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Highmark jobs in Madison, WI

- 150 jobs
  • Manager Broker Experience

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    This job manages the development and execution of short-term and long-term objectives to standardize business practices and enhance system applications. Actively participates in and leads projects. Develops and implements appropriate controls and processing methods and manage adherence to. Manages staff responsible for addressing daily system and process issues. Provides leadership in the development, implementation, management and accurate maintenance of all contractually-based producer arrangements. Establishes and maintain all operational and system processes across the organization to support producer arrangements. **This role can be remote or hybrid - If you are within 50 miles of an office you are required to be onsite 3 days a week - T, W, Th.** **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority. + Lead the delivery and execution of projects by: analyzing, identifying and problem solving business and systems issues; presenting recommendations to senior management; managing development of requirements, standard operating procedures, functional roles and responsibilities, process flow and user guides. Serve in consulting/training role to direct reports to develop and execute comprehensive test scripts decreasing likelihood of defects to be corrected after implementation. + Identify, research, determine, implement and validate solutions, fostering an environment of continuous improvement across the organization. Oversee ongoing analysis and implementation of procedures and systems. Contribute to operational readiness, organizational change management, solution capability, packaging and estimating, planning and delivery management. + Lead the development and implementation of contractually-based producer arrangements by: interpreting and translating requests for enhanced business considerations; identifying operational capabilities and/or limitations in delivering requested enhanced business considerations; presenting and working through recommendations with senior management; defining operational process and necessary system development to implement and maintain agreed-to enhanced business communications. Communicate enhanced business considerations and operational processes across the organization. Establish and manage audit controls to ensure enhanced considerations are consistently and accurately adhered to. + Manages employees in the following analytical functions: 1) Analysis and approval of retroactive Producer changes, exception or advance payments, non-standard commissions, and requests for refunds from Producers; 2) Determination/ set-up of payment arrangements, data transfer, and licensure / appointment procedures for business partners; 3) Maintenance/dissemination of state requirements for producer appointment and licensing; 4) Production of complex reports for Sales, Producers, Business Partners, Regulators and other business areas and external parties; 5) Monitoring and internal auditing of various business partners relative to payment and producer of record accuracy, appointment compliance and other controls; 6) Maintenance of workflow procedures, form communications, and messaging. + Maintains master Producer contract forms, coordinates amendments and re-distribution of contracts, and works with the legal department on complex contractual issues and special language requests. + Acts as custodian/business owner of the payment processes and functional project manager of commission cycle. + Coordinates/approves payment system enhancements, relevant system requirements for corporate projects and business partner implementations.Works with other business areas to resolve complex system issues and payment problems. + Other duties as assigned or requested. **EDUCATION** **Required** + Bachelor's degree **Substitutions** + 6 years related and progressive experience in lieu of Bachelor's Degree **Preferred** + Master's Degree **EXPERIENCE** **Required** + 5 years in Healthcare, Technology or Project Management + 3 years in a leadership or management role **Preferred** + 5 years performing or managing administrative and compliance processes related to Producer Relationships **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Customer focus, results orientation, strategic thinking, change advocate, continuous improvement, talent development + Knowledge of Producer agreements, commission payment calculation and how it interfaces with company financial systems. + Demonstrated competency in project execution and management of organizational units + Excellent written and verbal communication skills + Excellent leadership and interpersonal skills + Proven ability to build and sustain internal and external customer relationships + Experience evaluating and implementing technology + Presentation experience + Strong strategic development capabilities with creative problem-solving skills **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Constantly Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $78,900.00 **Pay Range Maximum:** $147,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273519
    $78.9k-147.5k yearly 5d ago
  • Business Process Analyst

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    **MUST BE A US CITIZEN ** This role will serve as a link between underwriting operations, financial strategy, and process optimization. The incumbent will apply strong analytical and financial acumen to understand, document, and improve processes within the underwriting lifecycle, ensuring efficiency, compliance, and alignment with financial objectives. While primarily focused on process improvement, this role will also support critical underwriting functions, leveraging data to drive strategic decisions and operational excellence. **ESSENTIAL RESPONSIBILITIES** + Create comprehensive process maps and documentation for underwriting procedures, identifying current state operations, future state recommendations, and potential financial impacts. + Develop desktop procedures and training materials specific to underwriting functions, ensuring clarity for audit and compliance. + Collaborate closely with underwriters to analyze existing processes and tools, identifying opportunities for financial efficiency, risk mitigation, and improved quote/renewal turnaround times. + Conduct analyses to quantify the financial impact of proposed process changes or tool enhancements, ensuring data-driven recommendations. + Actively participate in and support project meetings related to underwriting system enhancements, financial modeling tool development, and overall operational efficiency initiatives, ensuring the underwriting perspective is well-represented. + Support underwriting workloads by calculate rates utilizing Company rating algorithms, adjusting accordingly to cover questionable claim patterns or unusual situations not otherwise contemplated within the standard formula. **EDUCATION** **Required** + High School Diploma/GED **Substitutions** + None **Preferred** + Bachelor's Degree in finance, Accounting, Economics, Business Administration, or a related field. **EXPERIENCE** **Required** + **MUST BE A US CITIZEN ** + 3 - 5 years of experience in a Business Analyst or Business Process Analyst role or experience in a related operational area (e.g. claims, billing, customer service, etc.) **Preferred** + Experience in a financial analysis, underwriting support, or actuarial support role is highly desired. Strong understanding of financial concepts, risk assessment, and insurance product lifecycles. **LICENSES OR CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Analysis of business problems/needs + Written & Oral Presentation Skills + Business Analysis + Business Process Design + Business Process Improvement + Business Process Mapping + Business Requirements + Collaborative Problem Solving + Project Management **Languages (other than English)** None **Travel Required** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Remote 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 Never 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 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: J273104
    $50.2k-91.2k yearly 20d ago
  • Associate Architect

