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Humana jobs in Kendall, FL - 411 jobs

  • Bilingual Dispatch Coordinator

    Humana 4.8company rating

    Humana job in Miramar, FL

    Become a part of our caring community and help us put health first The Dispatch Coordinator is an entry level position. Key tasks include managing and interpreting data from the Electronic Medical Records (EMR) system, which encompasses patient history, equipment needs, and insurance details. This role acts as an essential link between intake processing and fulfillment teams, ensuring accurate coding and understanding of equipment specifications prior to dispatch. A deep knowledge of the types of medical equipment and their setup requirements is crucial for effective order entry and route planning. This role requires a blend of technological proficiency and logistical planning to efficiently handle equipment delivery orders. Works within defined parameters under direction to identify work expectations and quality standards. The Dispatch Coordinator handles high-volume medical orders ranging from urgent hospital discharges to routine equipment pickups. Primary responsibilities include analyzing work orders, understanding the specific requirements and urgency of each, and then prioritizing and organizing them into efficient geographical routes. Develop and manage daily routes per territory, considering factors such as order complexity, cycle times, and delivery setups. This role involves coordinating various types of deliveries, pickups, and exchanges in diverse settings, both in urban and rural locations. This role adheres to standard policies and practices but offers some room for interpretation, deviation, and independent discretion. Use your skills to make an impact Required Qualifications: Bilingual (English and Spanish) 1-2 years of experience in medical equipment, DME, healthcare, or logistics/warehouse roles Logistical aptitude with the ability to review maps, traffic patterns, and geography Strong organizational skills, time management, and critical thinking abilities Teamwork and collaboration skills Effective communication skills with a focus on customer service Preferred Qualifications: Medical coding knowledge Familiarity with medical equipment 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. $39,000 - $49,400 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $39k-49.4k yearly Auto-Apply 35d ago
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  • Delivery Specialist DME

    Humana 4.8company rating

    Humana job in Miramar, FL

    Become a part of our caring community and help us put health first The DME Delivery Specialist 2 handles the delivery, setup, and comprehensive explanation of various medical equipment in patients' homes. This role requires not only training patients and their families on equipment safety but also dealing with more technically demanding setups. Key responsibilities include loading vehicles, orchestrating logistics with warehouse staff, overseeing detailed work orders, and ensuring detailed communication with patients about their order specifics. Further responsibilities include managing a broader range of equipment inventory, performing precise refills of oxygen tanks, administering detailed paperwork, and executing skilled adjustments to equipment as needed. This position adheres to standard policies and practices but necessitates a higher degree of interpretation, deviation, and independent discretion to manage the complexity and variety of tasks efficiently. Performs varied activities that are moderately complex in nature. The DME Delivery Specialist 2 follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion The DME Delivery Specialist 2 is pivotal in educating patients on the effective use of their medical equipment, often acting as the first point of contact and playing a crucial role in their healthcare experience. This position requires an understanding of medical equipment setup, cleaning, and testing. Working closely with the dispatch and warehouse teams, this role demands a high level of proficiency with the DME SKU system to ensure seamless operations. The job calls for flexibility and advanced problem-solving skills to handle more complex tasks than those at the entry level, adapting to diverse environments and patient needs. This role operates within a demanding 24/7 schedule that includes weekends and holidays, requiring a robust commitment and adaptability. Use your skills to make an impact Required Qualifications: 1) High school diploma; 1 - 3 years experience 2) Knowledge of DOT requirements and regulatory compliance 3) One year clean driving record and background check required 4) Excellent verbal communication skills 5) Customer service oriented with an empathetic and compassionate demeanor 6) Ability to lift up to 100 lbs 7) Mechanical/electrical aptitude 8) Teamwork and collaboration skills Required Qualifications: 1) High school diploma; 0 - 1 years experience 2) Knowledge of DOT requirements and regulatory compliance 3) One year clean driving record and background check required 4) Excellent verbal communication skills 5) Customer service oriented with an empathetic and compassionate demeanor 6) Ability to lift up to 100 lbs 7) Mechanical/electrical aptitude 8) Teamwork and collaboration skills 9) Adaptability in dynamic environments Preferred Qualifications: 1) Experience in a home health setting, or previous experience with durable medical equipment (DME) 2) Bilingual 3) Prior experience in similar roles or settings 9) Adaptability in dynamic environments Preferred Qualifications: 1) Experience in a home health setting, or previous experience with durable medical equipment (DME) 2) Bilingual 3) Prior experience in similar roles or settings 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. $39,000 - $49,400 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $39k-49.4k yearly Auto-Apply 2d ago
  • Pharmacy Operations Manager

