Become a part of our caring community and help us put health first Humana's Transformation Program team is a high-performing team that works closely with senior leaders to help chart the course for the company's future. Transformation is critical to our core strategy: delivering great healthcare to seniors, providing a differentiated healthcare experience, and growing our reach and impact with members and patients. As a member of the Transformation team, you will support the complex and coordinated effort required to execute the enterprise strategy: accelerating our long-term vision by identifying opportunities, designing solutions, and implementing initiatives to fundamentally change the member, patient, provider, and associate experiences.
The Transformation team is modeled after top-tier management consultancies. Team members work on fast-faced and high-visibility projects aligned with the enterprise's most important Transformation topics. Every day in the role is different, but activities often include developing industry analysis, building high-level financial/business models, conducting informational interviews, managing complex projects with numerous stakeholders, and synthesizing recommendations into executive-level deliverables that drive real-world results. Work assignments require a combination of strategic thinking, quantitative analysis, workstream management, cross-team collaboration, and storytelling. Team members can align with one of the enterprise's lines of business, supporting functions, or key Transformation capabilities to become a trusted thought partner for the Transformation agenda.
Key Responsibilities:
Translate clinical, operational, and growth ideas into clear financial cases and scenario ranges
Work with senior leaders to sequence initiatives, surface interdependencies, and ensure resources flow to the highest opportunities
Design the framework that connects key performance indicators to the P&L and keeps leaders informed of near real-time progress
Partner with analytics, technology and FP&A teams to deliver dashboards and tools executives use, not just read
Package complex analysis into crisp narratives that secure sponsorship, funding, and enterprise adoption
Guide a team of analysts and collaborate with finance, clinical, and technology partners to move initiatives from concept to booked impact
Use your skills to make an impact
Required Qualifications:
8+ years in transformation, corporate finance, strategy consulting, or advanced analytics
Fluency in financial modeling and scenario analysis (Excel plus SQL/Python or similar)
Comfort navigating senior-executive conversations and cross-functional workshops
Strong storytelling skills, able to distill complex data into decisive recommendations
Bachelor's degree required; MBA, MHA, or MS Analytics preferred
Preferred Qualifications
Additional Information
Preferred working locations are Louisville, KY and Arlington, VA (Washington, DC metro area), with consideration for Chicago, IL, New York, NY, and alternative hub sites on a case-by-case basis. The Transformation team operates on a hybrid work arrangement (in office expectation of 3 days per week).
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.
$168,000 - $231,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
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.
$79k-102k yearly est. Auto-Apply 7d ago
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Inpatient Medical Coding Auditor
Humana 4.8
Humana job in Frankfort, KY
**Become a part of our caring community and help us put health first** The Inpatient Medical Coding Auditor reviews a variety of medical records and to determine appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT.) The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Inpatient Medical Coding Auditor confirms appropriate diagnosis related group (DRG) assignments upon appeal. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. 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**
**WORK STYLE:** Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week-- some flexibility might be possible, once training is complete and depending on business needs.
Associates are expected to start each workday between 6AM-9AM EST, regardless of their home time zone.
**Required Qualifications**
+ RHIA, RHIT, or CCS Certification
+ At least 2 years' experience in acute in-patient coding experience and/or MS-DRG auditing
+ Recent experience auditing using CMS Manual, LCD, NCD, and Coding Guidelines
+ Experience reading and interpreting claims
+ Excellent written and verbal communication skills
+ Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
+ Strong attention to detail
+ Can work independently and determine appropriate course of action
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Associate's Degree or higher in Health Information Management (HIM)
+ Experience in Financial Recovery
+ Experience in a fast paced, metric driven operational setting
+ Experience in APR DRG coding/auditing
**Additional Information**
**Work at Home Requirements**
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
- Satellite, cellular and microwave connection can be used only if approved by leadership
- Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
**Interview Format**
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-22-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$71.1k-97.8k yearly 16d ago
Analyst, Data
Molina Healthcare 4.4
Louisville, KY job
**JOB DESCRIPTION** **Job 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.
$80.2k-116.8k yearly 29d ago
Strategy Advancement Director
Molina Healthcare Inc. 4.4
Louisville, KY 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 9d ago
Supervisor, Pharmacy Operations/Call Center
Molina Healthcare Inc. 4.4
Louisville, KY 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.
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.
$28k-34k yearly est. 27d ago
Associate Specialist, Appeals & Grievances
Molina Healthcare 4.4
Louisville, KY 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: $21.65 - $34.88 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$21.7-34.9 hourly 6d ago
Associate Actuary, SPA-Rx
Humana 4.8
Humana job in Frankfort, KY
**Become a part of our caring community and help us put health first** The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
_This a remote nationwide position_
The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
**Use your skills to make an impact**
**Required Qualifications**
+ Bachelor's Degree
+ Associate of Society of Actuaries (ASA) designation
+ MAAA
+ Strong communication skills
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Prior Part D experience
+ Strong SAS skills
+ Prior Databricks experience
**Our Hiring Process**
As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
**Alert:** Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website.
**_Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful._**
\#LI-Remote
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$106,900 - $147,000 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-29-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$106.9k-147k yearly Easy Apply 30d ago
Adjudicator, Provider Claims-On the phone
Molina Healthcare 4.4
Louisville, KY 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 26d ago
Manager, IT Services
Molina Healthcare Inc. 4.4
Louisville, KY job
Responsible for all information technology operations activities, including computer operations, data and operations support. Monitor budgets and expenses within department and accountable for meeting budget goals. Recommends input to policy principles and budget constraints. Provides expertise to departments regarding policies and procedures, problem resolution, and methods.
