Manager Broker Experience
Highmark Health job in Baton Rouge, LA
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 Baton Rouge, LA
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 Baton Rouge, LA
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
Program Delivery Lead
Baton Rouge, LA job
**Become a part of our caring community and help us put health first** The Program Delivery Lead will support programs designed to maximize value-based relationships with Providers in our Gulf South Region. We are looking for a dynamic healthcare professional who can drive network performance with a focus on interoperability, MRA coding and closing gaps in care. This is a unique opportunity to work with corporate teams and professionals in the field and use your understanding of electronic health data solutions to impact the business and our members.
The Program Delivery Lead drives the quantity and quality of EMR data connections and supplemental data files. They partner with leaders regarding implementation planning, communicating the results of programs and advising executives to develop functional strategies on matters of significance. They ultimately help providers' systems perform better by working on challenges with different EMR programs. Responsibilities will fall into the following areas:
**Corporate interconnectedness (30%)**
+ Identify new interoperability targets for Epic, eCW and Athena by using a variety of available lists and sources.
+ Collaborate with Interoperability Recruiting and Implementation team on regional provider Implementations in Process.
+ Develop and maintain regional Live Connection Tracking report
+ Manage Implementations in Process reporting to track progress and follow up with Interoperability teams.
+ Follow progress, submit, and track the Interoperability Support Request Intake process.
**Strategy & Operations (30%)**
+ Consider potential regional and provider goals and targets for next implementations.
+ Collaborate to establish priorities based on next product for implementation.
+ Manage and develop a regional process to track providers in progress: push to contracting and follow up to communicate progress until fully executed.
+ Identify and research groups with low performance measures related to prospective programs.
**Market support (40%)**
+ Engage and assist market with understanding of providers' Interoperability products.
+ Coordinate scheduling and communication for providers' kick-off meetings and provide resources to the team and providers.
+ Oversee and track regional health data new connections, while maintaining and communicating regional data outage report.
+ Report both HEDIS and Lab data feeds where providers have a missing data submission.
+ Manage Data Retrieval Method maximization, including Cotiviti retrieval methods and identify sites with active interoperability pathways to ensure appropriate retrieval method is implemented.
**_Success in this position requires the following key attributes:_**
+ Ability to self-direct, take initiative and meet deadlines
+ Use of independent judgment to analyze variable factors and determine the best course of action.
+ Strong time-management and prioritization skills, with stellar attention to detail
+ Excellent organizational skills, with ability to manage multiple priorities, maintain clear structure in complex workflows and ensure timely, accurate completion of responsibilities in fast-paced environment
+ Impeccable attention to detail, identifying discrepancies, improving data integrity, and elevating operational accuracy across high impact initiatives
+ Strong analytical thinking and problem-solving skills
+ Proven relationship building skills with ability to act as a liaison between corporate and market professional and providers in the field
**Use your skills to make an impact**
**Required Qualifications**
+ 5 or more years of experience in Managed Care with Stars, Risk Adjustment or Network Management experience
+ 2 or more years of experience in project work or process improvement
+ Advanced working knowledge of MS Excel (vLookups, pivot tables)
+ Experience partnering with leadership on strategic initiatives
+ Demonstrated ability to articulate ideas effectively in both written and oral forms
**Preferred Qualifications**
+ Bachelor's degree or higher in a related field
+ PMP certification a plus
+ Experience working with health data collected from Electronic Health Records (EHR), Health Information Systems (HIS), or other healthcare IT systems.
+ Six Sigma Certification also a plus
+ Live within the stated region
**Additional Information**
This role is "remote/work at home" and can be based anywhere in the United States, however, preference will be given to candidates that live/work within the region (AL, MS, TN, LA, SW VA)
**Work-At-Home Requirements**
To ensure Home-based employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
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.
**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 ***************************************************************************
Strategy Advancement Advisor - Distribution Strategy
Baton Rouge, LA job
**Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does.
The Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.
**Become a part of our caring community and help us put health first**
The Strategy Advisor (Distribution) provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for the Enterprise Growth vertical. The Strategy Advisor's work involves complex assignments performed without direction where the analysis of situations or data requires an in-depth evaluation of variable factors. This work may require leading end-to-end strategy engagements.
