Highmark jobs in Tallahassee, FL - 168 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 Consumer Service Operations Representative 3 is responsible for the daily activities across multiple service functions area. The Consumer Service Operations Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. **THIS POSITION IS LOCATED IN THE PORT ST. LUCIE, FLORIDA AREA - YOU WILL BE TRAVELING TO ONE OF FOUR DIFFERENT LOCATIONS EACH DAY ON ROTATION IN THE AREAS LISTED BELOW.** The Consumer Service Operations Representative III may perform installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations. This individual investigates and settles claims and customer service issues. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. This individual regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge. **Use your skills to make an impact** **Required Qualifications** + **Must be able/willing to travel between the 4 different locations in Stuart, East St. Lucie, Southeast St. Lucie, and West St. Lucie (zip codes ranging from 34994, 34952, 34984, and 34986). You will travel to a different clinic each day.** + Minimum 1 year of customer service experience in a healthcare setting + Proficient in Microsoft Office, Outlook, Word, and Excel + Excellent verbal, listening and written communication skills + Aptitude for quickly learning and navigating new technology, systems and applications as well as working knowledge of computers **Preferred Qualifications** + Undergraduate Degree + Clerical support experience in a healthcare environment + CNA or Medical Assistant experience + Quality experience + Medicare experience + Familiarity with medical terminology and/or ICD-10 codes **Additional Information** + Must be able/willing to travel between the 4 different locations in Stuart, East St. Lucie, Southeast St. Lucie, and West St. Lucie (zip codes ranging from 34994, 34952, 34984, and 34986). You will travel to a different clinic each day. + 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 HireVue. HireVue 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. **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. $43,000 - $56,200 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About Us** 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 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 ***************************************************************************

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

**Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Humana is seeking a Part C Grievance & Appeals (G&A) Nurse who will assist in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The Nurse reviews the medical documentation, researching claims, benefits, as well as prior determinations pertinent to the appeal and provides a written summary of findings using a template for each case. The associate will be working and collaborating with Humana CIT teams, Vendors, G&A specialists, and Humana Medical Directors on submitted G&A cases. The G&A Nurse will participate in initiatives which result in improved member outcomes, operational efficiencies, and process improvement opportunities. + Case preparation of Medicare and/or Duals line of businessinvolving expedited, pre-service and post serviceappeals + Apply and implement Medicare, Medicaid,MCG, claims policy and evidence of coverage guidelines for reviews + Perform outreach to providers and/or members + Utilize multiple systems such as MHK, CGX, MRM, SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action + 3 or more years of clinical experience preferably in an acute care, skilled or rehabilitation clinical setting or broad clinical nursing experience + Comprehensive knowledge of Microsoft Word, Outlook and Excel + Strong organizational and effective time management skills + Ability to work independently under general instructions and with a team **Preferred Qualifications** + Bachelor's degree (BSN) + Appeal Review Experience + Knowledge of MHK + Previous Medicare/Medicaid Experience + Previous experience in utilization management + Previous claims experience **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Additional Information** + Hours are Monday-Friday 9am-6pm EST with a weekend rotation (Your 8-hour shift will fall within this timeframe) + Candidate's must also commit to working on the holidays as needed + This is a remote position, but all candidates must work in the Eastern Standard Time Zone (EST) Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-21-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

