Highmark jobs in Raleigh, NC - 216 jobs

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

**Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. _This a remote nationwide position_ The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + Associate of Society of Actuaries (ASA) designation + MAAA + Strong communication skills + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Prior Part D experience + Strong SAS skills + Prior Databricks experience **Our Hiring Process** As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you. If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. **Alert:** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. **_Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful._** \#LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $106,900 - $147,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-29-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

This job plays a key role in ensuring projects (i.e. change initiatives) meet objectives on time and on budget by increasing employee adoption and usage of the change solution. The incumbent focuses on the people side of change - including changes to business processes, systems and technology, job roles and organization structures. Creates and implements change execution strategies and plans that maximize employee adoption and usage and minimize risk to implementation. Works to drive faster adoption, higher ultimate utilization and greater proficiency of the changes that impact employees in the organization to increase benefit realization, value creation, ROI and the achievement of results and outcomes. While this job does not have supervisory responsibility, the incumbent works through many others in the organization to succeed. Acts as a coach for senior leaders and executives in helping them fulfill the role of change sponsor. May also provide direct support and coaching to frontline managers and supervisors as they help their direct reports through transitions. Supports project teams in integrating change execution activities into their project plans. **ESSENTIAL RESPONSIBILITIES** + Apply a structured change methodology and lead change management activities.This involves partnering with sponsors and project managers to create actionable change management deliverables: (e.g. communications plans, sponsor roadmap, management coaching plans, training plans, resistance management plans, etc.).Integrate change management activities into overall master project plan.Consult and coach project teams in value and integration of change management with project management.Support development and execution of communications strategies and plans to build necessary commitment.Support development and execution of training efforts. + Complete change management assessments (e.g. risk, sponsorship, capacity, etc.).Identify key stakeholders who play role in organizations commitment to change.Assess the change impact on individuals and organizations and capacity to execute change.Support change execution capability building across the organization (leaders, managers, program/project leaders, front-line employees, etc.). + Create and execute a change management strategy.Partner with senior leadership to obtain and maintain sponsorship.Identify, analyze, and prepare risk mitigation tactics.Identify and manage anticipated resistance.Define and measure success metrics and monitor change progress. + Assess organizational culture to identify consistency with change and gaps that need to be addressed.Work with leadership to mitigate culture barriers by advising on action plans.Follow through to measure and track results. + Work directly with change sponsors and leaders and multiple levels to help strengthen their sponsorship skills.Evaluate and ensure user readiness for change.Train sponsors, project leaders, and stakeholders on change methodology.Coach managers and supervisors in preparing organization and staff for change. + Track and report issues to successful change implementation and realization.This includes report outs to senior leadership, project owners, stakeholders, and project sponsors. + Other duties as assigned. **EDUCATION** **Required** + Bachelor's Degree in Business Administration/Management, Industrial Psychology, Organizational Behavior Studies or related field **Substitutions** + 6 years of relevant work experience in healthcare, project management, change management and/or business analysis in lieu of a Bachelor's Degree **Preferred** + Master's Degree in Business Administration/Management, Industrial Psychology, Organizational Behavior Studies or related field **EXPERIENCE** **Required** + 5 years in Consulting + 5 years in Strategic Planning/Corporate Development **Preferred** + None **LICENSES AND CERTIFICATIONS** **Required** + None **Preferred** + Prosci Certification + Certified Change Management Professional (CCMP) **SKILLS** + Change Management + Leading Change + Organizational Change Management + Relationship-builder with Unsurpassed Interpersonal Skills + Flexibility + Analysis of business problems/needs + Stakeholder Management + Business Strategy + Program Management + Training Delivery **Language (Other than English)** None **Travel Required** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-Based Teaches / trains others regularly Constantly Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $78,900.00 **Pay Range Maximum:** $147,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273828