    Walgreens 4.4company rating

    Pembroke Pines, FL job

    Where state and federal laws/regulations allow, accountable for performing day-to-day non-clinical pharmacy operations, administrative activities; Ensures efficient pharmacy workflow and a positive patient experience. Serves as a full-time certified pharmacy technician. Responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. Under the supervision of a pharmacist, supervising pharmacy technicians and pharmacy cashiers within the guidelines of authorized company policies, laws, regulations and business ethics. Responsible for the selection, scheduling, and development of pharmacy technician personnel. Leads training, coaching, and performance management of pharmacy technicians. Makes decisions regarding performance management including discipline and termination. Customer Experience Engages customers and patients by greeting them and offering assistance with products and services. Resolves customer complaints, helps respond to customers' requests in a timely manner and answers non-clinical questions to ensure a positive customer experience. Models and shares customer service best practices. Develops strong relationships with customers by anticipating customer needs and proactively offering services to provide the best experience possible when using the pharmacy. Enhances customer experience by increasing focus on healthcare services. Operations Responsible for assisting pharmacist in the delivery of patient care including patient registration, prescription data entry, preparation of medications for patients, counting, and verifying (where allowed by law). Completes patient and physician calls under the supervision of a pharmacist (where allowed by law). Under the supervision of a pharmacist assists with healthcare service offerings including administering vaccines, health screenings, and any health services allowed by law. Within the guidelines of authorized company policies, state and federal laws/regulations, exercises independent judgment to delegate, direct, and assign non-clinical work in the pharmacy. Ensures tasks are completed on-time and holds others accountable for efficient workflow. At the direction of the Pharmacy Manager or pharmacist, prepares, and files reports and records required by the company and various government agencies. Manages core pharmacy workflow and drives excellence in pharmacy operations. Coordinates and organizes pharmacy daily schedule of activities. Recommends allocation of pharmacy hours. Assures the pharmacy is clean, neat, orderly, and stocked with adequate supplies. Under the direction of the pharmacist, exercises independent judgment to ensure compliance and execution of all business administrative activities and pharmacy inventory management tasks that do not require pharmacist licensure. Manages annual inventory preparation. Accountable for completion of non-clinical patient calls. Drives new technology/ process roll out, champions change and engages team around action planning. Assures proper operation and maintenance of pharmacy department equipment. In collaboration with Pharmacy Manager, responsible for recordkeeping and ensuring security safeguards are in-place. Under supervision of the pharmacist, strictly adheres to the Walgreen Co. policy regarding Good Faith Dispensing during all applicable prescription-dispensing activities and understands their role in ensuring that the elements of Good Faith Dispensing are met. Maintains and applies knowledge of Company asset protection techniques. Supports Pharmacy Manager with diversion monitoring and reports any concerns that would compromise the security of the pharmacy to the Pharmacy Manager. Communicates prescription errors to the accountable pharmacist, and adheres to Company policies and procedures in relation to pharmacy errors and the Continuous Quality Improvement Program. Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with insurance companies as well as medical providers and conducts or participates in 3rd party audit. Assists and supports Store Manager and Pharmacy Manager in analyzing and seeking to improve pharmacy financials, operational quality and customer service. Manages Community Outreach Portal and coordinates and, at the direction of the Pharmacy Manager, assigns pharmacists to off-site immunization clinics and community events. Builds and sustains relationships with retail partnerships. People & Performance Management Leads performance management of technicians including making decisions and recommendations regarding discipline and termination. Follows constructive discipline policy to discipline, suspend, terminate or effectively recommend the same. Uses constructive discipline policy to ensure pharmacy technicians are compliant with state and federal laws. Holds technician accountable for attendance and timeliness. Maintains and improves performance of pharmacy through team member engagement and action planning. Accountable for technician hiring, on-boarding, training, and scheduling. Monitors and holds pharmacy technicians accountable for timely training completion. Follows established policies and procedures set by the company for scheduling and training. Accountable for identifying gaps in pharmacy operations knowledge among team members and supporting those team members in their training, either through hands-on training or assignment of learning modules. Assists Pharmacy Manager in monitoring that all pharmacy and team member licensures, registrations and certifications are active and in good standing/ compliant with all regulatory and legal requirements. Leverages Walgreens resources such as Walgreens Online Verification System to assist in documenting licensure status. Ensures proper procedures are followed for selection, recruitment, record retention, and training as required by Company policy and local, state and federal laws. Training & Personal Development Maintains PTCB certification through the designated PTCB training program and/or state required certification/registration. Maintains and enhances current knowledge and skills related to pharmacy and healthcare. Obtains necessary certifications, education credits and training such as LTMP e-modules as required by the Company. Follows performance improvement plans offered by Pharmacy Manager. Seeks professional development by monitoring one's own performance, solicits for constructive feedback, and leverages Healthcare Supervisor as mentor and coach. Communication Communicates with pharmacy team, relaying messages from the support center or other key emails as required. Participates in key store/pharmacy meetings, including 5-minute meetings and weekly check-ins with the Store Manager Basic Qualifications High School Diploma, GED, or equivalent. PTCB or ExCPT certification (except in Puerto Rico). Has one year of work experience as a pharmacy technician in a retail or hospital setting. Must be fluent in reading, writing, and speaking English (except in Puerto Rico). Requires willingness to work flexible schedule, including evening and weekend hours. Willingness to obtain active immunization certification within 90 days of hire (except in Community Specialty Pharmacy and Health System Pharmacy locations) Preferred Qualifications Previous people management/ leadership experience. Previous work experience with Walgreens with an Exceeding Expectation on last performance evaluation. We will consider employment of qualified applicants with arrest and conviction records. This information is being provided to promote pay transparency and equal employment opportunities at Walgreens. The current salary range for this position is $22.50 per hour - $31.00 per hour. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits Salary Range: Hourly
    $22.5-31 hourly 1d ago
  • Pharmacist

    Walgreens 4.4company rating

    Fort Lauderdale, FL job

    Join Our Team at Walgreens as a Pharmacist! Why Walgreens - For You, For Your Family, For Your Future At Walgreens, pharmacists are medication experts and trusted healthcare providers reshaping the future of patient-focused care. With industry-leading resources, career advancement opportunities, and a strong commitment to work-life balance, we invest in you so you can invest in your patients. For You - Competitive Pay & Flexible Scheduling Competitive pay - Competitive wage offered based on geography and other business-related factors Paid Time Off (PTO) - Available after three months of service (subject to state law) because work-life balance matters Flexible scheduling - Flexible scheduling options to fit your lifestyle For Your Family - Comprehensive Health & Wellness Benefits Comprehensive benefits package including medical, prescription drug, dental, vision, disability and life insurance for qualifying team members. Plus free flu shots for all team members and other voluntary benefits 365 Get Healthy Here & Life365 Employee Assistance Program (EAP) - Mental health support and wellness programs Family-forming support - Walgreens provides financial support for fertility treatments, including medical procedures and prescription medications. Eligible team members can also receive reimbursement for qualified adoption and surrogacy-related expenses For Your Future - Growth, Education & Exclusive Perks Opportunities for growth - Many pharmacists advance quickly into leadership roles in pharmacy operations, retail management, multi-site leadership, and corporate support functions Walgreens University - Free training, certifications, and leadership development, plus tuition discounts at 30+ universities Employee discounts - 25% off Walgreens brands and 15% off national brands, plus exclusive savings on electronics, travel, and more 401(k) with company match - Contribute to your retirement, and Walgreens provides matching contributions after one year and 1,000 hours of service. Additionally, Walgreens matches qualifying student loan payments as if they were 401(k) contributions What You'll Do Provide compassionate, expert-level pharmacy consulting services to patients Educate and consult patients on medication usage, side effects, and cost-effective options Deliver clinical healthcare services, including immunizations, diagnostic testing, and medication therapy management Ensure medication safety through accurate compounding, dispensing, and regulatory compliance Mentor and train pharmacy team members in a collaborative and supportive environment Who You Are Patient-focused & service-driven - You're committed to making healthcare personal A collaborative team leader - You support, inspire, and uplift those around you A lifelong learner - You stay ahead of industry advancements and professional growth A problem-solver - You navigate challenges, from insurance claims to medication management, with ease Apply Today & Build Your Future with Walgreens! This is more than just a job-it's a career with purpose. See below for more details! About Us Founded in 1901, Walgreens (****************** proudly serves more than 9 million customers and patients each day across its approximately 8,000 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 211,000 team members, including roughly 85,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities. Basic Qualifications BS in Pharmacy or Pharmacist Degree from an accredited educational institution. Current pharmacist licensure in the states within the district. Experience performing prescription dispensing activities that demonstrate a strong working knowledge of applicable state and federal controlled substance laws. Certified Immunizer or willing to become an immunizer within 90 days of hire. Preferred Qualifications At least 1 year experience as a pharmacist in a retail setting including prescription filling and verification, records and legal compliance, pharmacy operations, pharmacy software and technology systems and insurance. We will consider employment of qualified applicants with arrest and conviction records. An Equal Opportunity Employer, including disability/veterans. The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits Salary Range: Pharmacist Hourly $61.50-$67.60
    $61.5-67.6 hourly 1d ago
  • Analyst, Data