As part of the Strategy Advancement team, this role will support MarketPoint's investment rationalization and strategic planning efforts. The role requires comfort with ambiguity and creating new solutions in the "white space" where answers are not clear cut or readily available. A successful candidate will be someone who has worked for several years in large matrixed organization (e.g. a publicly traded corporation or large not profit organization) or has several years' experience with stakeholder management (strategy/operations at a top-tier consulting/professional services firm). They will have a demonstrated ability to synthesize large amounts of information into clear and concise outputs (PPT, Excel). This person must be comfortable working collaboratively with senior leaders and subject matter experts alike and should have a high degree of executive presence leading engagements with these stakeholders. This person also will be effective at multitasking and possess keen program and change management skills to balance an evolving set of priorities and deadlines. Healthcare experience is a plus, but not required, though must have a history of mastering an understanding of their prior industry.
Other examples of the kind of work required from this role include leading the analysis of complex business problems and issues using data from internal and external sources. The candidate should bring expertise or identify subject matter experts in support of multi-functional efforts to identify, interpret, and produce strategic recommendations and plans. The candidate's work will substantially shape the thinking of distribution org. They will exercise independent judgment and decision making on complex issues to determine the best course of action and work under minimal supervision.
**Use your skills to make an impact**
About the team: Humana's distribution organization, MarketPoint, plays a key part in driving Humana's long-term vision to achieve leading growth in Medicare and individual products. The MarketPoint strategy team was created to help transform Humana's customer acquisition approach. The team functions with a mandate to think creatively, discover new opportunities and re-envision operations to drive growth and deliver a first-class experience to our members and agents.
**Responsibilities:**
+ Leads multiple short- and long-term work streams sometimes across engagements, including hypothesis development, working sessions, and report-outs with leaders across the company, and documenting key ideas and actions to drive follow-up actions
+ Partners closely with finance, analytics, and operators to optimize, track, and report out on internal and external compensation strategy and results
+ Develop high-quality analysis and deliverables that clearly frame organizational objectives, issues/challenges, and articulate compelling, insightful findings, conclusions, and recommendations
+ Lead multiple cross functional investment sizing workstreams and provide high-level support for senior leaders to make informed decisions
+ Identify new growth avenues of opportunity through independent analysis and presents actionable findings
+ Lead key portions of presentations at high-visibility meetings
+ Assist MarketPoint leadership in communicating value and impact of MarketPoint initiatives to broader Humana organization
+ Coach junior team members to develop technical and professional skillsets
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree
+ **3+ years** of progressive experience consulting in finance, strategic planning, or related roles.
+ Proven track record in **building compensation models** and **incentive design frameworks** .
+ Advanced proficiency in **financial modeling and Excel**
+ Demonstrated experience **managing large, complex budgets** and guiding senior leadership through **trade-off decisions** .
+ Strong background in **business case development** , including **value sizing** , ROI analysis, and scenario modeling.
+ Ability to influence and partner with senior executives to drive strategic decisions.
+ Exceptional analytical and problem-solving skills with a focus on **data-driven decision-making** .
+ Strong communication skills to present complex financial concepts clearly to non-financial stakeholders.
**Preferred Qualifications**
+ Healthcare industry experience, preferably in the managed care or provider sector
+ Experience in **compensation strategy** within large organizations.
+ Exposure to **enterprise-level budgeting and resource allocation** .
**Additional Information**
**- Position does have the potential for up to 5% travel.**
**- Position will be working Eastern (EST) hours.**
**Virtual Pre-Screen**
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a HireVue interview. In this interview, you will listen to a set of interview questions over your phone or text and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website.
**Work-At-Home Requirements**
At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$115,200 - $158,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 12-28-2025
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
Easy ApplyAssociate Actuary
Baton Rouge, LA 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 ***************************************************************************
Senior Manager, MarketPoint Sales - Raleigh Durham, NC.
Baton Rouge, LA 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 ApplyMarket Underwriter
Highmark Health job in Baton Rouge, LA
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
Pharmacy Analyst
Highmark Health job in Baton Rouge, LA
The Pharmacy Analyst works with the Pharmacy Market business owners, stakeholders, and other management and supports the Specialty Pharmacy Products and Programs by performing critical analytical work and assisting with day-to-day departmental activities to achieve growth objectives, organizing and coordinating activities to ensure successful delivery of desired results. This role is instrumental in ensuring the end-to-end effectiveness, integrity, and quality of Highmark's specialty programs across both pharmacy and medical drug benefits.