**Become a part of our caring community and help us put health first** The Senior IT Product Manager - Information Marketplace & Data Governance is responsible for the strategic vision, roadmap, and execution of the Information Marketplace and its ecosystem of integrated enterprise capabilities. This role owns the end-to-end product lifecycle for the Information Marketplace as well as integrations with its supporting capabilities, data discovery, data quality and observability, metadata management, data cataloging, semantic enablement, and governed data usage processes such as the Protected Information Review Council (PIRC). The Information Marketplace serves as the front door and starting off point for finding and understanding Humana's data. It serves a large role in day-to-day data usage and management processes and that role will continue to expand and evolve. The Senior IT Product Manager partners closely with data governance leadership, architecture, engineering, security, compliance, and business stakeholders to ensure these capabilities operate as a cohesive, scalable product that enables trusted data use, risk reduction, and business value realization. They will create, prioritize and manage product backlogs with a focus on iteration and scalability. They will directly influence department strategy and make decisions on moderately complex to complex issues regarding technical and non-technical approaches for project components. Work will be performed without direction and considerable latitude will need to be exercised in determining objectives and approaches. Detailed Responsibilities **Product Strategy & Vision** + Define and own the long-term product vision and roadmap for the Information Marketplace and its integration to supporting capabilities and processes. + Translate enterprise data governance, compliance, and analytics strategies into actionable product capabilities and prioritized initiatives. + Act as the product authority for how data discovery, quality, observability, metadata management, and semantic layers work together as a unified experience. **Information Marketplace Ownership** + Own the Information Marketplace as a core enterprise product, including user experience, adoption, scalability, and extensibility. + Ensure the Marketplace enables intuitive discovery of curated and un-curated data assets. + Drive continuous improvement of Marketplace capabilities based on usage analytics, stakeholder feedback, and emerging governance trends. **Platform Integrations & Ecosystem Management** + Lead integration strategy and execution across platforms supporting: + Data quality and observability + Data cataloging and metadata management + Data lineage and impact analysis + Semantic layers and business term enablement + Workflow and approval processes (e.g., PIRC) + Partner with architecture and engineering teams to ensure integrations are scalable, secure, resilient, and aligned with enterprise standards. + Manage dependencies across internal platforms, vendor tools, and custom-built solutions. **Stakeholder Engagement & Leadership** + Serve as the primary product interface between data governance leadership and stakeholders. + Facilitate prioritization decisions. + Communicate product strategy, roadmap progress, and outcomes to executive and senior leadership audiences. **Delivery & Execution** + Own and manage the product backlog, ensuring clear articulation of epics, features, and acceptance criteria. + Partner with agile delivery teams to ensure timely, high-quality execution of product initiatives. + Define and track success metrics related to adoption, data trust, operational efficiency, and risk reduction. **Use your skills to make an impact** **Required Qualifications** + 8+ years of experience in product management, technology product ownership, or platform leadership roles. + Proven experience managing complex, enterprise-scale platforms with multiple integrations and stakeholders. + Demonstrated success owning products across the full lifecycle, from strategy and vision through delivery and adoption. + Ability to work effectively with architects and engineers on integration patterns, APIs, metadata flows, and platform interoperability. + Experience operating in hybrid or multi-platform environments, including vendor tools and custom-built solutions. + Exceptional stakeholder management skills, with the ability to influence without direct authority. **Preferred Qualifications** + Strong understanding of data governance concepts, including metadata management, data quality, data lineage, and data stewardship. + Experience with data discovery, data cataloging, or information marketplace-style platforms. + Familiarity with compliance-driven data usage processes (e.g., privacy reviews, data access approvals, risk assessments). + Strong understanding of how semantic layers, business glossaries, and metadata drive analytics and AI enablement. + Strong executive communication skills, including the ability to translate complex technical concepts into business outcomes. + Experience supporting regulated industries (e.g., healthcare, financial services, insurance). + Exposure to data observability platforms, data quality automation, or AI-enabled governance capabilities. + Experience operationalizing governance processes through workflow tools or custom platforms. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $104,000 - $143,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 03-26-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**Become a part of our caring community and help us put health first** As a Rx Clinical Programs Pharmacy Technician Representative 2 you will support Pharmacists and patients by executing programs developed to improve overall health outcomes with a focus on prescription drugs, and medication therapy and helps drive the strategy on comprehensive medication reviews. As a Rx Clinical Programs Pharmacy Technician Representative 2 you will perform varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. In this role as a Rx Clinical Programs Pharmacy Technician Representative 2 you will assist in driving prescription drug optimization in cases where patients are taking multiple medications. Through effective communication, helps drive health awareness with patients through Rx Education and targeted quarterly campaigns. Assists Pharmacists by placing and retrieving calls to confirm patients are taking drugs and provides counseling. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion. In this role, you will: + Make outbound and take inbound calls + Communicate with Humana members + Collect medication history information + Prepare members for a comprehensive medication review **Use your skills to make an impact** Additional Job Description ****PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT) **** **_*Earn a $1,500 hiring sign on bonus!_** * (50% payable at hire and 50% payable at 180 days; you must be employed until that date to be eligible to receive the payment!) + Applicable to external candidates only **Required Qualifications** + **Resident State Pharmacy Technician License** **OR** **National Pharmacy Technician Certification** + High School Diploma or equivalent + Excellent communication skills both written and verbal + Applied knowledge of insurance processing, customer service or call center processes and practices + High speed hardwired internet and phone, minimum speed 20Mbps + Must have a designated work area with a door that locks **Schedule:** Must have the flexibility to work any hours between 8:00am-7:00pm EST and holidays/weekends and overtime as needed. + **You must be on time, dressed appropriately, with your camera ON during 2+ weeks of training and for other meetings required by leadership** . Attendance is vital for success, time off during your 180-day appraisal period is not permitted. Exception: Should a Humana-observed holiday occur during training or within the 180-day appraisal period, you will have the holiday off (paid). **Preferred Qualifications** + Associate's degree or equivalent work experience + Experience in mail order and/or retail pharmacy setting + Ability to speak both English and Spanish fluently + Previous call center experience in a pharmacy setting + Strong communication and telephonic skills + Ability to solve problems and encourage others in collaborative problem solving + Self-directed, but also able to work well in a group + A positive, proactive attitude, energetic, highly motivated and a self-starter + Work ethic that is focused, accurate and highly productive **Referral Bonus Information** Associates may receive a bonus for the referral of external candidates to this requisition, provided that all other eligibility requirements are met. 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. $40,000 - $52,300 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** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Explore opportunities with Access Community-Based Services, 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 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.

Explore opportunities with Home Health of Wilson, 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 Scheduling Specialist you will managing patient referrals and visit schedules. Assigns patient assessments and other visits as ordered by the physician using an online scheduling system. Collaborate with the Team Leader to identify clinicians with the appropriate experience and skill set to match patient needs. Primary Responsibilities: * Utilizes an automated scheduling system to maintain a calendar of services for both episodic and per visit customers * Processes workflow for requested scheduled, missed, rescheduled, reassigned, declined, and delivered visits * Monitors pending referrals daily and assigns licensed professional and case manager for all start of care visits * Communicates daily with field staff regarding any visits unaddressed in late, pending, or incomplete status for resolution as appropriate 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 . #LHCjobs Required Qualifications: * High school education or equivalent experience Preferred Qualifications: * 1+ years of scheduling experience in a health care setting using an online scheduling system * Exceptional organizational, customer service, communication, and decision-making skills * Working knowledge of state and federal regulations governing OASIS visits, supervisory, and reassessment visits Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $14.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. #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.