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    Within area of expertise (application, solution, information, technology, business), assists in design, development, implementation, support, and optimization of architecture strategy to meet business capabilities and needs. Assists in ensuring completeness of architecture by adequately addressing all the pertinent concerns of its stakeholders. Assists in ensuring integrity of architecture by connecting various views of stakeholders, reconciling conflicting concerns, and showing the trade-offs made in so doing. Considers practicality and fitness for purpose in determining architecture to develop. Leverages business and technology knowledge to enable and/or alter business processes, practices, organizations and systems. Maintains knowledge of emerging technologies and best in class industry business trends and practices. **ESSENTIAL RESPONSIBILITIES** + Assists in providing strategic consultation to business customers in defining or designing less complex business processes, functions and organizational structures, as well as in researching, identifying and internally marketing enabling technologies based on customer capability requirements. Facilitates development of enterprise business solutions that combine knowledge of particular business processes and issues, general technological options, and process facilitation techniques. Participates in enterprise strategy development, including environmental analysis, opportunity identification, value cases and business innovation portfolio development. + Assists in specifying and designing less complex systems, solutions, networks, infrastructure elements, or processes. Selects appropriate design standards, methods and tools and ensures that they are applied effectively. Reviews others' system design to ensure selection of appropriate technology, efficient use of resources and integration of multiple systems and technology. Establishes policy for selection of architecture components. Evaluates and undertakes impact analysis on major design options. Ensures that the system architecture balances functional, service quality and systems management requirements. + Assists in using appropriate tools, including models of components and interfaces, to contribute to the development of architectures. Produces detailed component requirements, specifications and translates these into detailed solutions/designs for implementation using selected products. Provides advice on technical aspects of system development, integration (including requests for changes, deviations from specifications, etc.) and processes. Ensures that relevant technical and business strategies, policies, standards and practices are applied correctly. + Assists in selecting and using tools and methods to establish, clarify, and communicate the functional and non-functional requirements of system users, their characteristics, and tasks. Identifies the technical, organizational, and physical environment in which less complex products or systems will operate. Identifies, proposes, initiates, and leads improvement programs, taking responsibility for the quality and appropriateness of the work performed and the realization of measurable business benefits. Modifies existing process improvement approaches and/or develops new approaches to achieving improvement. + Assists in ensuring the resolution of a variety of architecture and business problems and serves as a technical or business resource for less complex project initiatives. + Communicates effectively with all levels of organization + Manages expectations of customers, partners and management + Participates in customer walkthroughs and plans; design and technical walkthroughs; and problem resolution and decision making + Interacts with departments across the organization as necessary, including the development and interpretation of less complex requirements for peers and other staff. + Maintains an in-depth knowledge of specific technical aspects in area of expertise and provides advice regarding their application. The area of specific expertise may be any aspect of information or communication technology, technique, method, process, product, or application area. + Provides leadership in the areas of expertise and architecture to their peers, developers, management and business users including technical expertise, coaching, and ad-hoc training by: + Preparing presentations on less complex issues on the area of expertise + Presenting to their peers to ensure consistency to Highmark's strategic direction. + Other duties as assigned or requested. **EDUCATION** **Required** + Bachelor's Degree in Information Technology or related field **Substitutions** + 6 years of related experience in lieu of a 4 year degree **Preferred** + Master's Degree **EXPERIENCE** **Required** + None **Preferred** + Health insurance industry business knowledge **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + Industry certifications **SKILLS** An Architect is not required to have experience in all of these, but is required to have those needed to support applications they are responsible for supporting. Current skill set are reviewed every other year, new skills may be required to meet changing business needs. + Skills: + IMS, DB2, Oracle and Teradata Databases, Data Warehousing + COBAL, Visual Basic, C C++, SAS + Java/JavaScript Framework + PEGA, CSS3, Mobile, JSON, Cognos, Hadoop, SQL, J2EE, HTML5/XML + Project Management Tools: + Waterfall + Agile + Certification in application areas such as: + Java Developer + DB2, Cogno, PEGA, Enterprise Architect(SCEA), Project Management **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Never **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $57,700.00 **Pay Range Maximum:** $107,800.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273535
    $57.7k-107.8k yearly 6d ago
  • Case Manager- Eau Claire, WI