**ESSENTIAL RESPONSIBILITIES**
+ Investigating product and program inquiries, ensuring adherence to standard operation procedures, mandates, and quality benchmark standards, analyzing variances, and conducting comprehensive program audits, including focused audits documenting variances, deviations and nonconformances within programs when product or process changes occur.
+ Monitoring and evaluating progress, status, and alignment of activities, with the ability to initiate corrective action as needed to maintain work viability and timeliness and monitoring the effectiveness of these actions.
+ Communicate regularly and effectively with customers regarding issues or concerns.
+ Responsible for research, project leadership and data analysis to identify business problems or process improvement opportunities and evaluating the feasibility of new Pharmacy products.
+ Partnering with business units to ensure compliance with governmental, contractual, and corporate guidelines, continuously monitoring regulatory changes, and providing consultation and analytic support to assigned functional areas.
+ Collaboration with business owners/stakeholders to translate business needs into clearly defined requirements, functional designs, and system specifications for new applications or change requests is also a core function.
+ Analyzing data to identify improvement opportunities
**PREFERRED RESPONSIBILITIES**
**EDUCATION**
**Required**
+ High school diploma / GED
**Substitutions**
+ None
**Preferred**
+ Bachelor's Degree (technical or science preferred)
**EXPERIENCE**
**Required**
+ Healthcare experience
+ Project Management experience
**Preferred**
+ Project Management
+ Technical proficiency in Excel
+ Analytical and problem-solving abilities
+ Technical proficiency in SQL
+ Experience with data visualization tools like Tableau or Power BI.
+ Experience in a quality control or quality assurance role.
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ Six-Sigma
**SKILLS**
+ Advanced experience with MS Office.
+ Experience in performing group/meeting presentations to technical/non-technical and customer audiences.
+ Strong critical thinking skills.
+ Ability to identify and assess patterns, trends, root causes, develop explanations and test solutions.
+ Ability to identify and assess problems and solutions, refer to applicable policies, identify options, and recommend appropriate courses of action.
+ Excellent verbal and written communication skills.
**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:**
$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: J271593
Medical Assistant
Hammond, LA 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
* Successful completion of MA school/training program or a Certified/Registered Medical Assistant or 5+ years of experience and approval from Provider
* High school diploma or equivalent
* CPR Certified
* This role is considered patient facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB
Preferred
* Certified or Registered - (Arizona, Indiana, & South Carolina candidates require Medical Assistant Certification or Registration)
* Phlebotomy experience• Medication/vaccine administration experience
* 1+ years MA experience
* Value Based Care experience including knowledge of HEDIS, CPT/ICD coding, and CAHPS/HOS Patient Experience.
* Bilingual proficiency in English and Spanish - must pass proficiency exam prior to foreign language communication
Additional Information:
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.
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:
* 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
#LI-BL1
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 ApplyBusiness Process Engineer
Highmark Health job in Baton Rouge, LA
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 Baton Rouge, LA
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
Crisis Intervention Specialist
Baton Rouge, LA job
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
**This role supports a 24 hour/365 day crisis call center. Applicants must reside in Louisiana.**
**Position Purpose:** Work in collaboration with schools of higher education, county first responders, law enforcement, emergency departments, providers, crisis mobile teams and the Cenpatico Crisis Line provider to support the delivery of coordinated and effective crisis services.
+ Develop relationship with all local schools of higher education and coordinate crisis prevention and disaster recovery efforts
+ Verify crisis provider services are delivered in accordance to contract expectations
+ Facilitate the issuing of Corrective Action letters to providers for non-compliance to contract requirements
+ Verify follow-up occurs after crisis interventions to effectively coordinate care
+ Educate local schools of higher education about how to identify the early warning signs of mental illness and what actions to take to safeguard students, faculty and the community
+ Support the Crisis System Plan and the development of provider crisis programs and services within the Provider Network.