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

**Become a part of our caring community and help us put health first** The Home Health Student Nurse Internship is a summer opportunity designed to provide nursing students with hands-on experience in a community-based home care setting. As an intern, you will have the opportunity to gain direct clinical experience in the home environment by assisting with essential patient care tasks such as measuring vital signs, performing physical assessments, supporting wound management, and providing Foley catheter care -all under the guidance of experienced registered nurses. This internship aims to enhance clinical assessment skills, foster compassionate communication, and offer exposure to the continuum of care outside traditional hospital settings. We are seeking interns for internship opportunities at our various branch locations across the South Region in the following locations: Beverly Hills, FL; Crestview, FL; Pensacola, FL; Viera, FL; Columbus, GA; Kinston, NC; Lillington, NC; Lumberton, NC; Pollocksville, NC; Charleston, SC; Columbia, SC. When submitting your application, please specify the branch or branches where you are interested and available to work. This will help us best match your skills and availability with our current openings. **Responsibilities:** + Assist Registered Nurses in providing direct patient care in home settings + Conduct patient assessments and document findings accurately + Participate in care planning and implementation under RN supervision + Practice effective, empathetic communication with patients and families + Adhere to all clinical protocols, safety guidelines, and regulatory requirements + Maintain patient confidentiality and professional conduct at all times + Engage in educational activities and team meetingswithin the branch and the Chief Nursing Office **Use your skills to make an impact** **Required Qualifications:** + Enrolledin an accredited Licensed Practical Nurse (LPN),Associate Degree in Nursing (ADN), or Bachelor of Science in Nursing (BSN)program, withexpected graduation date between December 2026 and Summer 2027 + Must be available to work full-time,40hoursper week, Monday - Friday for8weeksfromJune1-July24. + Must have a validdriver'slicenseforthe duration of the internship totravel tothe branch and/orpatient homes. Students will ride with their preceptors for most home visits. + Completion of at least one clinical rotation in an acute care setting and/orpreviousexperience in home health, hospice, or community-based care + Must have Certification in Basic Life Support (BLS) from the American Heart Associationthat must be activefor the duration of internship + Must not require sponsorship to work in the United States now or in the future **Preferred Qualification** **s:** + Have a strong academic history, with a minimum nursing GPA of 2.5 or higher + Havedemonstratedcommitment to patient-centered careand strong interest in home health care + Have strong organizational, prioritization, and critical thinking skills + Possess strong interpersonal, written, and oral communication skills **What to expect during your** **8** **-week internship program:** + Onboarding andorientationcompleted in week one + Work closelyin the homewithseasonedhome healthnursestoprovide hands on, supervised care to home bound patients + Interdisciplinary care team shadowingexperiences + Facilitated, virtualgroupmeetupswith other home health nursing interns across the US + Opportunities to connect andinteractwith home health andorganization leaders **Scheduled Weekly Hours** 1 **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. $37,440 - $43,800 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. **About Us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**Become a part of our caring community and help us put health first** The Provider Analytics organization's vision is to improve member healthcare through innovative analytics and actionable insights, which empower members, and providers to drive higher quality, lower cost of care, and improved health outcomes. Provider Analytics develops and applies actionable analytics and insights, which are integral to business needs, to drive informed provider network strategy and is looking for an Informaticist 2 to join their team. The Informaticist 2: + Designs and constructs models to estimate impact of contractual changes tied to ancillary and industry leading innovative care delivery models + Collates, models, interprets and analyzes data in order to identify, explain, and influence variances and trends + Explains variances and trends and enhances modeling techniques + Utilizes multiple data sources such as SQL, Power BI, Excel, etc., to create advanced analytics to facilitate contracting initiatives + Uses a consultative approach to collaborate effectively with the markets, and other customers, building productive cross-functional relationships + Extracts historical data, performs data mining, develops insights to drive provider contracting strategy and reimbursement terms for National Ancillary Contracting + Develops tools and automates processes to model financial implications of ancillary contracted rate changes, including changes in capitated arrangements In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits + Health Savings Accounts + Flex Spending Accounts + Life Insurance + 401(k) + PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time + And more **Use your skills to make an impact** **Required Qualifications** + 3+ years of demonstrated healthcare analytical experience + 1+ years SQL experience + 1+ years' experience in data visualization (ie. Power BI, Tableau, etc.) + Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends + Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues + Possess a working knowledge and understand department, segment and organizational strategy **Preferred Qualifications** + Bachelor's Degree in analytics or related field + Advanced Degree + Understanding of healthcare membership, claims, and other data sources used to evaluate cost and other key financial and quality metrics **Additional Information** Work at Home/Remote Requirements **Work-At-Home Requirements** + To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate. + Wireless, Wired Cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.) + Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. 