    Molina Healthcare Inc. 4.4company rating

    Miami, FL job

    JOB DESCRIPTIONJob Summary Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables by applying statistical analysis techniques to examine structured and unstructured data from multiple disparate sources. Collaborates across departments and with customers to define requirements and understand business problems. Uses advanced mathematical, statistical, querying, and reporting methods to develop solutions. Develops information tools, algorithms, dashboards, and queries to monitor and improve business performance. Creates solutions from initial concept to fully tested production, and communicates results to a broad range of audiences. Effectively uses current and emerging technologies. KNOWLEDGE/SKILLS/ABILITIES * Extracts and compiles various sources of information and large data sets from various systems to identify and analyze outliers. * Sets up process for monitoring, tracking, and trending department data. * Prepares any state mandated reports and analysis. * Works with internal, external and enterprise clients as needed to research, develop, and document new standard reports or processes. * Implements and uses the analytics software and systems to support the departments goals. JOB QUALIFICATIONS Required Education Associate's Degree or equivalent combination of education and experience Required Experience 1-3 years Preferred Education Bachelor's Degree or equivalent combination of education and experience Preferred Experience 3-5 years To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $80,168 - $116,835 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $80.2k-116.8k yearly 2d ago
  • Associate Specialist, Appeals & Grievances

    Molina Healthcare 4.4company rating

    Doral, FL job

    Provides entry level support for claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** - Enters denials and requests for appeals into information system and prepares documentation for further review. - Researches claims issues utilizing systems and other available resources. - Assures timeliness and appropriateness of appeals according to state, federal and Molina guidelines. - Requests and obtains medical records, notes, and/or detailed bills as appropriate to assist with research. - Determines appropriate language for letters and prepares responses to member appeals and grievances. - Elevates appropriate appeals to the next level for review. - Generates and mails denial letters. - Provides support for interdepartmental issues to help coordinate problem-solving in an efficient and timely manner. - Creates and/or maintains appeals and grievances related statistics and reporting. - Collaborates with provider and member services to resolve balance bill issues and other member/provider complaints. **Required Qualifications** - At least 1 year of experience in claims, and/or 1 year of customer/provider service experience in a health care setting, or equivalent combination of relevant education and experience. - Customer service experience. - Organizational and time management skills; ability to manage simultaneous projects and tasks to meet internal deadlines. - Effective verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency. **Preferred Qualifications** - Customer/provider experience in a managed care organization (Medicaid, Medicare, Marketplace and/or other government-sponsored program), or medical office/hospital setting experience. - Completion of a health care related vocational program (i.e., certified coder, billing, or medical assistant). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $14.9 - $29.06 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $14.9-29.1 hourly 9d ago
  • Primary Care APP

    Humana Inc. 4.8company rating

    Humana Inc. job in Coral Springs, FL

    Become a part of our caring community and help us put health first The Nurse Practitioner (NP) works in our team-based care environment. We are a value based care provider focused on quality of care for the patients we serve. Our care team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and more. Our approach allows us to provide an unmatched experience for seniors. Our model is positioned to provide higher quality care and better outcomes for seniors by providing a concierge experience, multidisciplinary services, coordinated care supported by analytics and tools, and deep community relationships. This robust support allows our Nurse Practitioner to see fewer patients and spend more time with them. Patient Care: Evaluates and treats center patients in accordance with standards of care. Follows level of medical care and quality for patients and monitors care using available data and chart reviews. Assists in the coordination of patient services, including but not limited to specialty referrals, hospital and SNF coordination, durable medical equipment and home health care. Acts as an active participant and lead with the care team through daily huddles. Helps Regional Medical Director (RMD), Physician and Center Administrator in setting a tone of cooperation in practice by displaying a professional and approachable demeanor. Completes all medical record documentation in a timely manner working with a quality- based coder to optimize coding specificity. Follows policy and protocol defined by Clinical Leadership. Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues. Participates in potential growth opportunities for new or existing services within the Center. Participates in the local primary care "on-call" program of Conviva. Assures personal compliance with licensing, certification, and accrediting bodies. Required Qualifications: Minimum of two to five years directly applicable experience preferred Successful completion of a Nurse Practitioner program with Board Certification Active, unrestricted Nurse Practitioner license in state of practice location Excellent communication skills; written and verbal, demonstrate a high level of skill with interpersonal relationships and communications with all colleagues; fully engaged in the concept of "Integrated team based care". Willingness and ability to learn/adapt to practice in a value based care setting. Superior patient/customer service. Basic computer skills, including email and EMR. Appropriate certification to write prescriptions under the authority of a collaborating physician/medical director This role is considered patient facing and is a part of our Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Preferred Qualifications: Active and unrestricted DEA license Medicare Provider Number/ Medicaid Provider Number Experience managing Medicare Advantage panel of patients with understanding of Best Practice in coordinated care environment in a value based relationship environment. Knowledge of Medicare guidelines and coverage. Bilingual is a plus Knowledge of HEDIS quality indicators. Additional Information: Guaranteed base salary + quarterly bonus Excellent benefit package -health insurance effective on your first day of employment CME Allowance/Time Occurrence Malpractice Insurance 401(k) with Employer Match Life Insurance/Disability Paid Time Off/Holidays Minimal call #physiciancareers #LI-JT1 Use your skills to make an impact Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $115,200 - $158,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $35k-57k yearly est. 51d ago
  • Adjudicator, Provider Claims-On the phone

