This architect position is focused on delivering Epic solutions. Candidate should be proficient in one or more epic modules. Candidate should have a general understanding of content management, downtime procedures and technical infrastructure.
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**
+ EPIC Applications
+ Health insurance industry business knowledge
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ EPIC 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.
**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
$57.7k-107.8k yearly 39d ago
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Change Execution Consultant
Highmark Health 4.5
Highmark Health job in Des Moines, IA
This job plays a key role in ensuring projects (i.e. change initiatives) meet objectives on time and on budget by increasing employee adoption and usage of the change solution. The incumbent focuses on the people side of change - including changes to business processes, systems and technology, job roles and organization structures. Creates and implements change execution strategies and plans that maximize employee adoption and usage and minimize risk to implementation. Works to drive faster adoption, higher ultimate utilization and greater proficiency of the changes that impact employees in the organization to increase benefit realization, value creation, ROI and the achievement of results and outcomes. While this job does not have supervisory responsibility, the incumbent works through many others in the organization to succeed. Acts as a coach for senior leaders and executives in helping them fulfill the role of change sponsor. May also provide direct support and coaching to frontline managers and supervisors as they help their direct reports through transitions. Supports project teams in integrating change execution activities into their project plans.
**ESSENTIAL RESPONSIBILITIES**
+ Apply a structured change methodology and lead change management activities.This involves partnering with sponsors and project managers to create actionable change management deliverables: (e.g. communications plans, sponsor roadmap, management coaching plans, training plans, resistance management plans, etc.).Integrate change management activities into overall master project plan.Consult and coach project teams in value and integration of change management with project management.Support development and execution of communications strategies and plans to build necessary commitment.Support development and execution of training efforts.
+ Complete change management assessments (e.g. risk, sponsorship, capacity, etc.).Identify key stakeholders who play role in organizations commitment to change.Assess the change impact on individuals and organizations and capacity to execute change.Support change execution capability building across the organization (leaders, managers, program/project leaders, front-line employees, etc.).
+ Create and execute a change management strategy.Partner with senior leadership to obtain and maintain sponsorship.Identify, analyze, and prepare risk mitigation tactics.Identify and manage anticipated resistance.Define and measure success metrics and monitor change progress.
+ Assess organizational culture to identify consistency with change and gaps that need to be addressed.Work with leadership to mitigate culture barriers by advising on action plans.Follow through to measure and track results.
+ Work directly with change sponsors and leaders and multiple levels to help strengthen their sponsorship skills.Evaluate and ensure user readiness for change.Train sponsors, project leaders, and stakeholders on change methodology.Coach managers and supervisors in preparing organization and staff for change.
+ Track and report issues to successful change implementation and realization.This includes report outs to senior leadership, project owners, stakeholders, and project sponsors.
+ Other duties as assigned.
**EDUCATION**
**Required**
+ Bachelor's Degree in Business Administration/Management, Industrial Psychology, Organizational Behavior Studies or related field
**Substitutions**
+ 6 years of relevant work experience in healthcare, project management, change management and/or business analysis in lieu of a Bachelor's Degree
**Preferred**
+ Master's Degree in Business Administration/Management, Industrial Psychology, Organizational Behavior Studies or related field
**EXPERIENCE**
**Required**
+ 5 years in Consulting
+ 5 years in Strategic Planning/Corporate Development
**Preferred**
+ None
**LICENSES AND CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ Prosci Certification
+ Certified Change Management Professional (CCMP)
**SKILLS**
+ Change Management
+ Leading Change
+ Organizational Change Management
+ Relationship-builder with Unsurpassed Interpersonal Skills
+ Flexibility
+ Analysis of business problems/needs
+ Stakeholder Management
+ Business Strategy
+ Program Management
+ Training Delivery
**Language (Other than English)**
None
**Travel Required**
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
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
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: J273828
$78.9k-147.5k yearly 32d ago
Senior Digital Designer
Humana 4.8
Des Moines, IA job
**Become a part of our caring community and help us put health first** The Senior Digital Designer responsible for creating, executing, developing, and maintaining digital design elements across multiple platforms. The Senior Digital Designer work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Digital Designer collaborate closely with cross-functional teams to conceptualize, design, and produce digital content, graphics, animations, and user interfaces that align with organizational goals and enhance the user experience. Utilize common frameworks to build and develop interactive and responsive digital solutions that ensure compatibility, efficiency, and maximum value for the end-user. Support various business objectives, including product development, advertising, marketing, media, and communications. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**Use your skills to make an impact**
Typically requires Bachelor's degree or equivalent and 5+ years of technical experience
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.
