable for service level agreements and expectations with end-users and external stakeholders.
+ Ensure that the Enterprise Data Warehouse (EDW)/Big Data platforms meets the needs of its customers.
+ Deliver/manage/monitor all data extracts, both to internal and external constituents.
+ Other duties as assigned or requested.
**EDUCATION**
Minimum
+ Bachelor's Degree in Business, Information Science or other related area, or relevant experience and/or education as determined by the company in lieu of bachelor's degree
Preferred
+ Master's Degree Business, Information Science or other related area
**EXPERIENCE**
**Minimum**
+ 10 years of information technology experience functioning in a data warehouse environment to include at least 5 years' performing in a managerial capacity
+ 3 years of healthcare related experience
+ Experience developing strategic plans and/or product road maps and communicating technical concepts to varying audiences
+ Experience acting as liaison between business and technical teams, translating business terms to technical needs
**Preferred**
+ None
**SKILLS**
+ Analytical and problem solving skills
+ Project management experience with multiple major development projects, demonstrating leadership skills and a track record of managing technical/business staff, financial resources and outside vendors
+ Strong teamwork and interpersonal skills
+ Ability to lead process improvement initiatives
+ Strong knowledge and understanding of business needs
+ Ability to establish and maintain high level of customer trust and confidence
+ Demonstrated abilities in relationship management
+ Strong communication skills
**LICENSES AND CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ PMP
**TRAVEL REQUIREMENT:**
0 - 25%
**LANGUAGE REQUIREMENT (** **_other than English_** **)?**
_None_
**PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS**
**Position Type**
Office-Based
**Office-Based Positions**
An employee in this position works in an office environment. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours.
Teaches/Trains others regularly
Frequently
Travels regularly from the office to various work sites or from site-to-site
Does Not Apply
Works primarily out-of-the office selling products/services (Sales employees)
Does Not Apply
Physical Work Site Required
Yes
Lifting: up to 10 pounds
Does Not Apply
Lifting: 10 to 25 pounds
Does Not Apply
Lifting: 25 to 50 pounds
Does Not Apply
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$126,400.00
**Pay Range Maximum:**
$236,000.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J271608
Primary Care Physician
Atlanta, GA job
Become a part of our caring community and help us put health first Humana's Primary Care Organization is one of the largest and fastest growing value-based care, senior-focused primary care providers in the country, operating over 350 centers across eight states under two brands: CenterWell & Conviva. Operating as a payor-agnostic, wholly owned subsidiary of Humana, our centers put the unique needs of seniors at the center of everything we do. Our Clinics offer a team-based care model where our physicians lead a multi-disciplinary care team supporting patient's physical, emotional, and social wellness.
At CenterWell Senior Primary Care, we want to help those in the communities we serve, including our associates, lead their best lives. We support our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate fresh perspective, new insights, and exciting opportunities to grow their careers. Our culture is focused on teamwork and providing a positive and welcoming environment for all.
* $60,000 Sign-on Bonus *
Total compensation package (base pay + bonus) could exceed $300K depending on experience and location.
The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a value based care provider focused on quality of care for the patients we serve. Our care team consists of Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators and more. Our approach allows us to provide an unmatched experience for seniors. Our model is positioned to provide higher quality care and better outcomes for seniors by providing a concierge experience, multidisciplinary services, coordinated care supported by analytics and tools, and deep community relationships. This robust support allows our PCP to see fewer patients and spend more time with those they do.
Responsibilities:
* Evaluates and treats center patients in accordance with standards of care.
* Follows level of medical care and quality for patients and monitors care using available data and chart reviews.
* Assists in the coordination of patient services, including but not limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care.
* Acts as an active participant and key source of medical expertise with the care team through daily huddles.
* Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in practice by displaying a professional and approachable demeanor.
* Completes all medical record documentation in a timely manner working with a quality- based coder to optimize coding specificity.
* Follows policy and protocol defined by Clinical Leadership.
* Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues.
* Participates in potential growth opportunities for new or existing services within the Center.