    Molina Healthcare 4.4company rating

    Miami, FL job

    Provides support for provider claims adjudication activities including responding to providers to address claim issues, and researching, investigating and ensuring appropriate resolution of claims. - Provides support for resolution of provider claims issues, including claims paid incorrectly; analyzes systems and collaborates with respective operational areas/provider billing to facilitate resolution. - Collaborates with the member enrollment, provider information management, benefits configuration and claims processing teams to appropriately address provider claim issues. - Responds to incoming calls from providers regarding claims inquiries - provides excellent customer service, support and issue resolution; documents all calls and interactions. - Assists in reviews of state and federal complaints related to claims. - Collaborates with other internal departments to determine appropriate resolution of claims issues. - Researches claims tracers, adjustments, and resubmissions of claims. - Adjudicates or readjudicates high volumes of claims in a timely manner. - Manages defect reduction by identifying and communicating claims error issues and potential solutions to leadership. - Meets claims department quality and production standards. - Supports claims department initiatives to improve overall claims function efficiency. - Completes basic claims projects as assigned. **Required Qualifications** - At least 2 years of experience in a clerical role in a claims, and/or customer service setting, including experience in provider claims investigation/research/resolution/reimbursement methodology analysis within a managed care organization, or equivalent combination of relevant education and experience. - Research and data analysis skills. - Organizational skills and attention to detail. -Time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines. - Customer service experience. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $38.37 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.7-38.4 hourly 19d ago
  • Home Health Aide

    Humana 4.8company rating

    Humana job in Pompano Beach, FL

    Become a part of our caring community and help us put health first Home Health Aide provides patients with assistance in activities in daily living. The Home Health Aide performs varied activities and moderately complex administrative/operational/customer support assignments. Assists patients within the home with daily living activities. Typically works on semi-routine assignments. The Home Health Aide addresses needs related to disabilities, disease and mental impairment. Helps to manage medications, baths and dresses, takes care of household chores, prepares meals and pays bills. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion. Use your skills to make an impact Required Qualifications CPR certification Current State License or Registration as a Certified Nursing Assistant (as required by state) This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits Excellent customer service Strong clinical background Strong sense of engagement to be a team player Strong written and verbal communication skills Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications High School Diploma or GED Knowledge of primary care medicine requirements (state specific). Working knowledge of clinical operations 3 - 5 years' experience in telephone triage Electronic Medical Record (EMR) experience Previous RN or Medical Assistant experience Ability to type 25-30 words per minutes accurately Scheduled Weekly Hours 1 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $37,440 - $43,800 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About Us About OneHome: OneHome coordinates a full range of post-acute care ranging from home health, infusion therapy and durable medical equipment services at patients' homes. OneHome's patient focused model creates one integrated point of accountability that coordinates with physicians, hospitals and health plans serving more than one million health plan members nationwide. OneHome was acquired by Humana in 2021 to advance value-based care. Our culture is inclusive, diverse, and above all, caring. It is important to us that our employees are engaged, supported and fairly treated. We offer a comprehensive benefits package to ensure the health and financial well-being of you and your family.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $37.4k-43.8k yearly Auto-Apply 8d ago
  • Supervisor, Pharmacy Operations/Call Center

    Molina Healthcare 4.4company rating

    Miami, FL job

    Leads and supervises a team of pharmacy call center representatives and operations staff responsible to ensure that members have access to medically necessary prescription drugs. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Essential Job Duties** - Hires, trains, develops, and supervises a team of pharmacy service representatives supporting processes involved with Medicare Stars and Pharmacy quality operations. - Ensures that average phone call handle time, average speed to answer, and average hold time are compliant with Centers for Medicare and Medicaid Services (CMS) regulations. - Ensures that adequate staffing coverage is present at all times of operation. - Assists pharmacy leadership with monitoring and oversight of Molina's contracted Pharmacy Benefit Manager (PBM) for pharmacy contractually delegated functions. - Responsible for key performance indicators (KPI) reporting to department leadership on a monthly basis. - Participates, researches, and validates materials for both internal and external program audits. - Acts as liaison to internal and external customers to ensure prompt resolution of identified issues. - Assists pharmacy leadership in the collection and tabulation of data for reporting purposes and maintains files of confidential information submitted for review. - Assures that activities and processes are compliant with CMS, National Committee of Quality Assurance (NCQA) guidelines, and Molina policies and procedures. - Participates in the daily workload of the department, performing Representative duties as needed. - Facilitates interviews with pharmacy service representative job applicants, and provides hiring recommendations to leadership. - Provides coaching for pharmacy representatives, and helps identify and provide for training needs in collaboration with pharmacy leadership. - Communicates effectively with practitioners and pharmacists. - Collaborates with and keeps pharmacy leadership apprised of operational issues, including staffing resources, program and system needs. - Assists with development of and maintenance of pharmacy policies and procedures - Participates in the development of programs designed to enhance preferential or required targeted drugs or supplies. **Required Qualifications** - At least 5 years of experience in health care, preferably within a health-related call center environment, or equivalent combination of relevant education and experience. - Knowledge of prescription drug products, dosage forms and usage. - Experience designing, implementing, monitoring, and evaluating metrics that measure call center agent productivity. - Working knowledge of medical/pharmacy terminology - Excellent verbal and written communication skills. - Microsoft Office suite, and applicable software program(s) proficiency. **Preferred Qualifications** - Supervisory/leadership experience. - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Call center experience. - Managed care experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $55,706.51 - $80,464.96 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $55.7k-80.5k yearly 19d ago
  • Strategy Advancement Director