$94,900 - $130,500 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 02-22-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$94.9k-130.5k yearly 4d ago
Associate Actuary, SPA-Rx
Humana 4.8
Des Moines, IA job
**Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
_This a remote nationwide position_
The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's Degree
+ Associate of Society of Actuaries (ASA) designation
+ MAAA
+ Strong communication skills
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Prior Part D experience
+ Strong SAS skills
+ Prior Databricks experience
**Our Hiring Process**
As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
**Alert:** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website.
**_Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful._**
\#LI-Remote
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$106,900 - $147,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-29-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$106.9k-147k yearly Easy Apply 26d ago
Senior IT Product Manager - Information Marketplace & Data Governance Platform
Humana 4.8
Des Moines, IA job
**Become a part of our caring community and help us put health first** The Senior IT Product Manager - Information Marketplace & Data Governance is responsible for the strategic vision, roadmap, and execution of the Information Marketplace and its ecosystem of integrated enterprise capabilities. This role owns the end-to-end product lifecycle for the Information Marketplace as well as integrations with its supporting capabilities, data discovery, data quality and observability, metadata management, data cataloging, semantic enablement, and governed data usage processes such as the Protected Information Review Council (PIRC).
The Information Marketplace serves as the front door and starting off point for finding and understanding Humana's data. It serves a large role in day-to-day data usage and management processes and that role will continue to expand and evolve.
The Senior IT Product Manager partners closely with data governance leadership, architecture, engineering, security, compliance, and business stakeholders to ensure these capabilities operate as a cohesive, scalable product that enables trusted data use, risk reduction, and business value realization. They will create, prioritize and manage product backlogs with a focus on iteration and scalability. They will directly influence department strategy and make decisions on moderately complex to complex issues regarding technical and non-technical approaches for project components. Work will be performed without direction and considerable latitude will need to be exercised in determining objectives and approaches.
Detailed Responsibilities
**Product Strategy & Vision**
+ Define and own the long-term product vision and roadmap for the Information Marketplace and its integration to supporting capabilities and processes.
+ Translate enterprise data governance, compliance, and analytics strategies into actionable product capabilities and prioritized initiatives.
+ Act as the product authority for how data discovery, quality, observability, metadata management, and semantic layers work together as a unified experience.
**Information Marketplace Ownership**
+ Own the Information Marketplace as a core enterprise product, including user experience, adoption, scalability, and extensibility.
+ Ensure the Marketplace enables intuitive discovery of curated and un-curated data assets.
+ Drive continuous improvement of Marketplace capabilities based on usage analytics, stakeholder feedback, and emerging governance trends.
**Platform Integrations & Ecosystem Management**
+ Lead integration strategy and execution across platforms supporting:
+ Data quality and observability
+ Data cataloging and metadata management
+ Data lineage and impact analysis
+ Semantic layers and business term enablement
+ Workflow and approval processes (e.g., PIRC)
+ Partner with architecture and engineering teams to ensure integrations are scalable, secure, resilient, and aligned with enterprise standards.
+ Manage dependencies across internal platforms, vendor tools, and custom-built solutions.
**Stakeholder Engagement & Leadership**
+ Serve as the primary product interface between data governance leadership and stakeholders.
+ Facilitate prioritization decisions.
+ Communicate product strategy, roadmap progress, and outcomes to executive and senior leadership audiences.
**Delivery & Execution**
+ Own and manage the product backlog, ensuring clear articulation of epics, features, and acceptance criteria.
+ Partner with agile delivery teams to ensure timely, high-quality execution of product initiatives.
+ Define and track success metrics related to adoption, data trust, operational efficiency, and risk reduction.
**Use your skills to make an impact**
**Required Qualifications**
+ 8+ years of experience in product management, technology product ownership, or platform leadership roles.
+ Proven experience managing complex, enterprise-scale platforms with multiple integrations and stakeholders.
+ Demonstrated success owning products across the full lifecycle, from strategy and vision through delivery and adoption.
+ Ability to work effectively with architects and engineers on integration patterns, APIs, metadata flows, and platform interoperability.
+ Experience operating in hybrid or multi-platform environments, including vendor tools and custom-built solutions.