    Humana 4.8company rating

    Madison, WI job

    **Become a part of our caring community and help us put health first** Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: + Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). + Coordinate services that address members' health and safety needs, ensuring support is provided in the least restrictive environment in accordance with the MCP. + Collaborate continuously with a Field Care Nurse (RN) to review and update care plans and address members' evolving needs. + Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence. + Schedule, conduct, and document quarterly in-person visits and maintain monthly contact with members by phone. + Identify, arrange, and monitor support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs. + Engage in clear and empathetic communication with members to better understand their needs, support informed decision-making, and ensure cost-effective service delivery. + Prioritize safety by continuously evaluating risk factors and providing education to members to promote overall health and wellness. + Maintain accurate and timely documentation of activities, including case notes, service authorizations, and updates to the Member Care Plan. + Foster direct collaboration with service providers, natural supports, and other community partners to enhance member outcomes. + Travel is necessary to conduct member visits and fulfill role responsibilities. **Use your skills to make an impact** **Required Qualifications** + Four-year bachelor's degree in human services or related field with one (1) year of experience working with at least one of the Family Care target populations **OR** a four-year bachelor's degree in any other field with three (3) years' related experience working with at least one of the Family Care target populations. + Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications. ***The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities*** **Preferred Qualifications** + Case Management experience + Experience with electronic case note documentation and experience with documenting in multiple computer applications/systems + Knowledge of community health and social service agencies and additional community resources **Additional Information** + **Workstyle:** This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes. + **Work Location:** Eau Claire and surrounding areas + **Travel:** up to 40% throughout Eau Claire and surrounding areas. Mileage reimbursement follows our mileage policy. + **Typical Workdays/Hours:** Monday - Friday, 8:00 am - 4:30 pm CST 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. $53,700 - $72,600 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 Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our 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 ***************************************************************************
    $53.7k-72.6k yearly 7d ago
  • Associate Actuary

    Humana 4.8company rating

    Madison, WI job

    **Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **In addition, the Associate Actuary will:** + Support long term projects aimed at advancing technical maturity, process efficiency, and forecasting accuracy. We are looking for creativity, curiosity, and a desire to explore and influence uncharted territory. + Conduct independent research, collaborate across many teams/departments, and require strong communication skills to be successful in the job. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + Associate of Society of Actuaries (ASA) designation + Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP) + MAAA + Strong communication skills + Demonstrated ability to communicate technical information with audiences not in the actuarial space + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + 3+ years health industry experience with ASA, or 1+ years health industry experience with FSA + 2+ years SQL experience, or equivalent skillset **Preferred Qualifications** + Medicare Advantage background + Creative, high degree of self-accountability + Experience in Python, PowerApps, and PowerBI Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $106,900 - $147,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-30-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $106.9k-147k yearly 28d ago
  • Senior Manager, MarketPoint Sales - Raleigh Durham, NC.

    Humana 4.8company rating

    Madison, WI job

    **Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact your own income potential? If so, we are looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan products and educate beneficiaries on our services in a field setting. Our teams also sell Life, Annuity, Indemnity, Dental, Vision, Prescription plans, and more. Humana has an inclusive and diverse culture welcoming candidates with multilingual skill sets to service our consumers. **This role is** **field** **based, and you will be out and about in the field in the Raleigh** **Durham, NC.** **area working with your team and meeting members face to face. You must reside in Raleigh** **Durham, NC.** **area or be willing to relocate to the area.** In this **field** position, you will; coach, mentor, educate, motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a solid understanding of the market they serve, how to resolve operational problems and provide creative solutions to increase sales while following CMS guidelines. This role also involves cultivating, maintaining, and building relationships with Humana's customers, both internal and external business partners, along with the community we serve through telephonic, virtual, and face-to-face interactions with individuals and groups. Other responsibilities include developing marketing budgets, and looking for branding opportunities. **Use your skills to make an impact** **Required Qualifications** + **Must reside in the** **Raleigh** **Durham, NC.** **area or be willing to relocate** + **Active Health & Life Insurance Licenses** + 2 or more years of sales leadership experience + 6 or more years of experience working in the insurance industry + Must be able to travel up to 50% of the time + Ability to lead a team of sales associates and train them in successful sales techniques, educational presentation skills, utilizing technology tools as well as building relationships with communities and medical providers + Strong aptitude for technology with proficiency in MS Office products, various CRM platforms, and various iPhone app capabilities + Must be a strong leader, strong producer + Strong organizational, interpersonal, communication and presentation skills + Ability to adapt and overcome when necessary + Community Engagement/Grassroots experience in marketing Medicare plans in the community + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits **Preferred Qualifications** + Bachelor's Degree + Prior experience working in Medicare and the health solutions industry + Engaged with the community through service, organizations, activities and volunteerism + Project management background or certification a plus + Bilingual with the ability to speak, read and write without limitations or assistance **Humana Perks:** Full time associates enjoy: + Base salary with a competitive commission structure + Medical, Dental, Vision and a variety of other supplemental insurances + Paid time off (PTO) & Paid Holidays + 401(k) retirement savings plan + Tuition reimbursement and/or scholarships for qualifying dependent children. + And much more! **Social Security Task:** Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. **Virtual Pre-Screen:** As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a HireVue interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes. \#MedicareSalesManager \#MedicareSalesReps Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $77,000 - $105,100 per year This job is eligible for a commission incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-18-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $77k-105.1k yearly Easy Apply 2d ago
  • Director Reimbursement Design & Market Evaluation