+ Monitor the performance of the Crisis Line provider, Crisis Mobile Teams and other providers of crisis services
+ Support the development of Crisis Response Center processes to verify effective coordination of care with other providers
+ Establish baseline data; collect, analyze and report outcomes and progress in reaching program goals.
+ Support the coordination of crisis system processes among system partners, including schools of higher education, crisis providers, intake agencies, emergency rooms, police and fire
+ Conduct root causes analyses, conduct rapid cycle improvement processes
+ Conduct cross departmental and cross system collaborative meetings to execute initiatives and resolve system issues
+ Receive and respond to external system partner related issues in a timely manner
+ Troubleshoot service delivery and coordination issues on behalf of system partners
+ Educate system partners regarding policies and procedures related to referrals, website education, and problem solving
+ Implement and monitor project plans to meet goals and timelines
+ Request corrective action plans from providers that are non-compliant and/or fail to meet contract requirements
+ Develop training modules and train appropriate users
+ Support the involvement of Peer and Family Support Services, and wrap around and community based services to both stabilize and reduce crisis in the community.
+ Provide on-call telephonic coverage 24 hours a day, in rotation as assigned, to provide consultation
+ Performs other duties as assigned
+ Complies with all policies and standards
**Education/Experience:** Bachelor's degree in Behavioral Health or equivalent experience. 5+ years of related experience. Master's degree in Behavioral Health or Social Science preferred.
**License/Certificates:** Licensed Independent Substance Abuse Counselor (LISAC), Licensed Master Social Worker (LMSW), Licensed Bachelor Social Worker (LBSW), Certified Employee Assistance Professional (CEAP) or Licensed Marriage & Family Therapist (LMFT) preferred.
**For LA Healthcare Connections plan only:** One of the following licenses is required: Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), or Licensed Addiction Counselor (LAC) Pay Range: $55,100.00 - $99,000.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Summer 2026 Software Engineer/Architect - Python Graduate Intern
Highmark Health job in Baton Rouge, LA
**SUMMARY OF JOB RESPONSIBILITIES** This job has the goal of developing Python-based microservices and APIs to support GenAI applications. Implementing backend components for RAG and AI agent orchestration. Participating in architecture discussions and contributing to design decisions. Writing unit and integration tests to ensure code quality and reliability.
**REQUIRED QUALIFICATIONS**
Currently pursuing a Master's in Computer Science, Software Engineering, or a related field.
**PREFERED QUALIFICATIONS**
+ Strong proficiency in Python and backend frameworks (e.g., FastAPI, Flask, Django).
+ Solid understanding of system design principles, including distributed systems, service orchestration, and API lifecycle management.
+ Familiarity with cloud-native development and containerization (e.g., Docker, Kubernetes).
+ Exposure to AI/ML concepts and interest in building software for GenAI applications.
+ Experience with Git, CI/CD pipelines, and agile development practices.
+ Bonus: Experience with RAG pipelines, vector databases, or AI agent orchestration.
**ESSENTIAL JOB FUNCTIONS**
+ Build and maintain Python-based microservices using frameworks like FastAPI or Flask.
+ Design and implement RESTful APIs and backend services for AI-powered applications.
+ Participate in system design discussions, including scalability
+ Contribute to the architecture of backend systems supporting GenAI applications, using RAG and AI agents.
+ Work with cloud platforms (e.g., Azure, AWS, GCP) to deploy and monitor services.
+ Participate in agile ceremonies, code reviews, and collaborative development workflows.
+ Assist in performance tuning, logging, and observability of backend systems
**_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: J270835
Summer 2026 Customer Experience Undergraduate Intern
Highmark Health job in Baton Rouge, LA
Applicants must be authorized to work in the U.S. independently. At this time, we do not offer visa sponsorship for this role. **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.
This internship offers a dynamic opportunity to contribute to enhancing our customer experience through both data-driven insights and digital design projects. On a daily basis, the intern will support the CXIA team by assisting with customer survey reporting, developing and testing new feedback tools, and helping to maintain and update our website using basic HTML. They'll gain hands-on experience in analyzing customer data, drafting digital communications, and collaborating with our CX and Digital Marketing analysts to optimize the customer journey for United Concordia Dental. AI tools background is also a plus.
**REQUIRED QUALIFICATIONS**
+ Full or part-time enrollment in an accredited college or university baccalaureate program.