+ Exceptional stakeholder management skills, with the ability to influence without direct authority.
**Preferred Qualifications**
+ Strong understanding of data governance concepts, including metadata management, data quality, data lineage, and data stewardship.
+ Experience with data discovery, data cataloging, or information marketplace-style platforms.
+ Familiarity with compliance-driven data usage processes (e.g., privacy reviews, data access approvals, risk assessments).
+ Strong understanding of how semantic layers, business glossaries, and metadata drive analytics and AI enablement.
+ Strong executive communication skills, including the ability to translate complex technical concepts into business outcomes.
+ Experience supporting regulated industries (e.g., healthcare, financial services, insurance).
+ Exposure to data observability platforms, data quality automation, or AI-enabled governance capabilities.
+ Experience operationalizing governance processes through workflow tools or custom platforms.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$104,000 - $143,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 03-26-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$104k-143k yearly 4d ago
Utilization Management Appeals Nurse
Humana 4.8
Des Moines, IA job
**Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
Humana is seeking a Part C Grievance & Appeals (G&A) Nurse who will assist in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The Nurse reviews the medical documentation, researching claims, benefits, as well as prior determinations pertinent to the appeal and provides a written summary of findings using a template for each case. The associate will be working and collaborating with Humana CIT teams, Vendors, G&A specialists, and Humana Medical Directors on submitted G&A cases. The G&A Nurse will participate in initiatives which result in improved member outcomes, operational efficiencies, and process improvement opportunities.
+ Case preparation of Medicare and/or Duals line of businessinvolving expedited, pre-service and post serviceappeals
+ Apply and implement Medicare, Medicaid,MCG, claims policy and evidence of coverage guidelines for reviews
+ Perform outreach to providers and/or members
+ Utilize multiple systems such as MHK, CGX, MRM, SRO
**Use your skills to make an impact**
**Required Qualifications**
+ Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action
+ 3 or more years of clinical experience preferably in an acute care, skilled or rehabilitation clinical setting or broad clinical nursing experience
+ Comprehensive knowledge of Microsoft Word, Outlook and Excel
+ Strong organizational and effective time management skills
+ Ability to work independently under general instructions and with a team
**Preferred Qualifications**
+ Bachelor's degree (BSN)
+ Appeal Review Experience
+ Knowledge of MHK
+ Previous Medicare/Medicaid Experience
+ Previous experience in utilization management
+ Previous claims experience
**Work-At-Home Requirements**
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
+ Satellite, cellular and microwave connection can be used only if approved by leadership
+ 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
**Additional Information**
+ Hours are Monday-Friday 9am-6pm EST with a weekend rotation (Your 8-hour shift will fall within this timeframe)
+ Candidate's must also commit to working on the holidays as needed
+ This is a remote position, but all candidates must work in the Eastern Standard Time Zone (EST)
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-21-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$71.1k-97.8k yearly 2d ago
LTSS Service Care Coordinator
Centene Corporation 4.5
Des Moines, IA job
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
****Applicants for this role must live in the Monona or Ida county area as the position requires approximately 65% travel to visit members. We reimburse mileage at the current IRS rate. The work schedule is Monday - Friday, 8am - 5pm.****
**Position Purpose:** Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.
+ Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
+ Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
+ Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
+ Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
+ Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
+ Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
+ Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
+ May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate
+ Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
+ Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
+ Performs other duties as assigned
+ Complies with all policies and standards
**Education/Experience:** Requires a Bachelor's degree and 1+ years of experience with populations served, or RN with 6+ years of experience with population served.
Pay Range: $22.94 - $38.79 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
$22.9-38.8 hourly 13d ago
Lead Experience Researcher
Humana 4.8
Des Moines, IA job
**Become a part of our caring community and help us put health first** The Lead Experience Researcher will inform experience strategy by identifying priority customer segments, uncovering unmet needs, and translating insights into differentiated experience capabilities. this role partners closely with product, design, and clinical staeholders to inform journey optimization and ensure solutions are grounded in customer and market evidence. The researcher will connect customer insight to business outcomes, enabling scalable, market-relevant experiences.
We are seeking a Lead Experience Researcher to drive high-impact experiences. This role blends qualitative and quantitative research expertise with strategic problem-solving to identify meaningful solutions that address unmet and unrealized needs. The ideal candidate will have a strong background in research design, a passion for human-centered innovation, and the ability to translate insights into actionable recommendations that advance business and experience outcomes.