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    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
    $82k-102k yearly est. 60d+ ago
  • Aide -Almost Family Personal Care

    Unitedhealth Group 4.6company rating

    Janesville, WI job

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

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    The Pharmacy Analyst works with the Pharmacy Market business owners, stakeholders, and other management and supports the Specialty Pharmacy Products and Programs by performing critical analytical work and assisting with day-to-day departmental activities to achieve growth objectives, organizing and coordinating activities to ensure successful delivery of desired results. This role is instrumental in ensuring the end-to-end effectiveness, integrity, and quality of Highmark's specialty programs across both pharmacy and medical drug benefits. **ESSENTIAL RESPONSIBILITIES** + Investigating product and program inquiries, ensuring adherence to standard operation procedures, mandates, and quality benchmark standards, analyzing variances, and conducting comprehensive program audits, including focused audits documenting variances, deviations and nonconformances within programs when product or process changes occur. + Monitoring and evaluating progress, status, and alignment of activities, with the ability to initiate corrective action as needed to maintain work viability and timeliness and monitoring the effectiveness of these actions. + Communicate regularly and effectively with customers regarding issues or concerns. + Responsible for research, project leadership and data analysis to identify business problems or process improvement opportunities and evaluating the feasibility of new Pharmacy products. + Partnering with business units to ensure compliance with governmental, contractual, and corporate guidelines, continuously monitoring regulatory changes, and providing consultation and analytic support to assigned functional areas. + Collaboration with business owners/stakeholders to translate business needs into clearly defined requirements, functional designs, and system specifications for new applications or change requests is also a core function. + Analyzing data to identify improvement opportunities **PREFERRED RESPONSIBILITIES** **EDUCATION** **Required** + High school diploma / GED **Substitutions** + None **Preferred** + Bachelor's Degree (technical or science preferred) **EXPERIENCE** **Required** + Healthcare experience + Project Management experience **Preferred** + Project Management + Technical proficiency in Excel + Analytical and problem-solving abilities + Technical proficiency in SQL + Experience with data visualization tools like Tableau or Power BI. + Experience in a quality control or quality assurance role. **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + Six-Sigma **SKILLS** + Advanced experience with MS Office. + Experience in performing group/meeting presentations to technical/non-technical and customer audiences. + Strong critical thinking skills. + Ability to identify and assess patterns, trends, root causes, develop explanations and test solutions. + Ability to identify and assess problems and solutions, refer to applicable policies, identify options, and recommend appropriate courses of action. + Excellent verbal and written communication skills. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $57,700.00 **Pay Range Maximum:** $107,800.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J271593
    $57.7k-107.8k yearly 33d ago
  • Home Caregiver

    Unitedhealth Group 4.6company rating

    Madison, WI job

    Explore opportunities with Almost Family Personal Care, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As the Home and Community Bases Services Aide, you will provide support, assistance with personal hygiene and household functions for an individual to be able to remain in their own home. **Primary Responsibilities:** + Provide personal care and assist with daily living activities such as bathing, grooming, dressing, ambulation, and medication reminders + Support household tasks, meal preparation, and accompany clients to appointments or errands as needed + Monitor and document client condition, vital signs, and incidents; maintain confidentiality and use EVV system + Ensure a safe environment, operate medical equipment properly, and respond promptly to client needs You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current driver's license, vehicle insurance, and reliable transportation or access to public transit + Current CPR certification + Ability to work flexible hours + Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client **State-Specific Requirement** + WI: Listed on Wisconsin Home Health Aide Registry **Preferred Qualifications:** + 6 months+ of home care experience Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $14.00 to $24.23 per hour based on full-time employment. We comply with all minimum wage laws as applicable. \#LHCJobs _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $14-24.2 hourly 3d ago
  • Strategy Advancement Advisor - Distribution Strategy