* Participates in the local primary care "on-call" program of CenterWell as needed.
* Assures personal compliance with licensing, certification, and accrediting bodies.
* Spend 100% of your time clinically focused on direct patient care, inclusive of patient facing time and general administrative time (charting, meetings, etc.) as it relates to direct patient care.
Use your skills to make an impact
Required Qualifications:
* Current and unrestricted medical license or willing to obtain a medical licenses in state of practice; eligible and willing to obtain licenses in other states in the region of assignment, as required
* Graduate of accredited MD or DO program of accredited university
* Excellent verbal and written communication skills
* Demonstrate a high level of skill with interpersonal relationships and communications with colleagues/patients
* Fully engaged in the concept of "Integrated team based care" model
* Willingness and ability to learn/adapt to practice in a value based care setting
* Superior patient/customer service
* Basic computer skills, including email and EMR
* This role is considered patient facing and is a part of our Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB
Preferred Qualifications:
* Board Certification or Eligible to become certified (ABMS or AOA) in Family Medicine, Internal Medicine or Geriatric Medicine preferred
* Active and unrestricted DEA license
* Medicare Provider Number
* Medicaid Provider Number
* Minimum of two to five years directly applicable experience preferred
* Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care environment in a value based relationship environment
* Knowledge of Medicare guidelines and coverage
* Bilingual is a plus
* Knowledge of HEDIS quality indicators
Additional Information:
* Total compensation package (base pay + bonus) could exceed $300K depending on experience and location
* Excellent benefit package - health insurance effective on your first day of employment
* CME Allowance/Time
* Occurrence Based Malpractice Insurance
* Relocation and sign-on bonus options
* 401(k) with Employer Match
* Life Insurance/Disability
* Paid Time Off/Holidays
* Minimal Call
#physiciancareers #LI-DH1
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.
$203,400 - $299,500 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Market Underwriter
Highmark Health job in Atlanta, GA
This job serves as the single-point-of-contact for sales teams and assigned customers, delivering insights and recommendations to sales in order to aid customer acquisition/retention while maintaining performance goals. This incumbent will collaborate with cross functional team members on client-level quotes and function as a trusted adviser by providing financial and risk management support to sales as well as strategic insight.
**ESSENTIAL RESPONSIBILITIES**
+ Understand department and the company'sstrategic goals and competitive position and drives client-level results towards these ends. Actively work with Sales team to manage portfolio of clients towards financial and business targets, e.g. membership, revenue, margin, etc.
+ Proactively draw insights from quote details, client understanding and regional insights to deliver best-possible recommendation to Sales. State and maintain independent perspective, including under pressure from more senior individuals, identifying opportunities and concerns.
+ Responsible for portfolio of clients through underwriting engagement, from identification through documentation of final sold-contract details
+ Assess risk by looking at various risk measures such as risk scores, demographic analysis, and turnover considerations.
+ Serve as the accountable owner for all quotes delivered to sales partners. Develop a perspective on each client package deliverable. Clearly and confidently communicates Underwriting's position on the risk profile of each client
+ Identify tool improvement needs and communicates needs to Product Development teams
+ Maintain accurate book management details including concession budget
+ Other duties as assigned or requested.
**Required**
+ Bachelor's Degree in Science, Technology, Mathematics or related field
**Substitutions**
+ Six (6) years additional experience required in lieu of degree
**Preferred**
+ None
**EXPERIENCE**
**Required**
+ 3 years of Health Care Underwriting OR risk mgmt OR actuary work OR applying advanced mathematics
to include
+ 1 years of external client interaction or comparable external interactions
**Preferred**
+ 1 year in Risk Management **OR** of Actuary work **OR** of applying Advanced Mathematics
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ None
**SKILLS**
+ Understanding of health products, services, risk assessment and techniques
+ Consultative mindset
+ Strong Oral and Written Communications skills
**Language (Other than English):**
None
**Travel Requirement:**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office-based
Teaches / trains others regularly
Rarely
Travel regularly from the office to various work sites or from site-to-site
Occasionally
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Rarely
Lifting: 25 to 50 pounds
Never
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$50,200.00
**Pay Range Maximum:**
$91,200.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J272541
Summer 2026 Software Engineer Graduate Intern
Highmark Health job in Atlanta, GA
**SUMMARY OF JOB RESPONSIBILITIES** This job has the goal of providing the opportunity to acquire practical experience through direct exposure to the related business line(s) and to develop the next generation of diverse business professionals. To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business.