The Research Consulting Lead provides expert guidance around study design, research methodology, analyses and interpretation of results. Acts as principal investigator, leading the study team from study inception to dissemination of research results. Advises leadership to develop functional strategies on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
**Key Responsibilities:**
+ **Lead Research Engagements:** Design and execute mixed-method research (qualitative and quantitative) to deeply understand patient, member, and associate experiences.
+ **Root Cause and Opportunity Analysis:** Investigate underlying drivers of key business challenges, surfacing unmet and unrealized needs.
+ **Insight Synthesis:** Translate research findings into clear, actionable insights that inform experience strategy, product design, and operational decision-making.
+ **Strategic Problem-Solving:** Partner with cross-functional teams to co-create solutions, identifying opportunities that align with organizational strategy, end-to-end journey transformation and deliver measurable impact.
+ **Thought Partnership:** Serve as a consulting partner to leaders and stakeholders, guiding them through the research-to-action process.
+ **Measurement & Impact:** Recommend success metrics and help establish measurement frameworks to evaluate the effectiveness of implemented solutions.
**Why Join Our Team**
As a Lead Experience Researcher, you'll play a pivotal role in shaping experiences that improve health outcomes and transform how care is delivered. You'll work on high-visibility projects that drive organizational learning, accelerate decision-making, and directly impact the lives of the people we serve.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree
+ A minimum of five years' experience successfully applying experience research methods to design differentiating products and services
+ Experience planning, developing and conducting quantitative and qualitative research
+ Working experience with human-centered design methodologies including design thinking or comparable iterative methodologies
+ Knowledge of service design, social science, behavior change, perception, cognition, task analysis, experimental design, and statistics
+ Experience applying insights to shape strategies, programs, or products.
+ Expertise in a range of research methodologies (in-depth interviews, surveys, journey mapping, statistical analysis)
+ Experience leading or participating in service design and/or service blueprinting
**Preferred Qualifications**
+ Master's degree in social science or healthcare strongly preferred (e.g., anthropology, health services research, psychology, public health, or social work)
+ Experience with Agile Methodologies
+ Experience informing zero to one experiences
**Additional Information**
+ Remote role
+ Must work central or eastern hours; 8-5 Monday-Friday
+ Travel - Intermittent, approximately 1x per quarter
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.
$138,900 - $191,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 03-01-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$138.9k-191k yearly 3d ago
Business Process Engineer
Highmark Health 4.5
Highmark Health job in Des Moines, IA
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
$50.2k-91.2k yearly 60d+ ago
Business Intelligence Lead - Digital VOC
Humana 4.8
Des Moines, IA job
**Become a part of our caring community and help us put health first** The Digital Voice of Customer (VoC) Program Leader & Insights Champion will own and advance the end-to-end VoC strategy across Digital CW, ensuring measurement approaches align with customer experience goals and business priorities. This position is responsible for vendor management (Qualtrics), cross-functional stakeholder collaboration, and driving everyday self-service and adoption of VoC insights throughout the organization. The ideal candidate will develop diverse VoC touchpoints, analyze structured and unstructured data, present findings through effective storytelling, and serve as a thought leader to educate and empower teams for data-driven decision-making.
**Key Responsibilities** :
+ Develop, execute, and continuously refine the comprehensive VoC Program strategy for Digital CW, ensuring alignment with enterprise customer experience objectives and business priorities.
+ Manage and cultivate the vendor relationship with Qualtrics, representing the interests of Digital CW and collaborating with the Humana Digital lead.
+ Partner with stakeholders across UX, Product, Business Intelligence, Operations, and other lines of business to strategize, design, and implement optimal VoC touchpoints-including expansion beyond digital channels-to capture actionable customer insights.
+ Champion the incorporation of VoC metrics into everyday business practices, fostering a pull-driven, self-service engagement model across the enterprise.
+ Analyze structured and unstructured data to identify trends, friction points, opportunities for improvement, and root causes impacting user experiences.
+ Synthesize and communicate insights through compelling storytelling to influence cross-functional teams and drive user-backed optimizations.
+ Stay current with industry trends, emerging tools, and best practices to enhance VoC program effectiveness and operational efficiency.