    Humana 4.8company rating

    Madison, WI job

    **Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor works on problems of diverse scope and complexity ranging from moderate to substantial. **Become a part of our caring community and help us put health first** The Strategy Advisor (Distribution) provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for the Enterprise Growth vertical. The Strategy Advisor's work involves complex assignments performed without direction where the analysis of situations or data requires an in-depth evaluation of variable factors. This work may require leading end-to-end strategy engagements. As part of the Strategy Advancement team, this role will support MarketPoint's investment rationalization and strategic planning efforts. The role requires comfort with ambiguity and creating new solutions in the "white space" where answers are not clear cut or readily available. A successful candidate will be someone who has worked for several years in large matrixed organization (e.g. a publicly traded corporation or large not profit organization) or has several years' experience with stakeholder management (strategy/operations at a top-tier consulting/professional services firm). They will have a demonstrated ability to synthesize large amounts of information into clear and concise outputs (PPT, Excel). This person must be comfortable working collaboratively with senior leaders and subject matter experts alike and should have a high degree of executive presence leading engagements with these stakeholders. This person also will be effective at multitasking and possess keen program and change management skills to balance an evolving set of priorities and deadlines. Healthcare experience is a plus, but not required, though must have a history of mastering an understanding of their prior industry. Other examples of the kind of work required from this role include leading the analysis of complex business problems and issues using data from internal and external sources. The candidate should bring expertise or identify subject matter experts in support of multi-functional efforts to identify, interpret, and produce strategic recommendations and plans. The candidate's work will substantially shape the thinking of distribution org. They will exercise independent judgment and decision making on complex issues to determine the best course of action and work under minimal supervision. **Use your skills to make an impact** About the team: Humana's distribution organization, MarketPoint, plays a key part in driving Humana's long-term vision to achieve leading growth in Medicare and individual products. The MarketPoint strategy team was created to help transform Humana's customer acquisition approach. The team functions with a mandate to think creatively, discover new opportunities and re-envision operations to drive growth and deliver a first-class experience to our members and agents. **Responsibilities:** + Leads multiple short- and long-term work streams sometimes across engagements, including hypothesis development, working sessions, and report-outs with leaders across the company, and documenting key ideas and actions to drive follow-up actions + Partners closely with finance, analytics, and operators to optimize, track, and report out on internal and external compensation strategy and results + Develop high-quality analysis and deliverables that clearly frame organizational objectives, issues/challenges, and articulate compelling, insightful findings, conclusions, and recommendations + Lead multiple cross functional investment sizing workstreams and provide high-level support for senior leaders to make informed decisions + Identify new growth avenues of opportunity through independent analysis and presents actionable findings + Lead key portions of presentations at high-visibility meetings + Assist MarketPoint leadership in communicating value and impact of MarketPoint initiatives to broader Humana organization + Coach junior team members to develop technical and professional skillsets **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + **3+ years** of progressive experience consulting in finance, strategic planning, or related roles. + Proven track record in **building compensation models** and **incentive design frameworks** . + Advanced proficiency in **financial modeling and Excel** + Demonstrated experience **managing large, complex budgets** and guiding senior leadership through **trade-off decisions** . + Strong background in **business case development** , including **value sizing** , ROI analysis, and scenario modeling. + Ability to influence and partner with senior executives to drive strategic decisions. + Exceptional analytical and problem-solving skills with a focus on **data-driven decision-making** . + Strong communication skills to present complex financial concepts clearly to non-financial stakeholders. **Preferred Qualifications** + Healthcare industry experience, preferably in the managed care or provider sector + Experience in **compensation strategy** within large organizations. + Exposure to **enterprise-level budgeting and resource allocation** . **Additional Information** **- Position does have the potential for up to 5% travel.** **- Position will be working Eastern (EST) hours.** **Virtual Pre-Screen** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a HireVue interview. In this interview, you will listen to a set of interview questions over your phone or text and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Work-At-Home Requirements** At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $115,200 - $158,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-28-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $115.2k-158.4k yearly Easy Apply 13d ago
  • Business Process Engineer

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    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 35d ago
  • Medicare Sales Field Agent - Madison, WI