**REQUIRED QUALIFICATIONS**
Bachelor's degree.
Pursuance of a graduate degree full or part-time in an accredited college or university in Software Engineering, Data Analytics, Computer Science or a related area.
**ESSENTIAL JOB FUNCTIONS**
1. Communicate effectively. This position displays effective communication skills while interacting directly with colleagues, clientele, and/or other internal or external constituencies in the planning of assignments and the resolution of day-to-day operational problems.
2. Under supervision, provide professional services as appropriate to the day-to-day operating objectives of the area. Receives guidance, training, and mentoring from senior personnel in planning and carrying out activities and assignments.
3. Undertake and/or participate in projects and programs designed to develop professional skills and expertise appropriate to the needs of the organization.
4. Participate in the planning and implementation of unit projects and initiatives within area of expertise and ability.
5. As specifically requested by management, conducts research and reporting inclusive of recommendations or alternative proposals for action.
6. Undertake related studies or enrichment programs as appropriate to the specific objectives of the operating unit.
7. Perform miscellaneous job-related duties as assigned.
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
**Pay Range Minimum:**
**Pay Range Maximum:**
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J270859
Business Process Engineer
Highmark Health job in Atlanta, GA
This job leads, supports and facilitates process improvement initiatives across multiple functional units for both strategic and continuous process improvement efforts. Strategic and transformational support includes design and support throughout implementation to ensure people/process/technical solutions align with strategic initiative while driving consensus among business units including process ownership and governance. Design activities include the documentation, management and oversight of end to end workflow process analysis assuring improved productivity, cost effectiveness, appropriate embedding of Key Performance Indicators, and appropriate controls for both regulatory and compliance considerations. Provides consultative services and analytic support to business management leveraging LEAN practices, Six Sigma methodologies and tools, capacity planning, resource allocation, work simplification, service level management, organizational design, consolidation, performance measurement systems, productivity improvement and expense control.
ESSENTIAL RESPONSIBILITIES
+ Support or lead the definition, scoping, chartering efforts for business process analysis/design projects related to process improvement initiatives assuring optimal business and functional delivery of the strategic delivery framework. This includes business modeling, documentation of the operating blueprint and process solution blueprinting efforts following the strategy definition as well as supporting the execution of the process solution blueprint during the implementation phase.
+ Provide process and business consultation services which include research, analysis facilitation, process modeling, and business process improvement techniques to propose and implement business and system solutions that meet strategic objectives. Provide and support periodic reporting to leadership on assigned project activities.
+ Establish and maintain strong working relationships across business unit/area level of management continuing to promote and continually broaden the level of business knowledge and the impact of quality/process improvement projects and programs. Participate in planning sessions with business owners to improve business processes and to prioritize and drive process re-engineering initiatives including process ownership and governance.
+ Participate and support business case development process to identify change execution impacts to people, process, and technology solutions to achieve business objectives. Participate and support the Change Execution Process assuring resource alignment/impacts are aligned with the process governance model.
+ Drive comprehensive business process standards, analysis and measurement to assigned projects including the definition of business process modeling standards for assigned projects and evolve the Business Process Management Nomenclature standards of a Business Process Competency Center.
+ Support the expansion and development of Continuous Process Improvement and business process engineering skills, including Lean Six Sigma methodology across specific divisions and the enterprise, promoting the understanding and use of process improvement tools and concepts. Support leadership and management with regard to the planning, implementation and production support of Lean Six Sigma projects and the Lean Six Sigma COE.
+ In collaboration with release planning and implementation functions across varying divisions and business platforms. Ensures all changes to processes are reflected in the repository of process documentation.