+ Serve as a thought leader, educating stakeholders and promoting a culture of data-driven decision-making.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree and 8 or more years of technical experience in data analysis OR Master's degree and 4 years of experience
+ 2 or more years of project leadership experience
**Preferred Qualifications**
+ Demonstrated experience leading VOC or customer experience programs in a digital environment
+ Strong vendor management skills, preferably with Qualtrics or similar platforms
+ Knowledge of current trends and tools in customer experience measurement and analytics
+ Advanced experience in analysis and synthesis of quantitative and qualitative data
+ Excellent communication, presentation, and storytelling skills to inform and influence senior and executive leadership
+ Experience aggregating data across multiple sources (e.g., primary research, secondary research, operational data)
+ Working knowledge of primary research techniques (e.g., basic survey design)
+ Advanced Degree in a quantitative discipline, such as **Business, Marketing, Analytics** , Mathematics, Statistics, Computer Science, or related field
+ Passion for contributing to an organization focused on continuously improving consumer experiences
+ Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction
+ Advanced experience working with big and complex data sets within large organizations
+ Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs
+ Proficiency in understanding Healthcare related data
+ Experience creating analytics solutions for various healthcare sectors
+ Advanced in SQL, SAS and other data systems
+ Experience with tools such as Tableau and Qlik for creating data visualizations
+ Expertise in data mining, forecasting, simulation, and/or predictive modeling
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$117,600 - $161,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 04-17-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$117.6k-161.7k yearly 3d ago
Senior Sales Compensation Professional - IFG
Humana 4.8
Des Moines, IA job
**Become a part of our caring community and help us put health first** The Senior Sales Compensation Professional performs ongoing administration of calculating and paying sales commissions. The Senior Sales Compensation Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Sales Compensation Professional interacts with sales employees to resolve any issues or explain sales payment details. Associate will focus on Life Insurance commissions, payments to downlines, tracking of debt, submission of Vectors to collect debt Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's degree, preferably in Business, Finance or Mathematics
+ 2 or more years of experience with large datasets
+ Hands-on experience with TSQL or other database query languages.
+ Demonstrated experience in MS Access and/or MS Excel
+ Direct experience with commission statements, calculation, and audits
+ Strong oral and written communication skills
+ Proven record of critical thinking and problem-solving experience
+ Dedication to accuracy and strong attention to detail
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ SQL experience
+ Experience with Kizen, Varicent, REM or similar commission tools
**Additional Information**
**Humana Perks:**
Full time associates enjoy:
+ 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.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$78,400 - $107,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-22-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$78.4k-107.8k yearly Easy Apply 60d+ ago
Associate Project Manager - HNAS
Highmark Health 4.5
Highmark Health job in Des Moines, IA
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
$50.2k-91.2k yearly 60d+ ago
Physical Therapist, Home Health
Humana Inc. 4.8
Marshalltown, IA job
Become a part of our caring community and help us put health first * $10,000 Sign On Bonus * As a fulltime Physical Therapist at CenterWell Home Health, you'll play a vital role in helping patients regain strength, mobility and independence-all from the comfort of their homes. By delivering personalized care that focuses on rehabilitation and functional improvement, you'll empower individuals to overcome physical limitations, perform everyday activities with confidence and enjoy a better quality of life.
As a Full Time Home Health Physical Therapist, you will:
* Receive a $10,000.00 Sign-On Bonus paid over one year.
* Plan and administer prescribed skilled physical therapy treatment and training for patients suffering from various injuries, illnesses and functional disabilities to attain highest level of physical function.
* Test/screen the patient's physical strengths to assist the physician in evaluating the patient's level of function and records findings to develop or pursue treatment programs and establish measurable training objectives.
* Develop/implement a conditioning/rehabilitation program consistent with physician's Plan of Treatment and the overall goals of the patient/rehab team. Adjust treatment as needed to achieve maximum results.
* Confer with physician and clinical team members to obtain additional patient information and assist in developing, implementing and revising the therapy treatment program and Plan of Treatment.
* Provide Physical Therapy Assistants and Home Health Aide staff with written instructions/care plan that reflects current plan of care as related to therapy, supervise/evaluate staffs' performance. Monitor the appropriate completion of documentation by physical therapy assistants and home health aides/personal care workers as part of the supervisory/leadership responsibility.
* Accurately, promptly and thoroughly document patients' care observations, interventions and evaluations. Assure that interim (verbal) orders received from the physician and physical therapist are promptly and accurately documented, submitted for physician signature and implemented
* Report patient's progress to the patient's physician, Clinical Manager, staff, patient and family. Submit evaluation, treatment plans, progress reports and discharge summary to the supervisor and care management staff.