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

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 Senior Sales Compensation Professional performs ongoing administration of calculating and paying sales commissions. The Senior Sales Compensation Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Sales Compensation Professional interacts with sales employees to resolve any issues or explain sales payment details. Associate will focus on Life Insurance commissions, payments to downlines, tracking of debt, submission of Vectors to collect debt Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree, preferably in Business, Finance or Mathematics + 2 or more years of experience with large datasets + Hands-on experience with TSQL or other database query languages. + Demonstrated experience in MS Access and/or MS Excel + Direct experience with commission statements, calculation, and audits + Strong oral and written communication skills + Proven record of critical thinking and problem-solving experience + Dedication to accuracy and strong attention to detail + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + SQL experience + Experience with Kizen, Varicent, REM or similar commission tools **Additional Information** **Humana Perks:** Full time associates enjoy: + Medical, Dental, Vision and a variety of other supplemental insurances + Paid time off (PTO) & Paid Holidays + 401(k) retirement savings plan + Tuition reimbursement and/or scholarships for qualifying dependent children. + And much more! **Social Security Task:** Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. **Virtual Pre-Screen:** As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a HireVue interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-22-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Explore opportunities with Archbold Home Health, 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 Physical Therapist Assistant you will perform treatment and provide exercise instruction and patient education aimed at improving/enhancing the patient's well-being while following the established plan of care. Primary Responsibilities: * Responsible for following all state specific laws governing the provision of physical therapy in home care, to follow the treatment set only as defined by the supervising PT; to perform only those procedures that he/she is qualified and trained to perform and to make all recommendations for changes in the plan of care to the supervising Physical Therapist * Instructs and aids patients in active and passive exercise, muscle re-education, gait, functional, ADL, transfer, safety, and prosthetic training * Observes, records, and reports to the supervising PT, the nurse supervisor, and/or the physician the patient's response to treatment and changes in the patient's condition. Coordinates care with the other members of the healthcare team as appropriate * Instructs patient, family, caregiver, and other members of the health care team in the areas of therapy within the scope of the physical therapy assistant 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, licensed, registered, or certified to assist in the practice of physical therapy in state of practice * Current CPR certification * Current driver's license and vehicle insurance, access to a dependable vehicle, or public transportation * Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client * Available to work a weekend rotation Preferred Qualifications: * Ability to perform physical tasks required for patient care, including lifting, transferring, and assisting with mobility Pay Range $49,500 $109,300 annual total cash target pay $28.56 - $63.06 per visit point $23.8 - $52.55 hourly rate Annual total cash compensation for this role assumes full-time employment (40 weekly hours) at full productivity and generally follows the range above. Total cash compensation includes earnings from per visit point pay and hourly pay 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. This role receives two types of compensation depending on the work being performed. When conducting visits, you will be paid per visit point rate compensation. Your per visit pay will be calculated by multiplying your per visit point rate by the productivity points you accrue for various types of visits. Each type of visit is assigned a certain number of productivity points that is inclusive of "direct" and "indirect" patient care activities. Visits are assigned based on patient and business needs. The number of visits performed each week will vary based on individual productivity targets and the productivity points assigned to the visits performed. You will be paid your hourly rate for certain non-visit activities such as orientation. We comply with all minimum wage laws as applicable. In addition to your pay, we offer benefits such as, a comprehensive benefits package, recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

**Become a part of our caring community and help us put health first** The Financial Reporting Professional 2 prepares and distributes periodic financial statements. The role requires data driven technical skills to support process improvement. The Financial Reporting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. This role is suited for a technically capable reporting professional who can work directly with data, understand end to end reporting flows, and exercise sound judgement within established accounting and organizational guidelines to deliver accurate and timely financial information. Individual will own assigned reporting processes and schedules within the financial reporting team with accountability for data readiness, documentation and adherence to filing requirements/timelines. The individual will partner with finance, accounting and engineering teams on broader automation and efficiency initiatives. The role requires the ability to implement basic technical solutions including revising SQL queries and modifying lightweight automation solutions. Advanced system development is NOT required **Key responsibilities** + Contribute to light automation and workflow improvements while partnering with technical resources for more complex development. + Maintain reporting calendars and filing schedules for regulatory submissions. + Coordination with Compliance to ensure deadlines are tracked and met across multiple states and programs + Support financial and regulatory reporting through accurate execution of reporting process + Post journal entries and perform data reconciliations across source systems and the general ledger + Load, validate and maintain reporting data tables + Operate as business owner for existing tools including coordination of inputs, validation of outputs, and design changes + Ensure compliance with internal controls and regulatory requirements + Analyze data flows and identify opportunities to improve accuracy, efficiency and automation + Collaborate with cross functional partners on finance and accounting initiative + Write and modify basic SQL queries and support data validation and troubleshooting **Use your skills to make an impact** **Required Qualifications** + Undergraduate degree with emphasis in Finance, Accounting, Data Analytics or related field + 3 years of experience in accounting/finance department + Basic understanding of SQL and Microsoft Power Platform + Intermediate Excel + Strong analytical and problem-solving capabilities + Experience supporting or improving financial reporting processes + Working knowledge of general ledger and financial statement preparation + Ability to work independently and exercise sound professional judgment **Preferred Qualifications:** + Healthcare insurance experience, including CMS and MLR ( **Medical Loss Ratio)** reporting requirements + Experience building apps on Microsoft Power Platform (Power BI, Power Apps, Power Automate, SharePoint) + Advanced SQL and/or VBA Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-29-2026 **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 ***************************************************************************

**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 ***************************************************************************