+ Access and analyze processes, data points, and controls to determine sub-optimal performance, communicate findings clearly and effectively and make recommendations for improvement. Identify root causes of problems and demonstrate the ability to development and make recommendations for solutions to mitigate root cause.
+ Other duties as assigned or requested.
**EDUCATION**
**Required**
+ Bachelor's Degree in Business, Industrial /Management Engineering or IT related field
**Substitutions**
+ 5 years experience in Process Improvement; to include process documentation or change, collection and analysis of related metrics, problem solving, and reduction in cycle time.
**Preferred**
+ Master's Degree in Health Administration, Business Administration, Industrial Engineering or IT Development
**EXPERIENCE**
**Required**
+ 5 - 7 years Managing small to medium projects across multifunctional teams
+ 3 - 5 years of related, progressive experience in the area of specialization
**Preferred**
+ 2 years in the Healthcare Industry
**LICENSES AND CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ Six Sigma Black or Green Belt
+ Project Management Professional (PMP)
**SKILLS**
+ Strong Facilitation skills
+ Strong verbal and written communication skills
+ Ability to use statistical assessment to quantify opportunities and to achieve process optimization
+ Knowledge of the roles and deployment of change execution
+ Knowledge of Business Process Modeling concepts and components and their respective application
+ Strong understanding of Highmark specific domains
+ Ability to observe and provide constructive performance feedback
+ Knowledge and understanding of Business Process Engineering standards/protocols
+ Knowledge and understanding of Lean Six Sigma Tools and Methodologies
**Language (Other than English)**
None
**Travel Requirement**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office-Based
Teaches / trains others regularly
Rarely
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Does Not Apply
Physical work site required
Yes
Lifting: up to 10 pounds
Occasionally
Lifting: 10 to 25 pounds
Does Not Apply
Lifting: 25 to 50 pounds
Does Not Apply
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
**Pay Range Minimum:**
$50,200.00
**Pay Range Maximum:**
$91,200.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J272323
Associate Project Manager - HNAS
Highmark Health job in Atlanta, GA
HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve.
Responsible for definition, planning and delivery of complex programs that require cross-functional collaboration and management of interdependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget. Includes the management of a group of internal exempt and/or matrixed employees and contractors that serve on the program(s) to deliver solutions for the business.
**ESSENTIAL RESPONSIBILITIES:**
+ Works with business and technical organizations to drive out program strategy and approach. Organizes, plans, and maintains Program roadmap consisting of cross-functional activities/projects.
+ Work with business and technical organizations to assemble project teams. Lead Project Managers and Program team in the development and maintenance of comprehensive plans for a defined program.
+ Work with Executive Sponsor and Business Owner of a Program, and other management as required, to achieve the Program objectives. Acquire understanding of the business objectives for an assigned area."
+ Monitor, evaluate and report on Program status inclusive of scope, schedule, budget and alignment to Program and strategic goals. Direct corrective action as needed to maintain the viability of the Program.
+ Develop and maintain positive customer relationships. Deliver presentations of project status to effectively communicate throughout the project lifecycle.
+ Adhere to Highmark project management methods, project lifecycle methodologies, and audit requirements. Support and contribute to the improvement of project management methods and practices.
+ Other duties as assigned or requested.
**QUALIFICATIONS:**
Minimum
+ High School Diploma or equivalent
+ One (1) to three (3) years experience performing project coordination activities such as analysis, information gathering, documentation preparation, project schedule maintenance, status report preparation, budget tracking, etc.
Preferred
+ Bachelor's degree
+ PMP certification or equivalent training
+ Health Care Insurance industry business and operational knowledge
+ Leadership skills
+ Solid organizational and planning skills
+ Exposure to an industry standard software development lifecycle
+ Good verbal and written communication skills
+ Good interpersonal skills
**Knowledge, Skills and Abilities**
+ Experience with customer relationship management
+ Presentation skills
+ Negotiation skills
+ Experience with conflict resolution
+ Experience with Risk Mitigation Planning
**Language (Other than English):**
None
**Travel Requirement:**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$50,200.00
**Pay Range Maximum:**
$91,200.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J271523
Home Health Clinical Triage Specialist - PRN - Weekends
Atlanta, GA job
Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together.