Use your skills to make an impact
Required Experience/Skills:
* Degree from an accredited Physical Therapy Program (approved by the APTA)
* Minimum of one year physical therapy experience preferred
* Current and unrestricted Physical Therapy license
* Current CPR certification
* Strong organizational and communication skills
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$93,000 - $128,000 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About Us
About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
$93k-128k yearly 4d ago
Technical Engineer (Starburst)
Highmark Health 4.5
Highmark Health job in Des Moines, IA
*****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
$58k-81k yearly est. 60d+ ago
Director Reimbursement Design & Market Evaluation
Highmark Health 4.5
Highmark Health job in Des Moines, IA
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
$80k-101k yearly est. 60d+ ago
Senior Financial Planning and Analysis Professional
Humana 4.8
Des Moines, IA job
**Become a part of our caring community and help us put health first** The Senior Financial Planning and Analysis Professional analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. The Senior Financial Planning and Analysis Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Financial Planning and Analysis Professional collects, compiles, verifies, and analyzes financial information and economic indicators so that senior management has accurate and timely information for making strategic and operational decisions on, for example, acquisitions, investments, capital expenditure, divestitures, mergers, or the sale of assets. Analyzes the financial implications of proposed investments or other transactions so that senior managers can evaluate alternatives against the organization's business objectives. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium, and long-term financial and competitive position. Analyzes revenues, expenses, costs, prices, investments, cash flow, profits, labor market trends, inflation, interest rates, and exchange rates. May involve financial modeling, reporting and budgeting as well. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's Degree in Finance, Accounting or a related field
+ 5 or more years experience in finance/accounting
+ Comprehensive knowledge of all Microsoft Office applications, and Access, SQL, and multi-dimensional databases
+ Ability to manage multiple priorities
+ Strong analytic skills with attention to details
+ Excellent oral and written communication skills
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Master's Degree in Business Administration or a related field
+ Previous health insurance industry experience
+ Experience with Oracle Planning, Power BI, SAS, and or Anaplan or other relational databases
**Location** **:**
Louisville, KY - Waterside Building. The team operates on a hybrid schedule, working 2-3 days per week in the office. We are open to considering remote arrangements for highly qualified candidates.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$86,300 - $118,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-29-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$30k-46k yearly est. 6d ago
Associate Architect - Oracle PaaS Administrator
Highmark Health 4.5
Highmark Health job in Des Moines, IA
*****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
$57.7k-107.8k yearly 48d ago
Wellness Coach
Highmark Health 4.5
Highmark Health job in Des Moines, IA
This job has primary ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizes data/analytics in conjunction with professional clinical judgement to identify the right clinical/lifestyle intervention for each member. The incumbent will be supported by a multi-disciplinary team and will use clinical judgment to refer members to appropriate multi-disciplinary resources. The incumbent conducts outreach to members enrolled in disease management including but is not limited to, developing a personalized care plan, encouraging behavior changes, identifying and addressing barriers, helping members to coordinate care, and identifying various resources to assist members in achieving their personal health goals. The incumbent engages with the member panel telephonically, digitally, or virtually to achieve improved health outcomes. The incumbent monitors, improves and maintains quality outcomes (clinical, financial and functional) for the specified panel of members.
**ESSENTIAL RESPONSIBILITIES**
+ Maintain knowledge of evidence based interventions and industry standards to deliver high quality lifestyle coaching in the areas of tobacco cessation, weight management, sleep hygiene, stress management, nutrition, physical activity and maternal health.
+ Maintain oversight over specified panel of members by performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address member needs and/or triaging members to appropriate resources for additional support.
+ For assigned case load, create care plans to address members' identified needs, remove barriers to care, identify resources (internal and external), and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals and plan of regular contacts for re-assessment of progress towards goals. .
+ Demonstrate clinical outcomes and cost savings based on wellness interventions and provide support to all members across all age bands, geographic regions, and products.
+ Ensure all activities are documented and conducted in compliance with applicable business process requirements, regulatory requirements,professional scope and accreditation standards.
+ Participates in workgroups focused on continually improving the efficiency, effectiveness, and member-centric focus of the wellness coaching services, including but not limited to the development and implementation of new programs and pilots.
+ Other duties as assigned or requested.