    Molina Healthcare Inc. 4.4company rating

    Miami, FL job

    The Strategy Advancement Director is responsible for advancing Molina's growth strategy and positioning the company for success in Medicaid, CHIP, DSNP, and Marketplace procurements. Reporting to the Vice President, Business Development, this position plays a pivotal role in the pre-RFP and procurement phases, guiding and organizing the project, ensuring deliverables are met, conducting research, tracking Business Development and/or Health Plan steps and projects, owning the governance structure for every opportunity, pulling together all the supporting team activities and pieces and connecting the dots between winning strategy and the relationships and partnerships developed by the VP, Business Development. This role requires a deep understanding of Medicaid programs, the regulatory environment, and the unique challenges of populations (i.e. TANF, ABD, DSNP, Foster Care, and DD/IDD). The Strategy Advancement Director works collaboratively across departments, including Product Development, Business Development, and Health Plans, to ensure that strategic initiatives align with state-specific priorities and are positioned for success in competitive procurements. The Director partners with the VP Market Development to provide thought leadership and subject matter expertise, identifying trends, providing insights, and continuously innovating to strengthen Molina's market position. Job Duties * Strategy Development & Innovation * Collaborate on the development of state-specific strategies aligned with state priorities, procurement objectives, and evolving Medicaid needs. Translate state regulatory requirements into actionable go-to-market strategies that are innovative and differentiate Molina in competitive procurements * Collaborate with Product Development, Health Plan leaders, Growth Leaders and cross-functional teams to support integration of innovative care models, operational efficiencies, and value-based care solutions tailored to the unique needs of market specific Medicaid populations, especially high-risk or vulnerable groups such as dual-eligible members, foster care, and ABD * Conduct market research, analyze industry trends, and monitor competitor activities to identify innovation opportunities. Propose solutions that address Medicaid ecosystem pain points and enhance Molina's value proposition * Use insights from market research and competitive analysis to stay informed on state Medicaid trends, regulatory changes, and market conditions, and to guide strategic adjustments and future market positioning * Drive the development of win themes and strategy recommendations that align with state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care * Track regulatory compliance and address any operational concerns or state-specific issues identified during the pre-procurement phase. Escalate issues when necessary and work to resolve them proactively * Market Development and Strategy Execution * Collaborate on the development of pre-RFP strategy and market readiness, creating and tracking playbooks, plans, and deliverables for Molina's strategy two to three years before RFP release. Ensure alignment with organizational goals and state requirements by collaborating with Market VPs, AVPs, and stakeholders * Identify and engage in thought leadership opportunities by representing Molina at state and national Medicaid conferences, industry forums, and other key events that enhance Molina's brand and expertise in Medicaid care delivery * Stakeholder Engagement & Thought Leadership * Support and track the development of relationships with state agencies, legislative leaders, regulatory bodies, and community organizations to enhance Molina's reputation and strengthen partnerships that could influence procurement outcomes * Represent Molina in strategic discussions with external partners and internal leadership, ensuring clear communication of strategy, innovation, and value propositions * Collaborate with internal stakeholders to influence thought leadership materials and content that showcase Molina's innovative approaches to Medicaid, particularly in high-needs areas like DSNP, ABD, and complex populations * Proposal Support & Competitive Differentiation * Serve as an expert on the pre-procurement process for the proposal team and closely collaborate with the Proposal Director to ensure consistency between market strategy, capture strategy and proposal content. Collaborate with the Proposal Director to ensure consistency between market strategy and RFP content * Track and support the execution of win strategy and strategic recommendations being incorporated throughout the proposal, ensuring Molina's proposals are differentiated and align with state-specific priorities and the competitive landscape * Actively participate in blue, pink, and red team reviews, providing strategic feedback to ensure proposal materials effectively communicate Molina's competitive advantages and compliance with RFP requirements * Support orals preparation, working across matrix partners to refine materials and messaging for presentations to state agencies * Operational Excellence & Cross-Functional Coordination * Use tools (i.e. Salesforce) to document market intelligence, track engagement activities, and share insights across departments. Ensure that data-driven insights are leveraged in proposal content development and strategic planning * Collaborate with the Growth Strategy, Competitive Intelligence and other stakeholders to leverage the competitive intelligence repository that informs decision-making and provides a strategic edge in Medicaid procurements * Develop project plans and roadmaps to guide the timely execution of pre-RFP and procurement activities, ensuring effective collaboration and alignment across functional teams * Facilitate cross-functional coordination for market entry, retention, and development strategies, ensuring that all teams are aligned and executing efficiently * Supports the VP Business Development as a SME during the "warranty period" post award through implementation to the IMO and health plan leadership * Mentorship & Team Development * Mentor junior staff and interns within the Business Development teams, fostering skills in strategic thinking, market research, and pre-procurement planning * Participate in business development activities on an ad-hoc basis, contributing to team knowledge and providing strategic insights to senior leadership * 50% or more Travel required Job Qualifications REQUIRED QUALIFICATIONS: * Bachelor's degree in business, Public Policy, Healthcare Administration or a related field or equivalent combination of education and experience * 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field * Proven experience in pre-RFP strategy development, with a strong understanding of Medicaid programs, including TANF, ABD, DSNP, and CHIP populations * Demonstrated ability to drive innovative solutions in the Medicaid space, leveraging market research and industry trends to inform strategic decisions * Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data * Strong experience in stakeholder engagement, particularly with state Medicaid agencies, regulatory bodies, and community-based organizations * Advanced proficiency in Microsoft Office tools (Excel, PowerPoint, Word), including for strategy development, data analysis, and presentation creation PREFERRED QUALIFICATIONS: * Master's degree (MBA, MPH, MPA) in business, public policy, or healthcare administration * 7+ years in business development and Medicaid procurements, particularly with complex populations (e.g., DD/IDD, Foster Care, Dual-Eligible Members) * Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data * Conference management experience and participation in industry forums To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $107,028 - $208,705 / ANNUAL * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
    $107k-208.7k yearly 2d ago
  • Home Health Student Nurse Internship - South Region

    Humana Inc. 4.8company rating

    Humana Inc. job in Fort Lauderdale, FL

    Become a part of our caring community and help us put health first The Home Health Student Nurse Internship is a summer opportunity designed to provide nursing students with hands-on experience in a community-based home care setting. As an intern, you will have the opportunity to gain direct clinical experience in the home environment by assisting with essential patient care tasks such as measuring vital signs, performing physical assessments, supporting wound management, and providing Foley catheter care -all under the guidance of experienced registered nurses. This internship aims to enhance clinical assessment skills, foster compassionate communication, and offer exposure to the continuum of care outside traditional hospital settings. We are seeking interns for internship opportunities at our various branch locations across the South Region in the following locations: Beverly Hills, FL; Crestview, FL; Pensacola, FL; Viera, FL; Columbus, GA; Kinston, NC; Lillington, NC; Lumberton, NC; Pollocksville, NC; Charleston, SC; Columbia, SC. When submitting your application, please specify the branch or branches where you are interested and available to work. This will help us best match your skills and availability with our current openings. Responsibilities: * Assist Registered Nurses in providing direct patient care in home settings * Conduct patient assessments and document findings accurately * Participate in care planning and implementation under RN supervision * Practice effective, empathetic communication with patients and families * Adhere to all clinical protocols, safety guidelines, and regulatory requirements * Maintain patient confidentiality and professional conduct at all times * Engage in educational activities and team meetings within the branch and the Chief Nursing Office Use your skills to make an impact Required Qualifications: * Enrolled in an accredited Licensed Practical Nurse (LPN), Associate Degree in Nursing (ADN), or Bachelor of Science in Nursing (BSN) program, with expected graduation date between December 2026 and Summer 2027 * Must be available to work full-time, 40 hours per week, Monday - Friday for 8 weeks from June 1 - July 24. * Must have a valid driver's license for the duration of the internship to travel to the branch and/or patient homes. Students will ride with their preceptors for most home visits. * Completion of at least one clinical rotation in an acute care setting and/or previous experience in home health, hospice, or community-based care * Must have Certification in Basic Life Support (BLS) from the American Heart Association that must be active for the duration of internship * Must not require sponsorship to work in the United States now or in the future Preferred Qualifications: * Have a strong academic history, with a minimum nursing GPA of 2.5 or higher * Have demonstrated commitment to patient-centered care and strong interest in home health care * Have strong organizational, prioritization, and critical thinking skills * Possess strong interpersonal, written, and oral communication skills What to expect during your 8-week internship program: * Onboarding and orientation completed in week one * Work closely in the home with seasoned home health nurses to provide hands on, supervised care to home bound patients * Interdisciplinary care team shadowing experiences * Facilitated, virtual group meetups with other home health nursing interns across the US * Opportunities to connect and interact with home health and organization leaders Scheduled Weekly Hours 1 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $37,440 - $43,800 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About Us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $37.4k-43.8k yearly 2d ago
  • Photo Specialist