As a T Home Health Clinical Triage Specialist, you'll be an integral part of the interdisciplinary team and as such is responsible for the excellent delivery of care through triage calls after hours and on holidays.
Must be available to work weekends.
Primary Responsibilities:
* Receive calls from patients and/or family members and respond appropriately and assess problems focusing on the delivery of high quality, patient-focused, compassionate care
* Assess patient status and intervene as indicated by the patient's condition and established protocols
* Timely and accurate documentation of calls received within the electronic medical records system including the processing of workflow associated with the clinical record
* Knowledge of basic triage protocols and best practices to guide and address the needs of patients in a crisis situation
* Coordinating with the agency on-call nurses to deliver high quality nursing care and schedule nursing assessments as required in a timely manner to meet the needs of the patients and families
* Ensure appropriate education regarding all updates/processes in the electronic medical record, relative state and federal regulations, documentation processes and needs, etc. by attending mandatory educational offerings and in-services
* Facilitates orientation of new personnel as assigned
* Exhibits exemplary and timely communication skills when assessing or educating patients/caregivers, performing telephone triage, or collaborating with fellow healthcare professionals
* Serves as a consistent example of dedication to patient advocacy, customer service, integrity, and superlative nursing practice
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Current, unrestrictive Registered Nurse licensed in all states of practice
* 2+ years RN experience
* 1+ years of direct patient care in a hospice, home health, or oncology setting
* Ability to work flexible hours and independently
* Driver's License and access to reliable transportation
Preferred Qualification:
* Registered Nurse Compact licensure
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Associate Architect - Oracle PaaS Administrator
Highmark Health job in Atlanta, GA
*****CANDIDATE MUST BE US Citizen (due to contractual/access requirements)***** We are seeking a highly skilled and experienced Oracle Platform as a Service (PaaS) Administrator to join our dynamic team. This pivotal role involves leading the definition and design of complex Oracle Financial PaaS processes and functions, facilitating the development of sophisticated enterprise business solutions, and contributing to strategic initiatives. The successful candidate will play a critical role in ensuring the robust, secure, and efficient operation of our Oracle PaaS environment, balancing functional requirements with service quality and adherence to enterprise policies and security standards. This role also involves providing leadership and mentorship in areas of expertise and architecture to peers, developers, management, and business users.
**Key Responsibilities:**
+ Lead the design and definition of complex Oracle Financial PaaS processes and functions.
+ Facilitate the development of advanced enterprise business solutions utilizing Oracle PaaS.
+ Contribute to enterprise strategy development, including opportunity identification and business innovation.
+ Select and ensure the effective application of appropriate design standards, methods, and tools.
+ Review application designs to ensure optimal technology selection, efficient resource utilization, and seamless system integration.
+ Ensure system architecture adheres to functional, service quality, security, and enterprise policy standards.
+ Participate in customer walkthroughs, technical reviews, problem resolution, and decision-making processes.
+ Provide leadership and mentorship to peers, developers, management, and business users on Oracle PaaS architecture and best practices.
+ Manage Oracle Cloud Infrastructure (OCI) resources, including provisioning and maintaining compute, storage (Object Storage, Block Volumes), and networking components (VCNs, subnets, NSGs, security lists).
+ Administer and configure Oracle PaaS services such as Oracle Integration Cloud (OIC), Autonomous Database (ADW, ATP), Oracle Analytics Cloud, and Oracle FDI, ensuring secure and efficient operation.
+ Implement and manage Identity and Access Management (IAM) through IDCS or OCI IAM, including role setup, policies, single sign-on (SSO), and application/user provisioning.
+ Conduct proactive monitoring, performance tuning, and cost optimization of Oracle PaaS environments.