**EDUCATION**
**Required**
+ Master's Degree in Nutrition, Health Education, Health Promotion, Exercise Science, Public Health, Social Work/Psychology, Health or Clinical related field OR relevant experience and/or education as determined by the company in lieu of master's degree
**Substitutions**
+ None
**Preferred**
+ None
**EXPERIENCE**
**Required**
+ 3 years as a Registered Dietician **OR** Exercise Physiologist **OR** Wellness/Lifestyle Coach in an environment that focuses on a wellness model or program delivery (i.e. health plan/insurance, disease or condition management or inpatient/outpatient acute care)
**Preferred**
+ None
**LICENSES or CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ Certified Tobacco Cessation specialist
+ Registered Dietician
+ Certified Diabetes Educator (CDE)
+ Exercise Physiology certification
+ Certified Lactation Counselor
+ National Diabetes Prevention Program Lifestyle Coach
+ Certified Health and Wellness Coach (CHWC)
**SKILLS**
+ Familiarity with Highmark's preventative health services programs & services
+ Effective presentation skills
+ Strong relationship builder
+ Skilled in basic computer skills and software applications including Microsoft TEAMS.
+ Comprehensive knowledge and understanding of current health education practices
+ Knowledge of Prochaska's Transtheoretical Stage of Change model
+ Experience working in a team environment that supports the management of health services and/or wellness program
+ Excellent interpersonal/ consensus building skills as well as the ability to work with a variety of internal and external colleagues from all levels of an organization
+ Ability to work in a high performing team environment that requires flexibility
+ Demonstrated ability to handle multiple priorities in a fast paced environment
+ Excellent organizational, time management and project management skills
+ Self-directed; self-starter, ability to work successfully with indirect supervision and moderate autonomy
**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: J273512
$28k-37k yearly est. 5d ago
Pharmacy Technician
Unitedhealth Group Inc. 4.6
Urbandale, IA job
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Location: 10607 Aurora Ave. Urbandale, IA 50322
Schedule: Monday through Friday with 8-hour shifts between the hours of 8:00am-5:00pm
Primary Responsibilities:
* Enter prescriptions from intake to order completion and verify member / patient data
* Contact patients, pharmacists, and doctor's offices as a liaison for the pharmacy team
* Communicate clearly and concisely via phone and electronic methods to patients, physicians, and other healthcare providers
* Contact patients to complete refill assessments, request payment information, establish delivery details, and set up treatment in the Ambulatory Infusion Suite and/or other outpatient facilities
* Access, input, and retrieve prescription and medical/lab information from computer system
* Verify whether medication is reimbursable, and resolve rejected claims
* Process prescription refills and interpret supply needs as related to various therapies
* Resolve customer issues, ensuring accurate information is provided
* Able to multitask and channel communication from various business partners, driving patient centric quality care
* Follow all State and Federal regulations and Pharmacy Policies and Procedures, adhering to HIPAA and confidentiality code of ethics
* Receive and replenish inventory/medication accurately by verifying quantity, lot number, expiration throughout multiple steps
* Reorder inventory/medication as needed based on usage and forecasting
* Manage inventory to reduce expiration losses through returns to wholesalers
* Received medication overstocks/purchases and transfer throughout the country (30+ locations)
* Track medication shipments for DSCSA compliance
* Monitor and manage recalled supplies and medications
* Physically count monthly inventory items and update quantity variances
* Collaborate with central OPS to best distribute and store overstocks/purchases of medications
* Receive, store, and infuse 340B medications into standard inventory
* Ensure electronic inventory matches/reflects physical inventory on-hand
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. be interested in.