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 **Our Hiring Process** As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging, and/or Video Interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone or computer. You should anticipate this interview to take approximately 10-15 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. \#LI-LM1 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. $73,400 - $100,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-21-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

This job has primary ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizes data/analytics in conjunction with professional clinical judgement to identify the right clinical/lifestyle intervention for each member. The incumbent will be supported by a multi-disciplinary team and will use clinical judgment to refer members to appropriate multi-disciplinary resources. The incumbent conducts outreach to members enrolled in disease management including but is not limited to, developing a personalized care plan, encouraging behavior changes, identifying and addressing barriers, helping members to coordinate care, and identifying various resources to assist members in achieving their personal health goals. The incumbent engages with the member panel telephonically, digitally, or virtually to achieve improved health outcomes. The incumbent monitors, improves and maintains quality outcomes (clinical, financial and functional) for the specified panel of members. **ESSENTIAL RESPONSIBILITIES** + Maintain knowledge of evidence based interventions and industry standards to deliver high quality lifestyle coaching in the areas of tobacco cessation, weight management, sleep hygiene, stress management, nutrition, physical activity and maternal health. + Maintain oversight over specified panel of members by performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address member needs and/or triaging members to appropriate resources for additional support. + For assigned case load, create care plans to address members' identified needs, remove barriers to care, identify resources (internal and external), and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals and plan of regular contacts for re-assessment of progress towards goals. . + Demonstrate clinical outcomes and cost savings based on wellness interventions and provide support to all members across all age bands, geographic regions, and products. + Ensure all activities are documented and conducted in compliance with applicable business process requirements, regulatory requirements,professional scope and accreditation standards. + Participates in workgroups focused on continually improving the efficiency, effectiveness, and member-centric focus of the wellness coaching services, including but not limited to the development and implementation of new programs and pilots. + Other duties as assigned or requested. **EDUCATION** **Required** + Master's Degree in Nutrition, Health Education, Health Promotion, Exercise Science, Public Health, Social Work/Psychology, Health or Clinical related field OR relevant experience and/or education as determined by the company in lieu of master's degree **Substitutions** + None **Preferred** + None **EXPERIENCE** **Required** + 3 years as a Registered Dietician **OR** Exercise Physiologist **OR** Wellness/Lifestyle Coach in an environment that focuses on a wellness model or program delivery (i.e. health plan/insurance, disease or condition management or inpatient/outpatient acute care) **Preferred** + None **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + Certified Tobacco Cessation specialist + Registered Dietician + Certified Diabetes Educator (CDE) + Exercise Physiology certification + Certified Lactation Counselor + National Diabetes Prevention Program Lifestyle Coach + Certified Health and Wellness Coach (CHWC) **SKILLS** + Familiarity with Highmark's preventative health services programs & services + Effective presentation skills + Strong relationship builder + Skilled in basic computer skills and software applications including Microsoft TEAMS. + Comprehensive knowledge and understanding of current health education practices + Knowledge of Prochaska's Transtheoretical Stage of Change model + Experience working in a team environment that supports the management of health services and/or wellness program + Excellent interpersonal/ consensus building skills as well as the ability to work with a variety of internal and external colleagues from all levels of an organization + Ability to work in a high performing team environment that requires flexibility + Demonstrated ability to handle multiple priorities in a fast paced environment + Excellent organizational, time management and project management skills + Self-directed; self-starter, ability to work successfully with indirect supervision and moderate autonomy **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $50,200.00 **Pay Range Maximum:** $91,200.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273512