    Walgreens 4.4company rating

    Miami, FL job

    Provides customers with courteous, friendly, fast, and efficient photo service and information. Models and delivers a distinctive and delightful customer experience. Assists in other store functions, as requested (e.g. assisting customers at register, maintaining other departments). Customer Experience Engages customers and patients by greeting them and offering assistance with products and services. Resolves customer issues and answers questions to ensure a positive customer experience. Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including interpersonal habits (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., offering help proactively, identifying needs, servicing until satisfied, etc.). Operations Provides customers with courteous, friendly, fast, and efficient service in the photo area, including digital passport photo service and suggestive sell of promotional photo products. Recommends items for sale to customer and recommends trade-up and/or companion items. Registers customer purchases on assigned cash register, collects cash and distributes change as requested; processes voids, returns, rain checks, refunds, and exchanges as needed. Keeps counters and shelves clean and well merchandised, takes inventory, and maintains records. Checks in and prices merchandise as required or as directed by store manager or communicated by the shift leader. Implements Company asset protection procedures to identify and minimize profit loss. Ensures compliance with state and local laws regarding regulated products (e.g., alcoholic beverages and tobacco products). Constructs and maintains displays, including promotional, seasonal, super structures, and sale merchandise. Completes resets and revisions as directed. Has working knowledge of store systems and store equipment. Assumes web pick-up responsibilities (monitors orders in Picture Care Plus, fills orders (pick items), delivers orders to customers as they arrive at store). Assists with exterior and interior maintenance by ensuring clean, neat, orderly store condition and appearance. Complies with all company policies and procedures; maintains respectful relationships with coworkers. Completes special assignments and other tasks as assigned. Training & Personal Development Attends training and completes PPLs requested by Manager or assigned by corporate. Must be fluent in reading, writing, and speaking English. (Except in Puerto Rico) Requires willingness to work flexible schedule, including evenings and weekend hours. Prefer six months of experience in a retail environment. Prefer to have prior work experience with Walgreens. We will consider employment of qualified applicants with arrest and conviction records. An Equal Opportunity Employer, including disability/veterans. The actual compensation that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits
    $28k-39k yearly est. 17d ago
  • Pharmacy Technician

    Molina Healthcare 4.4company rating

    Miami, FL job

    Provides support for pharmacy technician activities. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care. **Shift: (11 AM-7:30 PM MST or 12:30-9 PM MST)** Essential Job Duties - Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly evaluate requests. - Accurately enters approvals or denials of requests. - Facilitates prior authorization requests within established pharmacy policies and procedures. - Participates in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices. - Identifies and reports pharmacy departmental operational issues and resource needs to appropriate leadership. - Assists Molina member services, pharmacies, and health plan providers in resolving member prescription claims, prior authorizations, and pharmacy service access issues. - Articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed. Required Qualifications - At least 2 years pharmacy technician experience, or equivalent combination of relevant education and experience. - Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice. - Ability to abide by Molina policies. - Ability to maintain attendance to support required quality and quantity of work. - Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA). - Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers. - Excellent verbal and written communication skills. - Microsoft Office suite (including Excel), and applicable software program(s) proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $31.71 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $21.7-31.7 hourly 19d ago
  • Care Manager - Multiple Openings in FL (RN, LBSW, LLMSW, LMSW)

    Molina Healthcare 4.4company rating

    Fort Lauderdale, FL job

    Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Completes assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments. - Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. - Conducts telephonic, face-to-face or home visits as required. - Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. - Maintains ongoing member caseload for regular outreach and management. - Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. - Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. - Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. - Assesses for barriers to care, provides care coordination and assistance to member to address concerns. - Collaborates with licensed care managers/leadership as needed or required. - 25- 40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications - At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. - Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. - Demonstrated knowledge of community resources. - Ability to operate proactively and demonstrate detail-oriented work. - Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. - Ability to work independently, with minimal supervision and self-motivation. - Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. - Ability to develop and maintain professional relationships. - Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. - Excellent problem-solving and critical-thinking skills. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency. - In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V \#PJHS \#HTF Pay Range: $24 - $46.81 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $24-46.8 hourly 60d+ ago
  • TRA Florida Sterile Proc Tech Ja Ki

    Tenet Healthcare Corporation 4.5company rating

    Coconut Creek, FL job

    Responsible for activities including, but not limited to decontamination, assembly, and sterilization of surgical instrumentation including various software applications, assembly, and delivery of surgical and interventional procedure case carts, paring and replenishment of materials, and working in collaboration with surgical partners to provide accurate and complete surgical instrumentation and needed supplies. The Sterile Processing Technician is responsible for task-based sterile processing activities. This position will support all the facilities in the market as needed. Education: Required: High school diploma or GED. Completion of a formal Sterile Processing Technician course with field training. Experience: Preferred: 1 year in sterile processing. Certifications: Preferred: Current certification through internationally recognized organizations such as IAHCSMM (International Association of Healthcare Central Service Materials Management) or Certification Board for Central Sterile Processing. Physical Demands: Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
    $22k-31k yearly est. 1d ago
  • Analyst, Compliance (Sales)