Required Qualifications:
* High School Diploma / GED (or higher) OR 4+ years of experience working as a Pharmacy Technician
* Active and unrestricted Pharmacy Technician license in the state of Iowa
* Intermediate level of experience with Windows PC applications including the ability to navigate and learn new and complex computer system applications
* Ability to stand, walk, and lift to 30 pounds
* Ability to work onsite at 10607 Aurora Ave. Urbandale, IA 50322, Monday through Friday with 8-hour shifts between the hours of 8:00am-5:00pm
Preferred Qualifications:
* National Pharmacy Technician Certification (PTCB)
* Pharmacy/prescription data entry experience
* Previous Home Infusion 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 $17.98 to $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #RED
$18-32.1 hourly 2d ago
Manager Information Security & Risk Management - Cloud Security Manager
Highmark Health 4.5
Highmark Health job in Des Moines, IA
This job provides Information Security and Risk Management services for the Organization. Works with peers within security, HM Health Solutions customers and application teams to ensure alignment with current and future security needs. Manages activities of various Information Security personnel. Makes decisions on personnel actions (promotions, hiring, terminations, etc.). Develops talent, addresses resource management, cultivates capabilities of staff, planning and coordination of work, and managing performance. Conducts the oversight of security technology products for network, systems, and data. Controls expenses within the operating unit and is responsible for meeting budget goals. Actively contributes to the Information Security ans Risk Management (ISRM) strategic planning process by working with the Directors to develop and implement department strategic plans and action steps that support the corporate strategic objectives. Actively involved in the coordination, implementation, problem solving, communication, and training of new technologies and processes, as they are developed and moved into the environment. Develops and presents Information Security awareness and training programs.
**ESSENTIAL RESPONSIBILITIES**
+ Perform management responsibilities including, but not limited to: involved in hiring and termination decisions; coaching and development; rewards and recognition; performance management and staff productivity.
+ Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
+ Provide oversight of all aspects of project management to ensure continuous improvement of processes: negotiate and collaborate with leadership and staff to develop security solutions and options; develop and adhere to internal standards and strategies; ensure adherence to approved methodologies; coordinate resources, time, contingency plans and risk management.
+ Provide leadership to the department: lead and champion organizational change; encourage participation in activities that support relationship development; champion information security innovation; encourage and enforce proper training in regards to security issues.
+ Ensure compliance to Corporate and Information Security policies, standards and procedures.
+ Communicate effectively with all levels of the organization: facilitate meetings; plan, design and provide presentations; represent HM Health Solutions with outside entities; prepare divisional procedures, policies, reports and correspondence; spread awareness of new and existing security threats; provide oversight regarding metrics, funding, budgets and resources.
+ Other duties as assigned or requested.
**EDUCATION**
**Required**
+ Bachelor's Degree in Information Security, Information Systems, Information Assurance, Computer Science or related field
**Substitutions**
+ 6 years of relevant experience substitution for a Bachelor's Degree
**Preferred**
+ Master's Degree in Computer Science, Information Security or related field
**EXPERIENCE**
**Required**
+ 7 - 10 years in Information Security and/or Information Risk Management and/or Information Technology
+ 7 - 10 years in developing, communicating and presenting Information Security and Risk Management concepts to varying audiences
+ 1 - 3 years in mentoring others in a leadership role
+ 1 - 3 years in Staff Management
+ 1 - 3 years in developing and executing strategic plans to realize business objectives
**Preferred**
+ 10 - 15 years in Information Security and/or Information Risk Management and/or Information Technology
+ Experience managing an information security function using the HITRUST Common Security Framework (HITRUST CSF), or the NIST 800-83 cyber security framework
+ Experience supporting SSAE 16 or SOC 2 Security Trust Principle audits
+ Experience establishing budgets and meeting fiduciary goals
+ Security industry organization participation/leadership (HITRUST, ISACA, InfraGard, ISC2, ISSA, etc.)
**LICENSES AND CERTIFICATIONS**
**Required**
+ None
**Preferred**
+ Certified Information Systems Security Professional (CISSP) **OR**
+ Certified Information Security Manager (CISM) **OR**
+ Certified in Risk and Information Systems Controls (CRISC) **OR**
+ Information Technology Infrastructure Library (ITIL)
**SKILLS**
+ Knowledge of regulatory requirements such as Health Insurance Portability and Accountability Act (HIPPA), Payment Card Industry Data Security Standards (PCI DSS), and FIPS-140
+ Strong teamwork and interpersonal skills
+ Experience in leading process improvement initiatives
+ Ability to motivate high performance, multi-discipline teams
+ Demonstrated competency in project execution
+ Demonstrated abilities in relationship management
**Languages (Other than English)**
None
**Travel Requirement**
0% - 25%
**PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS**
**Position Type**
Office-Based
Teaches/Trains others regularly
Frequently
Travels 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)
Does Not Apply
Physical Work Site Required
Yes
Lifting: up to 10 pounds
Does Not Apply
Lifting: 10 to 25 pounds
Does Not Apply
Lifting: 25 to 50 pounds
Does Not Apply
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This 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:**
$108,000.00
**Pay Range Maximum:**
$201,800.00
_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: J269753