The Senior Marketing Analytics Analyst plays a critical role in transforming customer, digital, and campaign data into insights that improve acquisition, retention, member experience, and marketing effectiveness. This role works across Marketing, Digital, Sales, and Enterprise Analytics to translate business questions into analytical approaches, build performance dashboards, evaluate campaign ROI, and uncover opportunities to improve engagement across the member and patient lifecycle. This individual must bring strong statistical rigor, advanced marketing analytics skills, and deep understanding of healthcare customer journeys-including Medicare, Medicaid, Commercial, and provider engagement pathways. Experience with enterprise data platforms such as Salesforce Data Cloud, Adobe AEP/CJA, and Tableau is preferred. **ESSENTIAL RESPONSIBILITIES** + Develops, evolves, and then communicates various digital strategy, including but not limited to web, social, and/or mobile strategy. Defines engaging, retail-oriented solutions, best practices, and opportunities to meet business objectives and the broader customer experience. + Works closely with customers, stakeholders, and technology partners to understand business goals, multi-channel marketing strategies, brand strategies, content strategies, product strategies, and technology solutions in order to create best-fit digital marketing programs and solutions, serving as a trusted advisor to internal customers. + Keeps management informed of project activity, interdependencies, challenges and opportunities and educates stakeholders by socializing new, interdependent, or evolving digital capabilities and opportunities. + Manages and distills research, analytics, competitive activities, and emerging trends to support digital strategy. Makes tactical decisions, and socializes opportunities with stakeholders. Monitors competitive landscape as well as other related verticals such as retail or financial, creating insights for future development; sets, meets, and re-evaluates key performance indicators for all projects and BAU digital capabilities + Ensures consistent messaging within digital channel by working with content providers, content strategists, and cross-channel marketing and business partners to ensure consistency throughout customer experience. + Other duties as assigned or requested. **QUALIFICATIONS:** **Required** + High School Diploma or GED + 5-10 years of relevant, progressive experience in the area of specialization **Preferred** + 5-10 years in marketing analytics, digital analytics, or customer analytics. + Experience in **healthcare** , payer/provider environment, or other regulated industries (preferred). + Proventrack recordanalyzing complex customer and campaign datasets from CRM, CDP, web/app analytics, and marketing automation platforms. + Experience with Adobe Web SDK or Tealium/Freshpaintevent instrumentation. + Background in behavioral science, marketing science, or healthcare consumer experience. + Exposure tomachine learning operations (MLOps) or automated model scoring. + Familiarity with call center analytics, provider engagement data, or member experience metrics (CAHPS, HEDIS, STARS). **Technical Skills** + **Advanced SQL** (window functions, CTEs, analytical modeling). + **Tableau / Tableau Next** (LOD expressions, parameters, data modeling, AI-driven insights). + Experience with at least one major CDP/marketing cloud: + **Salesforce:** MCI (Datorama), MCE (Engagement), Data Cloud + **Adobe:** AEP (RTCDP), CJA + Strong data wrangling skills (Dataiku,Pythonor R preferred). **Analytical Skills** + Strong foundationin statistics: regression, hypothesis testing, forecasting, experimental design. + Hands-on experience with multichannel attribution and media performance evaluation. + Ability to build and interpret predictive models and customer segmentation. **Domain Expertise** + Understanding ofhealthcare marketing (enrollment flows, provider networks, Medicare AEP/OEP). + Familiarity with HIPAA, PHI, consent management, and data governance best practices. **SKILLS** + Proactive in learning and adapting to new marketing technologies, tools, and AI-powered marketing platforms. + Exceptional communication andinsightstorytelling ability. + Strong stakeholder engagement skills-comfortablepresenting tomarketing, product, and executive leadership. + Highly organized and comfortable operating in a fast-paced, matrixed environment. **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: J273819

**Become a part of our caring community and help us put health first** The Senior Digital Designer responsible for creating, executing, developing, and maintaining digital design elements across multiple platforms. The Senior Digital Designer work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Digital Designer collaborate closely with cross-functional teams to conceptualize, design, and produce digital content, graphics, animations, and user interfaces that align with organizational goals and enhance the user experience. Utilize common frameworks to build and develop interactive and responsive digital solutions that ensure compatibility, efficiency, and maximum value for the end-user. Support various business objectives, including product development, advertising, marketing, media, and communications. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** Typically requires Bachelor's degree or equivalent and 5+ years of technical experience Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $94,900 - $130,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-22-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Explore opportunities with PharmScript, part of the Optum family of businesses. PharmScript is one of the nation's leading pharmacies, partnering with long-term and post-acute care facilities to supply medications to thousands of residents and patients. Be part of our team that's dedicated to delivering safe, accurate and timely medication to those who need it most. PharmScript is a place where you can thrive and contribute. Join us to start **Caring. Connecting. Growing together.** We seek a **Staff Pharmacist** to perform professional duties and responsibilities associated with the processing of prescriptions at our pharmacy in Morrisville, NC. In this role, you'll provide comprehensive pharmaceutical care through routine and emergency drug screening, information, processing and dispensing services for various drug distribution systems to the facilities. You'll also be responsible for ensuring that standards are maintained, policies carried out and objectives accomplished. The ideal candidate will be organized, detail-oriented and have established management experience. They will be required to ensure that the appropriate drug product reaches the customer safely. Always a team player, you're eager to support your colleagues by sharing knowledge and leadership to support the overall goals of the pharmacy and needs of customers. **Work schedule:** Monday - Friday / 5:30 pm - 2:00 am **Location:** 140 Southcenter Ct, Suite 600, Morrisville, NC **Primary Responsibilities:** + Execute day-to-day operations in the pharmacy as they pertain to workflow, production quotas and deadlines + Assist in the proper ordering, handling, receiving, documentation and storage of all controlled substances; assist in maintaining a perpetual inventory for scheduled drugs + Ensure that the pharmacy is compliant with all local, state and federal rules and regulations regarding the practice of pharmacy + Supervise the pharmacy production staff to ensure proper order entry, workflow and security of the pharmacy area, and adherence to delivery schedules + Prepare and/or supervise the preparation of all sterile IV drug products or solutions + Check for completeness and accuracy of all new and refill labels and orders. Check for content and accuracy of all drug packaging and labeling + Ensure that the pharmacy is compliant with all DEA policies and procedures and follows all applicable government regulations 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:** + Bachelor's Degree in Pharmacy or PharmD + Current pharmacist license in North Carolina 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 $44.09 to $78.70 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._

*****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

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. ***NOTE: For this role we are seeking candidates who live within the Eastern Standard Time Zone*** Position Purpose: Perform duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider claims issues. Perform training, orientation and coaching for performance improvement within physician practices. Serve as primary contact for providers serving as a liaison between the provider and the health plan Conduct monthly face to face meetings with the providers documenting discussions, issues, attendees, and action items researching claims issues on site and routing to the appropriate party for resolution Receive and respond to external provider related issues Initiate entry or change of provider related database information and oversee testing and completion of change request Investigate, resolve and communicate provider claim issues and changes Educate providers regarding policies and procedures related to referrals and claims submission, web site education, EDI solicitation and problem solving Perform provider orientations, including writing and updating orientation materials Ability to travel Performs other duties as assigned Complies with all policies and standards Education/Experience: High school diploma or equivalent. Bachelor's degree in healthcare related field preferred. 3+ years of sales, provider relations, or contracting experience. Knowledge of health care, managed care, Medicare or Medicaid. Claims billing/coding knowledge preferred. Driver's License may be required by some plans. Specific language skills may be required by some plans. License/Certification: Valid driver's license.Pay Range: $23.23 - $39.61 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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

*****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

$40,000 Student Loan Repayment Or $20,000 Sign-on Bonus for Individuals Who Have Not Previously Participated in this Program Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Senior Community Care (SCC) product, we work with a team to provide care to patients at home in a nursing home, assisted living for senior housing. This life-changing work adds a layer of support to improve access to care. We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. We're fast becoming the nation's largest employer of Nurse Practitioners; offering a superior professional environment and incredible opportunities to make a difference in the lives of patients. This growth is not only a testament to our model's success but the efforts, care, and commitment of our Nurse Practitioners. Serving millions of Medicare and Medicaid patients, Optum is the nation's largest health and wellness business and a vibrant, growing member of the UnitedHealth Group family