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. **Position Purpose:** Ensures the organization's responsible and compliant use of artificial intelligence (AI). Collaborates with various departments and stakeholders to promote a culture of AI compliance and ensures that all AI initiatives adhere to relevant laws, regulations, and ethical standards. Ensures fairness, transparency, and accountability in AI systems across the organization. Mitigate potential biases and discriminatory outcomes, fostering trust with members and the public + Establishes and maintains a comprehensive AI compliance program that aligns with organizational goals, legal requirements, and ethical standards + Develops and implements AI-specific policies and procedures, addressing data governance, bias mitigation, transparency, accountability, and risk management + Conducts AI risk assessments to identify potential compliance risks associated with AI applications + Develops and maintains a centralized inventory of all AI models and solutions used across the organization, documenting purpose, data sources, and any ethical or legal considerations associated with each model + Oversees the selection and management of third-party vendors providing AI solutions, ensuring compliance with organizational policies and regulatory requirements + Maintains current knowledge of applicable AI-related regulations and government policies, ensuring organizational compliance + Monitors and audits compliance with AI governance policies and procedures. Collaborates with legal counsel on AI-related matters. Take appropriate corrective actions in case of non-compliance, including conducting investigations and implementing remediation plans + Develops and delivers AI compliance training and awareness programs for employees and stakeholders. Promotes AI literacy across the organization, fostering a shared understanding of AI's impact and facilitating smooth adoption + Performs other duties as assigned + Complies with all policies and standards **Education/Experience:** **Bachelor's Degree in Computer Science, Data Science, Law, Healthcare Management or related field required** **:** 7+ years leadership experience in related field required In depth experience with AI compliance frameworks, principles and best practices required Strong knowledge of the healthcare industry, including relevant regulations (e.g., HIPAA) and ethical considerations required Proven ability to identify, assess, and mitigate risks associated with AI technologies required Experience developing and implementing AI compliance programs preferred Experience with AI model development and deployment preferred Knowledge of data governance frameworks and best practices preferred Pay Range: $148,000.00 - $274,200.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

**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 ***************************************************************************

*****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

Become a part of our caring community and help us put health first As a therapist at CenterWell Home Health, you'll play a vital role in helping patients regain strength, mobility and independence-all from the comfort of their homes. By delivering personalized care that focuses on rehabilitation and functional improvement, you'll empower individuals to overcome physical limitations, perform everyday activities with confidence and enjoy a better quality of life. As a Home Health Speech Language Pathologist, you will: * Evaluate, direct and provide speech/language pathology service to patients in the home or facility * Participate in the development and periodic review of the Plan of Treatment and Plan of Care. * Utilize professional skills and judgment in assessing and treating disorders of speech, voice, language, hearing and swallowing to prevent, identify, evaluate and minimize the effects of such disorders and conditions. * Administer and interpret diagnostic tests and applications of therapeutic treatments including audio logic screening. * Observe, record and report changes in the patient's condition and response to treatment to supervisor and/or the physician. * Provide instruction and training to patients in use of alternative communication systems when appropriate. * Provide counsel and instruction to patients, families and healthcare staff. * Maintain and submit documentation as required by the Company and/or facility. Prepare and submit timely written reports of evaluations, visits, summaries, care plans, care coordination activities and progress reports as required by Company policy. * Participate in care coordination activities and discharge planning. * Maintain the highest standards of professional conduct in relation to information that is confidential in nature. Share information only when the recipient's right to access is clearly established and the sharing of such information is clearly in the best interests of the patient. * Attend, participate in and/or conduct internal staff development programs, obtain continuing education as required by Company policy, regulation. Use your skills to make an impact * Meet the education and experience requirements for Certification of Clinical Competence in Speech Language Pathology or Audiology granted by ASHA * Minimum of six months experience as a speech therapist / speech language pathologist * Home Health experience a plus * Current and unrestricted license * Current CPR certification * Good organizational and communication skills * A valid driver's license, auto insurance, and reliable transportation are required. Pay Range * $49.00 - $69.00 - pay per visit/unit * $77,200 - $106,200 per year base pay 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. $85,400 - $117,500 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 About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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. **Position Purpose:** Provide hands-on training to corporate quality staff and line of business partners. Training will encompass, but not limited to: Star measures and HEDIS or HEDIS like measures. Liaise to ensure training curriculum and content reflect the latest quality requirements. ***The HEDIS Clinical Trainer is primarily remote. Candidates will be considered nationally.*** **Responsibilities:** + Facilitate in-person and virtual clinical trainings + Identify, select and develop, in conjunction with subject matter experts, plan-specific curriculum content and teaching aids such as training handbooks, demonstration models, multimedia visual aids, computer tutorials, and reference work + Coordinate and build collaborative working relationships with subject matter experts and preceptors within specific health plans or conduct train-the-trainer sessions + Evaluate training needs and effectiveness of training programs, and communicate results to management + Maintain records of training activities and employee progress + Assist in auditing work performed by staff and present findings and recommendations for areas of improvement to management + Assist with revisions to policy and procedures and/or work process development + Share best training practices with other trainers + Research, analyze, and recommend external training programs + Travel as required **Highly Preferred Skills:** + 3+ years of HEDIS experience + 2+ years as a LPN or RN + Prior training experience **Education/Experience:** Associate's degree or equivalent experience in nursing; 2+ years of experience in nursing, managed care, training, or related field. LPN or RN license required. **License/Certification:** Valid driver's license may be required. Nursing license required. Pay Range: $56,200.00 - $101,000.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

*****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

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