**PREFERRED QUALIFICATIONS**
+ Graduation date: 2028
+ Relevant Coursework: Studies in Customer Experience, Marketing Analytics, or Web Design.
+ Analytical Skills: Experience with data analysis or survey platforms. Web/Digital Proficiency: Basic HTML/CSS knowledge and interest in digital content.
+ Communication: Proven ability to draft clear, customer-focused digital content.
+ Problem-Solver: Proactive mindset with strong problem-solving and organizational skills.
+ AI Interest: Curiosity about AI tools for data analysis or digital optimization.
**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.
8. Customer Experience Insights & Analytics: Support member survey reporting, develop and test customer feedback surveys, and assist with data visualization and analysis.
9. Digital Experience & Web Support: Contribute to website updates (including basic HTML), draft customer email communications, and collaborate on digital content initiatives. Utilize AI support to improve our designs as needed.
10. Research & Reporting: Conduct research on CX best practices and prepare summaries of project findings and recommendations.
**_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: J270617
Aide HSP - Heart of Hospice, LLC
Baton Rouge, LA job
Explore opportunities with Heart of Hospice, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.**
As the Home and Community Bases Services Aide, you will provide support, assistance with personal hygiene and household functions for an individual to be able to remain in their own home.
**Primary Responsibilities:**
+ Provide personal care and assist with daily living activities such as bathing, grooming, dressing, ambulation, and medication reminders
+ Support household tasks, meal preparation, and accompany clients to appointments or errands as needed
+ Monitor and document client condition, vital signs, and incidents; maintain confidentiality and use EVV system
+ Ensure a safe environment, operate medical equipment properly, and respond promptly to client needs
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Current driver's license, vehicle insurance, and reliable transportation or access to public transportation
+ Current CPR certification
+ Ability to work flexible hours and independently
+ Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client
**State-Specific Requirements:**
Category I and II- Home Health Aide- Medicare Certified Home Health Provider
+ LA: Current CNA certification or successful completion of a training program. Current First Aide Certification
**Preferred Qualifications:**
+ 6+ months of home care experience
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $14.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
Summer 2026 - Finance - Undergraduate Intern
Highmark Health job in Baton Rouge, LA
**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
Technical Engineer (Starburst)
Highmark Health job in Baton Rouge, LA
*****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
Primary Care Physician - Primary Care Plus - Houma, LA
Thibodaux, LA job
**$30,000 SIGN-ON BONUS!** **Join a Physician-Led, Patient-Centered Team Focused on Quality Care** Primary Care Plus (PCPlus), a value-based care delivery organization, is seeking Board-Certified/Board-Eligible Internal Medicine or Family Medicine Physicians to join our growing team across Louisiana. Our mission is to provide a path of well-being for our patients through high-quality, cost-effective, and coordinated care that delivers superior outcomes and satisfaction.
**Why Join PCPlus?**
+ Physician-led, team-based environment with support from APRNs, RNs, and a dedicated Quality Improvement team
+ Focus on quality, not quantity - see 10-16 patients/day with 30-60 minute appointments
+ No overnight call and 4.5-day work week with early Friday departures
+ Autonomy to practice at the top of your license
+ Robust transitional care and high-risk outreach programs
+ Consistent feedback on quality measures, diagnostic accuracy, and hospitalization rates
**Compensation & Benefits:**
+ Competitive guaranteed salary with sign-on bonus
+ Up to 20% annual bonus based on quality care metrics
+ 36 days off annually (PTO, CME, and holidays)
+ Comprehensive benefits: medical, dental, vision, STD/LTD, CME allowance
+ Malpractice insurance with tail coverage
+ Retirement plans including employer-funded contributions and Employee Stock Purchase Plan (UHG stock)
+ Clinician learning and development programs
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:**
+ M.D. or D.O.
+ Active, unrestricted Louisiana medical license
+ Valid DEA and CDS licenses (or ability to obtain)
+ Board Certified/Eligible in Family or Internal Medicine
**Preferred Qualifications:**
+ 1+ years of clinical experience in adult, family, or geriatric care
+ Basic Cardiac Life Support (BCLS) certification
Compensation for this specialty generally ranges from $226,000 to $366,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. 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.
_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 Baton Rouge, LA
*****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