    Humana 4.8company rating

    Madison, WI job

    **Become a part of our caring community and help us put health first** With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll help bring Humana's strategy to life: Deliver on the fundamentals, differentiate through exceptional service, and grow by expanding our reach and impact. **What You'll Do in This FIELD Based Role:** + **Deliver** : Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental, Vision, and Prescription coverage. + **Differentiate** : Create meaningful, face-to-face connections through grassroots marketing, community events, and in-home visits-providing a personalized experience that sets Humana apart. + **Grow** : Drive self-generated sales, meet performance goals, and expand Humana's presence in the market by becoming a valued resource in your community. You'll engage with customers in the **FIELD** through a mix of in-person, virtual, and phone interactions. **Face-to-face visits in prospective members' homes are a key part of this role.** **Why Join Humana?** + **People-first culture** that supports your personal and professional growth. + **Inclusive and diverse environment** that values multilingual talent and cultural understanding. + **Autonomy and flexibility** to manage your schedule and success. + **Purpose-driven mission** to help people achieve their best health-and transform healthcare along the way. **Benefits include:** + Medical, Dental, Vision, and a variety of other supplemental insurances + Paid Time Off (PTO) and Paid Holidays + 401(k) retirement savings plan with a competitive match + Tuition reimbursement and/or scholarships for qualifying dependent children + **And much more!** **Use your skills to make an impact** **Required Qualifications** + **Active Health Insurance License** or ability to obtain. + Must reside in **the designated local territory** to effectively serve the community. + Comfortable with **daily face-to-face interactions** in prospective members' homes and engaging with the community through service, organizations, volunteer work, or local events. + Valid state **driver's license** and **proof of personal vehicle liability insurance** meeting at least 25/25/10 coverage limits (or higher, based on state requirements). **Preferred Qualifications** + **Active Life and Variable Annuity Insurance License** . + Prior experience **selling Medicare products** . + Experience in **public speaking or delivering presentations** to groups. + Associate's or Bachelor's degree. + Experience using Microsoft Office tools such as **Teams, Excel, Word, and PowerPoint** . + **Bilingual** in English and Spanish, with the ability to speak, read, and write fluently in both languages. **Additional Information** + This position is in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and MVR review. + Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. + Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **Schedule** **:** Meeting with members requires appointments and/or event times that may vary on nights and weekends. Flexibility is essential to your success. **Training:** The first five weeks of employment and attendance is mandatory. **Interview Format:** As part of our hiring process for this opportunity, we are using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward in the process, you will receive a text message inviting you to participate in a HireVue prescreen. In this prescreen, you will receive a set of questions via text and given the opportunity to respond to each question. You should anticipate this prescreen taking about 15 minutes. Your responses will be reviewed and if selected to move forward, you will be contacted with additional details involving the next step in the process. **Pay Range** The range below reflects a good faith estimate of total compensation for full time (40 hours per week) employment at the time of posting. This compensation package includes both base pay and commission with guarantee. The pay range may be higher or lower based on geographic location. Actual earnings will vary based on individual performance, with the base salary and commission structure aligned to company policies and applicable pay transparency requirements. $80,000 - $125,000 per year \#medicaresalesrep Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **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 ***************************************************************************
    $37k-45k yearly est. Easy Apply 56d ago
  • Director Data Services - Data Governance

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    This job is responsible for developing the strategy, planning and delivery of all aspects related to data governance, data warehousing, data management and related efforts for the organization. Directs the coordination of involvement of all business area Subject Manager Experts (SMEs) and other staff members. Promotes the proliferation of a data driven organization in end-user processes and the integration of applications; as well as the promotion of enterprise-wide thinking among business and technical areas. Responsible for defining, documenting, and making available data sources of truth throughout the enterprise. Participation in project management and budgeting to assure data related projects are included in the organizational roadmap and produce tangible results. Champions the use of data as an asset across the enterprise. Improvement and maturity of data sources to move through the life cycle of data, information, and knowledge. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority. + Assure all related projects or initiatives are delivered on time, within the specified budget and in accordance with the agreed upon scope. + Define, build, and maintain a data warehouse/big data platform and associated data stores that maintain an enterprise focus and meet the needs of its varied stakeholders. + Ensure that decisions are made reflecting that position and carefully managing on the part of the incumbent to satisfactorily resolve situations with competing priorities or different perceptions, particularly among senior management. + Communicate and act as the ambassador for data management and data governance within the organization, which includes upward and downward communication of the outcomes produced through the efforts of the team and driving the organization to a data-driven operating approach. + Accountable for service level agreements and expectations with end-users and external stakeholders. + Ensure that the Enterprise Data Warehouse (EDW)/Big Data platforms meets the needs of its customers. + Deliver/manage/monitor all data extracts, both to internal and external constituents. + Other duties as assigned or requested. **EDUCATION** Minimum + Bachelor's Degree in Business, Information Science or other related area, or relevant experience and/or education as determined by the company in lieu of bachelor's degree Preferred + Master's Degree Business, Information Science or other related area **EXPERIENCE** **Minimum** + 10 years of information technology experience functioning in a data warehouse environment to include at least 5 years' performing in a managerial capacity + 3 years of healthcare related experience + Experience developing strategic plans and/or product road maps and communicating technical concepts to varying audiences + Experience acting as liaison between business and technical teams, translating business terms to technical needs **Preferred** + None **SKILLS** + Analytical and problem solving skills + Project management experience with multiple major development projects, demonstrating leadership skills and a track record of managing technical/business staff, financial resources and outside vendors + Strong teamwork and interpersonal skills + Ability to lead process improvement initiatives + Strong knowledge and understanding of business needs + Ability to establish and maintain high level of customer trust and confidence + Demonstrated abilities in relationship management + Strong communication skills **LICENSES AND CERTIFICATIONS** **Required** + None **Preferred** + PMP **TRAVEL REQUIREMENT:** 0 - 25% **LANGUAGE REQUIREMENT (** **_other than English_** **)?** _None_ **PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS** **Position Type** Office-Based **Office-Based Positions** An employee in this position works in an office environment. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours. Teaches/Trains others regularly Frequently Travels regularly from the office to various work sites or from site-to-site Does Not Apply Works primarily out-of-the office selling products/services (Sales employees) Does Not Apply Physical Work Site Required Yes Lifting: up to 10 pounds Does Not Apply Lifting: 10 to 25 pounds Does Not Apply Lifting: 25 to 50 pounds Does Not Apply **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $126,400.00 **Pay Range Maximum:** $236,000.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J271608
    $73k-95k yearly est. 21d ago
  • Market Underwriter