+ Implement and enforce security best practices, including encryption, patch management, vulnerability scanning, backup/recovery, access audits, Cloud Guard, and Data Safe, ensuring SOX compliance.
+ Provide frontline support for incident management, diagnosing and resolving platform issues, coordinating with IT teams and vendors, and documenting operational processes.
+ Develop and maintain automation scripts (Shell, Python) for streamlining tasks, ensuring peer review and version control.
+ Maintain comprehensive technical documentation, oversee licensing, manage change control, and develop recovery plans.
+ Collaborate effectively with developers, analysts, and security teams, and potentially mentor junior staff.
**Core Skills and Experience:**
+ **Oracle Cloud Infrastructure (OCI) Expertise:** Compute, Storage (Object Storage, Block Volumes), Networking (VCNs, subnets, NSGs).
+ **Oracle PaaS Services:** Oracle Integration Cloud (OIC), Oracle Data Integrator (ODI), Identity Cloud Service (IDCS), Autonomous Database (ADW, ATP), Oracle Analytics Cloud (OAC), Visual Builder Cloud Service (VBCS), APEX, WebLogic.
+ **Database Administration:** Oracle Database administration and data transformation experience.
+ **Scripting & Automation:** Proficiency in Shell/Bash scripting and Python. Java experience is a plus.
+ **Security & Compliance:** IAM/Policy configuration, encryption, patching strategies, SOX compliance, and audit experience.
+ **APIs & Integrations:** Experience with REST APIs and FDI SOAP.
+ **Performance Optimization:** Proven ability in performance tuning, health checks, and cost tracking.
+ **Operational Excellence:** Strong skills in incident triaging, technical documentation, backup strategies, and disaster recovery.
**ESSENTIAL RESPONSIBILITIES**
+ Assists in providing strategic consultation to business customers in defining or designing less complex business processes, functions and organizational structures, as well as in researching, identifying and internally marketing enabling technologies based on customer capability requirements. Facilitates development of enterprise business solutions that combine knowledge of particular business processes and issues, general technological options, and process facilitation techniques. Participates in enterprise strategy development, including environmental analysis, opportunity identification, value cases and business innovation portfolio development.
+ Assists in specifying and designing less complex systems, solutions, networks, infrastructure elements, or processes. Selects appropriate design standards, methods and tools and ensures that they are applied effectively. Reviews others' system design to ensure selection of appropriate technology, efficient use of resources and integration of multiple systems and technology. Establishes policy for selection of architecture components. Evaluates and undertakes impact analysis on major design options. Ensures that the system architecture balances functional, service quality and systems management requirements.
+ Assists in using appropriate tools, including models of components and interfaces, to contribute to the development of architectures. Produces detailed component requirements, specifications and translates these into detailed solutions/designs for implementation using selected products. Provides advice on technical aspects of system development, integration (including requests for changes, deviations from specifications, etc.) and processes. Ensures that relevant technical and business strategies, policies, standards and practices are applied correctly.
+ Assists in selecting and using tools and methods to establish, clarify, and communicate the functional and non-functional requirements of system users, their characteristics, and tasks. Identifies the technical, organizational, and physical environment in which less complex products or systems will operate. Identifies, proposes, initiates, and leads improvement programs, taking responsibility for the quality and appropriateness of the work performed and the realization of measurable business benefits. Modifies existing process improvement approaches and/or develops new approaches to achieving improvement.
+ Assists in ensuring the resolution of a variety of architecture and business problems and serves as a technical or business resource for less complex project initiatives.
+ Communicates effectively with all levels of organization
+ Manages expectations of customers, partners and management
+ Participates in customer walkthroughs and plans; design and technical walkthroughs; and problem resolution and decision making
+ Interacts with departments across the organization as necessary, including the development and interpretation of less complex requirements for peers and other staff.
+ Maintains an in-depth knowledge of specific technical aspects in area of expertise and provides advice regarding their application. The area of specific expertise may be any aspect of information or communication technology, technique, method, process, product, or application area.