of businesses. You have found the best place to advance your advanced practice nursing career. As an CCM Nurse Practitioner/ Physician Assistant per diem you will provide care to Optum members and be responsible for the delivery of medical care services in a periodic or intermittent basis. Primary Responsibilities: * Primary Care Delivery * Deliver cost-effective, quality care to assigned members * Manage both medical and behavioral, chronic and acute conditions effectively, and in collaboration with a physician or specialty provider * Perform comprehensive assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations * Responsible for ensuring that all diagnoses are ICD10, coded accurately, and documented appropriately to support the diagnosis at that visit * The APC is responsible for ensuring that all quality elements are addressed and documented * The APC will do an initial medication review, annual medication review and a post-hospitalization medication reconciliation * Facilitate agreement and implementation of the member's plan of care by engaging the facility staff, families/responsible parties, primary and specialty care physicians * Evaluate the effectiveness, necessity and efficiency of the plan, making revisions as needed * Utilizes practice guidelines and protocols established by CCM * Must attend and complete all mandatory educational and LearnSource training requirements * Travel between care sites mandatory * Care Coordination * Understand the Payer/Plan benefits, CCM associate policies, procedures and articulate them effectively to providers, members and key decision-makers * Assess the medical necessity/effectiveness of ancillary services to determine the appropriate initiation of benefit events and communicate the process to providers and appropriate team members * Coordinate care as members transition through different levels of care and care settings * Monitor the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change * Review orders and interventions for appropriateness and response to treatment to identify most effective plan of care that aligns with the member's needs and wishes * Evaluate plan of care for cost effectiveness while meeting the needs of members, families and providers to decreases high costs, poor outcomes and unnecessary hospitalizations * Program Enhancement Expected Behaviors * Regular and effective communication with internal and external parties including physicians, members, key decision-makers, nursing facilities, CCM staff and other provider groups * Actively promote the CCM program in assigned facilities by partnering with key stakeholders (i e : internal sales function, provider relations, facility leader) to maintain and develop membership growth * Exhibit original thinking and creativity in the development of new and improved methods and approaches to concerns/issues * Function independently and responsibly with minimal need for supervision * Ability to enter available hours into web-based application, at least one month prior to available work time * Demonstrate initiative in achieving individual, team, and organizational goals and objectives * Participate in CCM quality initiatives * Availability to check Optum email intermittently for required trainings, communications, and monthly scheduling 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: * Education: * NP: Graduate of an accredited Master of Science Nursing or Doctor of Nursing Practice program * PA: Graduate of an accredited Physician Assistant degree program * Certified Nurse Practitioner through a national board * For NPs: Graduate of an accredited Master's degree in Nursing (MSN) program and board certified through the American Academy of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC), Adult-Gerontology Acute Care Nurse Practitioners (AG AC NP), Adult/Family or Gerontology Nurse Practitioners (ACNP), with preferred certification as ANP, FNP, or GNP * For PAs - Certified Physician Assistant through a national board: Graduate of an accredited Physician Assistant degree program and currently board certified by the National Commission on Certification of Physician Assistants (NCCPA) * Active and unrestricted license in the state which you reside, or the ability to obtain by start date * Current active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice) * Ability to gain a collaborative practice agreement, if applicable in your state * Ability to move a 30-pound bag in and out of car and to navigate stairs and a variety of dwelling conditions and configurations * Driver's license and access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area Preferred Qualifications: * 1+ years of hands-on postgrad experience within Long Term Care * Understanding of Geriatrics and Chronic Illness * Understanding of Advanced Illness and end of life discussions * Proficient computer skills including the ability to document medical information with written and electronic medical records * Ability to develop and maintain positive customer relationships * Demonstrated adaptability to change Compensation for this specialty generally ranges from $109,500 to $164,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. PLEASE NOTE Employees must be in an active regular status. Employees must remain in role for a minimum of 12 months from the date of hire /rehire/transfer. If an employee leaves Home and Community, the student loan repayments will cease. The employee must remain in an Advanced Practice Clinician or Physician role within Home and Community for 36 months to receive the full benefit of the student loan repayments. 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