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    This job serves as the single-point-of-contact for sales teams and assigned customers, delivering insights and recommendations to sales in order to aid customer acquisition/retention while maintaining performance goals. This incumbent will collaborate with cross functional team members on client-level quotes and function as a trusted adviser by providing financial and risk management support to sales as well as strategic insight. **ESSENTIAL RESPONSIBILITIES** + Understand department and the company'sstrategic goals and competitive position and drives client-level results towards these ends. Actively work with Sales team to manage portfolio of clients towards financial and business targets, e.g. membership, revenue, margin, etc. + Proactively draw insights from quote details, client understanding and regional insights to deliver best-possible recommendation to Sales. State and maintain independent perspective, including under pressure from more senior individuals, identifying opportunities and concerns. + Responsible for portfolio of clients through underwriting engagement, from identification through documentation of final sold-contract details + Assess risk by looking at various risk measures such as risk scores, demographic analysis, and turnover considerations. + Serve as the accountable owner for all quotes delivered to sales partners. Develop a perspective on each client package deliverable. Clearly and confidently communicates Underwriting's position on the risk profile of each client + Identify tool improvement needs and communicates needs to Product Development teams + Maintain accurate book management details including concession budget + Other duties as assigned or requested. **Required** + Bachelor's Degree in Science, Technology, Mathematics or related field **Substitutions** + Six (6) years additional experience required in lieu of degree **Preferred** + None **EXPERIENCE** **Required** + 3 years of Health Care Underwriting OR risk mgmt OR actuary work OR applying advanced mathematics to include + 1 years of external client interaction or comparable external interactions **Preferred** + 1 year in Risk Management **OR** of Actuary work **OR** of applying Advanced Mathematics **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Understanding of health products, services, risk assessment and techniques + Consultative mindset + Strong Oral and Written Communications skills **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Rarely Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Never **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $50,200.00 **Pay Range Maximum:** $91,200.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J272541
    $50.2k-91.2k yearly 29d ago
  • Per Diem Associate Patient Care Coordinator