+ Provides leadership in the areas of expertise and architecture to their peers, developers, management and business users including technical expertise, coaching, and ad-hoc training by:
+ Preparing presentations on less complex issues on the area of expertise
+ Presenting to their peers to ensure consistency to Highmark's strategic direction.
+ Other duties as assigned or requested.
**EDUCATION**
**Required**
+ Bachelor's Degree in Information Technology or related field
**Substitutions**
+ 6 years of related experience in lieu of a 4 year degree
**Preferred**
+ Master's Degree
**EXPERIENCE**
**Required**
+ None
**Preferred**
+ Health insurance industry business knowledge
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ Industry certifications
**SKILLS**
An Architect is not required to have experience in all of these, but is required to have those needed to support applications they are responsible for supporting. Current skill set are reviewed every other year, new skills may be required to meet changing business needs.
+ Skills:
+ IMS, DB2, Oracle and Teradata Databases, Data Warehousing
+ COBAL, Visual Basic, C C++, SAS
+ Java/JavaScript Framework
+ PEGA, CSS3, Mobile, JSON, Cognos, Hadoop, SQL, J2EE, HTML5/XML
+ Project Management Tools:
+ Waterfall
+ Agile
+ Certification in application areas such as:
+ Java Developer
+ DB2, Cogno, PEGA, Enterprise Architect(SCEA), Project Management
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Never
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$57,700.00
**Pay Range Maximum:**
$107,800.00
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J273116
Summer 2026 - Finance - Undergraduate Intern
Highmark Health job in Atlanta, GA
**This is a Hybrid based role - 3 days a week in Pittsburgh - T, W, TH** **SUMMARY OF JOB RESPONSIBILITIES** This job has the goal of providing the opportunity to acquire practical experience through direct exposure to the related business line(s) and to develop the next generation of diverse business professionals. To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business.
Typical responsibilities include, providing services to the day-to-day operating objectives of the assigned area, participating in projects and programs appropriate to the needs of the assigned area, participating in the planning and implementation of projects and initiatives, conducting research and reporting including recommendations or proposals for action.
The role is within the health plan finance organization with a specific focus in areas including:
+ Forecasting financial performance and analyzing financial trends.
+ Prepare monthly financial reports, analyzing variances against budget, forecast, and prior year.
+ Collaborate with cross-functional teams (e.g., Actuarial, Sales, Pharmacy, Underwriting) to gather data, understand business drivers, and provide financial insights.
+ Utilize data analytics and visualization tools to create dashboards and reports that effectively communicate financial performance to stakeholders.
+ Develop clear and concise presentations to communicate financial insights and recommendations.
+ Identify and implement process improvements to enhance the efficiency and accuracy of finance business processes.
**REQUIRED QUALIFICATIONS**
+ Full or part-time enrollment in an accredited college or university baccalaureate program.
**PREFERRED QUALIFICATIONS**
Degree path in one of the following
+ Bachelor of Science in Finance
+ Bachelor of Science in Accounting
+ Bachelor of Arts in Economics
+ Bachelor of Business Administration (BBA) with a concentration in Finance
+ Bachelor of Science in Financial Mathematics
+ Bachelor of Science in Computer Science
**Anticipated Graduation date 2027 or 2028**
**ESSENTIAL JOB FUNCTIONS**
1. Communicate effectively while interacting directly with colleagues, clientele, and/or other internal or external constituencies in the planning of assignments and the resolution of day-to-day operational problems.
2. Under supervision, provide entry-level professional services as appropriate to the day-to-day operating objectives of the area. Receives guidance, training, and mentoring from senior personnel in planning and carrying out activities and assignments.
3. Undertake and/or participates in projects and programs designed to develop professional skills and expertise appropriate to the needs of the organization.
4. Participate in the planning and implementation of unit projects and initiatives within area of expertise and ability.
5. As specifically requested by management, conduct research and reporting inclusive of recommendations or alternative proposals for action.
6. Undertake related studies or enrichment programs as appropriate to the specific objectives of the operating unit.
7. Perform miscellaneous job-related duties as assigned.
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J270566