    Molina Healthcare 4.4company rating

    Miami, FL job

    **(Sales) Compliance Analyst** Molina Healthcare's Medicare Compliance team supports sales operations for the Molina Medicare product lines. It is a centralized corporate function supporting compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** is primarily responsible for Sales Oversight. · Provide regulatory expertise to the Sales Organization: both State and Federal · Have working knowledge of federal and state guidelines pertaining to Sales and Marketing. · Perform internal Sales/Marketing Compliance Reporting. · Perform internal Sales/Marketing monitoring. · Detailed oriented to conduct thorough Sales allegations investigations. · Recommend applicable corrective action(s) when applicable to business partners. · Process improvement driven. · Create, update, and retire P&Ps, Standard Operating Procedures and Training documents. · Lead regularly scheduled Sales & Compliance leadership meetings. · Interpret and analyze Medicare, Medicaid, and MMP Required Sales & Marketing Reporting Technical Specifications. · Create and maintain monthly and quarterly Sales Complaint Key Performance Indicator (KPI) reports. · Review and interpret internal Sales dashboards for outliers and deeper dive research. · Manage compliance Sales Allegations, Secret Shops, and recommend corrective action plans for deficiencies found. · Responds to legislative inquiries/ Sales complaints (state insurance regulators, Congressional, etc.). · Leads projects to achieve Sales compliance objectives. · Interprets and analyzes state and federal regulatory manuals and revisions. · Interpret and analyze federal and state rules and requirements for proposed & final rules for Sales Oversight. · Interact with Molina external customers, via verbal and written communication. · Ability to work independently and set priorities. **Experience** · 2-4 years' related compliance work experience · Exceptional communication skills, including presentation capabilities, both written and verbal. · Excellent interpersonal communication and oral and written communication skills. · High level Interaction with Leadership. · Sales Allegation Investigations · Policy & Procedures Pay Range: $80,168 - $116,835 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
    $80.2k-116.8k yearly 22d ago
  • Primary Care Physician

    Humana Inc. 4.8company rating

    Humana Inc. job in Pembroke Pines, FL

    Become a part of our caring community and help us put health first The Physician serves as a health-care professional and capable of handling a variety of health-related problems. The Physician work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Physician focuses on outpatient medicine, continuity of care, health maintenance, and disease prevention. Keeps a medical history and medical records. Refers the patient to specialists as needed. 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 5 or more years of technical experience Licensure requirements of the state of jurisdiction Graduate of accredited MD or DO program of accredited university Prefer Internal Medicine specialty Board Certification in Family Medicine, Internal Medicine or Geriatric Medicine This role is considered patient facing and is part of Humana/Senior Bridge's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Must be passionate about contributing to an organization focused on continuously improving consumer experiences Must be willing to participate in limited on-call coverage by phone Preferred Qualifications Additional Information 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. $219,400 - $306,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $219.4k-306.9k yearly 2d ago
  • Beauty and Wellness Consultant

    Walgreens 4.4company rating

    Aventura, FL job

    Job Objectives Maximizes sales and brand awareness by providing exceptional customer care to all customers in a friendly, efficient, and professional manner; gives impartial, personalized, expertise and advice regardless of brand and budget. Demonstrates a passion for beauty and wellness and provides inspirational beauty knowledge and know-how. Provides customers with solutions for their beauty and wellness needs, including mini-makeovers and skincare consultations, with an emphasis on the customers' total look. Models and delivers a distinctive and delightful customer experience. Oversees and maintains overall beauty department standards. Job Responsibilities/Tasks Customer Experience * Engages customers by greeting them and offering assistance with products and services. Resolves customer issues and answers questions to ensure a positive customer experience. * Models and shares customer care best practices by proactively offering assistance, asking questions to determine customers' needs, and informing customers of options. * Greets, listens, and engages customers to identify their needs, making them aware of appropriate products and services, and providing warm transfers to other areas of the store when necessary * Provides expertise in product demonstrations and consultations utilizing tools such as the Skin Hydrometer and tablet. * Leads and delivers in-store events to promote brand awareness and loyalty of Owned Brands and total Beauty, Wellness and Personal Care. * Builds relationships with customers; provides authentic closure of customer interaction and builds and fosters relationships. * Engages with omni-channel solutions to enhance customer engagement/experience. * Locates products in other stores or online if unavailable in the store. Operations * Achieves or exceeds predetermined sales goals by assisting customers in the purchase of products and by modeling exceptional customer care. * Reviews beauty business on a regular basis to understand performance within store and district in partnership with store leadership. * Consistently focuses on link-selling and up-selling with customers by showing them sale items and complimentary offerings. * Uses testers and sampling to demonstrate product application and leverage items from beauty promotional programs. * Ensures testers are stocked and maintained in compliance with hygiene standards; maintains a clean and organized department. * Implements company asset protection procedures to identify and minimize profit loss. * Processes sales for customers and/or employee purchases on cash register. * Participates in meetings and conference calls concerning programs and promotions, new items, brand launches, sales goals, and modeling exceptional customer care. * Has working knowledge of store systems and store equipment. * Ensures compliance with state and local laws regarding regulated products (e.g., alcoholic beverages and tobacco products). * Complies with all company policies and procedures; maintains respectful relationships with coworkers. * Completes special assignments as assigned. Training & Personal Development * Seeks self-development by monitoring own performance, setting high personal standards, maintaining awareness of beauty and wellness trends, learning from others, and improving job performance. * Maintains knowledge of competition, new product/brand launches, and overall industry trends * Attends and participates in meetings, seminars, and other knowledge and business-driving opportunities; educates store team on new beauty updates, information, and learnings from training. * Attends training and completes e-learning modules requested by Manager or assigned by Corporate. * Maintains professional appearance and image in compliance with company guidelines at all times. * Models and shares behavior with other Beauty and Wellness Consultants; provides training and assistance to new Beauty and Wellness Consultants. * Works collaboratively with Store Leadership to review goals and maintain product knowledge. About Walgreens Founded in 1901, Walgreens (****************** proudly serves more than 9 million customers and patients each day across its approximately 8,000 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 211,000 team members, including roughly 85,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities. Basic Qualifications * High School Diploma/GED and at least one year of experience working in a retail sales environment that required meeting a defined sales goal OR at least one year of experience proactively selling beauty or cosmetic products and providing customer care * Experience in developing ways to accomplish goals with little or no supervision, depending on oneself to complete objectives and determining when escalation of issues is necessary * Knowledge of products and brands in order to engage and meet the needs of the customer. * Experience building and maintaining relationships within a team. * Basic level PC/tablet skills. * Requires willingness to work flexible schedule including evenings, weekends, and holidays. * Must be fluent in reading, writing and speaking English. (Except in Puerto Rico) Preferred Qualifications * Licensure in Cosmetology or as an Esthetician as granted by appropriate state licensing authority. * Experience establishing & maintaining relationships with individuals at all levels of the organization, in the business community & with vendors. * Experience demonstrating makeup application and providing makeovers to customers. * Experiencing selling Prestige brands. * Degree from Beauty School. * Experience with another retailer in the form of an Externship. We will consider employment of qualified applicants with arrest and conviction records. An Equal Opportunity Employer, including disability/veterans. The actual compensation that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits Salary Range: $16 - $21 / Hourly
    $16-21 hourly 44d ago
  • Inventory Specialist