    Unitedhealth Group 4.6company rating

    Oconomowoc, WI job

    **$750 SIGN ON BONUS FOR EXTERNAL APPLICANTS** **Explore opportunities with Optum** , in strategic partnership with ProHealth Care. ProHealth Care is proud to be a leader in health care services, serving Waukesha County and the surrounding areas for more than a century. Explore opportunities across the full spectrum of care as you help us improve the well-being of the community with your skills, compassion and innovation. Be part of a collaborative environment that strives for excellence, nurtures respect and ensures high-quality care delivery to our patients. Join us in making an impact as an Optum Team Member supporting Pro Health Care and discover the meaning behind **Caring. Connecting. Growing together** . The **Per Diem Associate Patient Care Coordinator** is responsible for the completion of set processes and protocols. Works cooperatively with all members of the care team to support the vision and mission of the organization, deliver excellent customer service and adhere to Lean processes. Supports the teams in meeting financial, clinical and service goals. **Location:** 1185 Corporate Center Dr. Oconomowoc, WI 53066 **Hours:** Hours are as needed must be open to working 1st, 2nd & 3rd shift **Primary Responsibilities:** + Greets visitors and patients in person, or communicates by telephone or video conferencing, upholding excellent customer service + Enters and updates patient demographic and financial information, ensuring the patient is fully registered as early in the process as possible + Obtains appropriate applications and forms, confirming signatures are on file. Photocopies/scans documents as needed + Provides patients with financial responsibility information and collects patient liabilities, documents amount in the appropriate fields, and balances the cash box daily + Works with partnering departments (Financial Counseling, Scheduling, Financial Clearance, and clinical areas) to ensure all aspects of the patient's encounter are completed as needed + Provides wayfinding instructions and assists with hospital information as requested + Coordinates patient admission needs, bed assignments, and tracking boards where applicable + Meets or exceeds audit accuracy standards. Works worklists and error reports timely, and proactively seeks assistance to resolve as needed + May perform other duties upon request **What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:** + Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Medical Plan options along with participation in a Health Spending Account or a Health Saving account + Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage + 401(k) Savings Plan, Employee Stock Purchase Plan + Education Reimbursement + Employee Discounts + Employee Assistance Program + Employee Referral Bonus Program + Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) + More information can be downloaded at: ************************* You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma/GED (or higher) + 1+ years of customer service experience in an office setting or professional work environment + Basic level of proficiency in Microsoft Office Products + Ability to work a minimum of 2 shifts within 1st, 2nd and 3rd shift every 2 weeks + Ability to work 1 weekend shift per month + Ability to work and/or be on call 2 holidays per year (New Year's Day, Memorial Day, July 4 th , Labor Day, Thanksgiving Day and Christmas Day) + Ability to travel to other local sites as needed + Must be 18 years of age OR older **Preferred Qualifications:** + Experience in a medical office or hospital admitting/registration office + Experience with electronic medical records system + Knowledge of medical terminology **Soft Skills:** + Strong communication and customer service skills both in person and via phone + Strong organizational and time management skills + Ability to multi-task and prioritize tasks to meet all deadlines + Ability to work well under pressure in a fast-paced environment + Ability to work independently and maintain good judgment and accountability + Demonstrated ability to work well with others + Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others ****PLEASE NOTE** The sign-on bonus is only available to external candidates. Candidates who are currently working for UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.** Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO #RED
    $16-27.7 hourly 60d+ ago
  • Associate Architect - Oracle PaaS Administrator

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    *****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 15d ago
  • Technical Engineer (Starburst)

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    *****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
    $65k-89k yearly est. 48d ago
  • Pharmacy Technician Medication Coordinator

    Unitedhealth Group 4.6company rating

    Madison, WI job

    **Opportunities with Genoa Healthcare.** A career with Genoa Healthcare means you're part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness - and those who care for them - have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services - in-clinic pharmacies, medication management and more - are leading the way to a new level of care. Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group's family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start **Caring. Connecting. Growing together.** The **Pharmacy Technician Medication Coordinator** position at Genoa is an essential role that impacts the lives of an underserved population that needs a voice. This onsite position is a liaison between a partner clinic and a Genoa mental health specialty pharmacy. Primary responsibilities include building strong relationships with the clinic partners and communicating with consumers to assist them with their medication plan, insurance and the full services of the Genoa pharmacy. A key function will be promoting Genoa services to obtain new consumers and increasing the number of consumers Genoa serves. Address: 425 W. Main St., STE 201, Sun Prairie, WI (Located within Mercyland Psychiatry) Hours: Hours: Monday -Friday 8:00 AM - 5:00 PM - (Lunch 1 hour) No weekends or Holidays **Primary Responsibilities:** + Communicates with all consumers of the mental health center regarding the medication services Genoa provides + Recruits and enrolls consumers utilizing enrollment forms and copy the consumer's insurance card + Facilitates the collection of prescriptions to be faxed to the pharmacy for dispensing + Ensures all consumer insurance information is up to date in the Pharmacy system and is properly charged for the medications dispensed + Assists consumers in contacting the pharmacist regarding all their medication questions and ensure a prompt response to their questions + Assists clinic staff and pharmacy with prior authorizations and Patient Assistance programs as needed + Monitors compliance by contacting the consumer at least monthly to ensure compliance and determine refill needs as applicable + Prescription refill management by utilizing the no refill report and contacting the appropriate prescriber to ensure timely refills are completed and dispensed to the consumer + Medication delivery when needed and appropriate {Only applicable in states that are allowed} + Checks for expiration dates (both on consumer's medications as well as house account products/standing order meds) + Ensures that medications are stored properly (refrigerated drugs are kept in the refrigerator, pen-tips are not stored on insulin pens, etc.) + Checks for discrepancies (dose changes, discontinued medications, etc.) You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Pharmacy Technician License in WI + Drivers License + Reliable Transportation + 10% local travel **Preferred Qualifications:** + PTCB Certification + Sales and Marketing 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 $20.00 to $35.72 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._
    $20-35.7 hourly 39d ago
  • Associate Project Manager - HNAS

    Highmark Health 4.5company rating

    Highmark Health job in Madison, WI

    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 54d ago

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