    Walgreens 4.4company rating

    Fort Lauderdale, FL job

    * Responsible for executing, monitoring, and training inventory best practices and standard operating procedures for the entire store, including both front end and pharmacy. Supports pharmacy inventory management activities, including receiving, counting, ordering, and facilitating returns. Champions On-Shelf Availability and is responsible for receiving, counting, pricing, returns, and all in-store inventory processes. Validates and ensures accuracy of planograms. * Responsible for reviewing and coordinating the proper use of reports and system applications, which have an impact on the accuracy of front end and pharmacy on-hand balances and pricing. * Responsible for executing and maintaining front end and pharmacy asset protection techniques, and filing claims for warehouse and vendor overages (merchandise received, but not billed), shortages (merchandise billed, but not received), order errors or damaged goods including prescription drugs. * In designated stores, as required, opens and closes the store in the absence of store management, including all required systems start-ups, required cash handling and cashier responsibilities, and ensuring the floor and stock room are ready for the business day. Customer Experience * Engages customers by greeting them and offering assistance with products and services. In designated stores, when serving as the leader on duty, resolves customer issues and answers questions to ensure a positive customer experience. * Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including interpersonal habits (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., offering help proactively, identifying needs, servicing until satisfied, etc.). Operations * Executes and coaches team members on warehouse and vendor inventory management processes including but not limited to creating, reviewing, and receiving orders. * Scans in all deliveries while the vendor is still in the store, including common carrier deliveries. Focuses on One Box receiving. Takes the appropriate action marking delivery as received if the product was physically delivered, contacting vendor for past undelivered scheduled receipts, and opening tickets as needed to correct inaccurate orders. * Under the supervision of the pharmacist-in-charge, verifies all pharmacy shipments are posted for products physically received at the store. Completes or verifies postings of all pharmacy warehouse orders, ABC prescription and OTC orders daily, secondary vendor orders, flu and dropship orders performing any necessary tote audits, and accurately reporting any shortages or damaged product. * Completes On-Shelf Availability (OSA) end-to-end process including warehouse and direct store delivery (DSD) for planogrammed departments, executing disposals, call-ins, and vendor returns before expiration, completes scan outs/ scan outs returns on all subscribed departments including vendor/ DSD departments and pharmacy scan outs. * Under the supervision of the pharmacist-in-charge,completes pharmacy inventory activities including but not limited to pharmacy recalls following Pharmacy Hazardous Waste Policy, vendor returns, non-controlled, and damaged salvage returns. Facilitates excess inventory returns or interstore pharmacy transfers where applicable for non-returnable ABC overstock. Verifies posting of all pharmacy/ prescription claims. * Completes execution of all pricing activities including price changes, markdowns, and markdowns deletes. Responsible for basic department pricing, including daily price changes, accurate pricing with correct signage, and reliable and timely completion of any additional regulatory pricing tasks. * Responsible for supporting front end and pharmacy ordering by ordering expense items. Monitors pharmacy manual orders to identify excess orders. Maintains consigned inventory and orders as required. * Ensures all designated pull & quarantine item on-hands are updated and placed in the designated holding area. * Maintains accurate inventory counts. Maintains the accuracy of on-hand quantities including but not limited to basic departments, stockroom, overstock locations. * Under the supervision of the pharmacist-in-charge, maintains accurate inventory counts and accuracy of on-hand quantities in pharmacy and completes pharmacy smart counts. * Ensures the store maintains inventory compliance with state and local laws regarding regulated products (e.g., alcoholic beverages and tobacco products). * Assists in the maintenance of inventory records, including receiving and posting of all products (in the front-end)) received at the store in all inventory systems. Organizes files and retains all invoices/receipts/return authorizations necessary for all inventory activities. * Helps to prepare for physical inventory and supports the physical inventory day activities, including but not limited to preparing sales floor, stockroom, and pharmacy for inventory and auditing the third party team on the day of inventory. * Supports keeping all counters and shelves clean and well merchandised. * Knowledgeable of all store systems and equipment. * Assists and coaches store team on all package delivery activities, including scanning in and out of packages, completing all daily inventory functions and, package returns at Walgreens. Supports execution of Pickup Program. * In designated stores, when serving as the leader on duty, responsible and accountable for registering all related sales on assigned point-of-sale system (POS), including records of scanning errors, price verifications, items not on file, price modifications, and voids. Completes product returns, order voids, customer refunds, cash drops to safe, and provides change as requested for point of sale. * Complies with all company policies and procedures; maintains respectful relationships with coworkers. * Completes any additional activities and other tasks as assigned. Training & Personal Development * Attends company-based trainings for continuous development and completes all e-learning modules including safety training requirements. * Obtains and maintains a valid pharmacy license/certification as required by the state. Communications * Serves as a liaison between management and non-management team members by coaching and developing other capabilities with inventory systems. When serving as the leader on duty, communicates assigned tasks to team members and reports disciplinary issues and customer complaints to management. Basic Qualifications * Six months of prior work experience with Walgreens (internal candidates) or one year of prior retail work experience (external candidates). * Must be fluent in reading, writing, and speaking English (except in Puerto Rico). * Must have a willingness to work a flexible schedule, including evening and weekend hours. * "Achieving expectations" rating on last performance review and no written disciplinary actions in the previous 12 months (internal candidates only). * Demonstrated attention to detail and ability to multi task and manage execution. * Experience in identifying operational issues and recommending and implementing strategies to resolve problems. Preferred Qualifications * Prefer previous experience as a shift lead, pharmacy technician, designated hitter, or customer service associate. * Prefer to have prior work experience with Walgreens, with an evaluation on file. We will consider employment of qualified applicants with arrest and conviction records. An Equal Opportunity Employer, including disability/veterans. The actual compensation that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits Salary Range: $17 - $20 / Hourly
    $17-20 hourly 38d ago

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