KNOWLEDGE/SKILLS/ABILITIES
* Analyzes, reviews and measures service level performance against agreed upon service level agreements (Service Level Agreements) with the business and operating-level agreements with service providers (internal and external).
* Works closely with the business and service providers to negotiate and agree on service level requirements off any proposed new services and changes to existing services.
* Works with the business and service providers to define the proper metrics and KPIs in evaluating service delivery quality and performance levels. Produces regular reports on service performance and achievement to stakeholders.
* Organizes and maintains the service level review process with the business and service providers. Initiates any actions required to maintain or improve service levels.
* Acts as a change agent to implement and manage quality improvement processes in service delivery management.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
5-7 years
Preferred Education
Graduate Degree or equivalent combination of education and experience
Preferred Experience
7-9 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: $80,412 - $188,164 / 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.
$80.4k-188.2k yearly 6d ago
Medical Records Collector
Molina Healthcare Inc. 4.4
Louisville, KY job
JOB DESCRIPTION Job SummaryProvides support for medical records collection activities. Supports quality improvement activities through outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
* Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records.
* Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application.
* Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database.
* Provides project management support to leadership via coordination, identification, pursuit and collection of medical records and other required data with other HEDIS staff.
* Participates in meetings with vendors related to the medical record collection process.
* Some medical records collection related travel may be required.
Required Qualifications• At least 1 year customer service experience, preferably in an administrative support capacity in a health care setting, or equivalent combination of relevant education and experience.
* Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements.
* Excellent customer service and active listening skills.
* Proficiency with data analysis tools (e.g., Excel).
* Ability to manage files, schedules and information efficiently.
* Ability to effectively interface with staff, clinicians, and leadership.
* Strong prioritization skills and detail orientation.
* Strong verbal and written communication skills, including professional phone etiquette.
* Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs.
Preferred Qualifications
* Registered Health Information Technician (RHIT).
* Medical records collection experience.
* Managed care experience.
* Basic knowledge of Healthcare Effectiveness Data Information Set (HEDIS) and National Committee for Quality Assurance (NCQA).
* Project planning 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: $21.65 - $31.71 / HOURLY
* 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.
$21.7-31.7 hourly 2d ago
Medical Assistant
Humana Inc. 4.8
Humana Inc. job in New Albany, IN
Become a part of our caring community and help us put health first Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At CenterWell, a division of Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. At CenterWell, we're seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.
The Medical Assistant is the first point of contact for patient care. Responsible for administrative duties in addition to patient care. The Medical Assistant performs varied activities and moderately complex administrative / operational / customer support assignments. Performs computations. Typically works on semi-routine assignments. Responsible for decisions focusing on interpretation of area/department policy and methods for completing assignments. CenterWell Medical Assistants work within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, while working under minimal direction. Medical Assistants follow standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
CenterWell is seeking a dedicated, compassionate, and experienced - Float Medical Assistant - who is interested in growing with the company and being a part of something great!
Please note: This is a FLOAT position and will require you to work between offices as business needs require. Mileage will be reimbursed for travel between clinics.
About CenterWell Senior Primary Care:
CenterWell Senior Primary Care, a subsidiary of Humana Inc., is Humana's primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, Missouri, Arizona, Nevada, North Carolina, South Carolina, Georgia, Kentucky and Texas. CenterWell Senior Primary Care has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality primary care combined with an excellent patient experience. CenterWell Senior Primary Care has experience in both the treatment and management of most chronic and acute-care conditions. The practices also provide health education and value-added, well-being services at the centers and around their neighborhoods to help both patients and community members improve their health.
Medical Assistant Role Overview:
* Prepare patients for examinations, including taking vitals
* Recording & updating patient medical histories in electronic medical records software
* Performing routine tests and/or screenings such as mammograms, colorectal screening, and EKGs
* Preparing and administering medications, including intramuscular, intradermal, and subcutaneous injections-including vaccinations/immunizations, as directed by a physician or other licensed provider
* Counseling patients on medication and special diets
* Wound care and changing dressings
* Sterilizing and cleaning equipment and ensuring maintenance of examination rooms
* Collaborates closely with physicians and nurses to ensure top level patient care
* Highly accurate in collecting phlebotomy samples from senior-aged patients
Vaccine Policy:
* Humana, and its affiliates, encourages primary vaccination and an initial booster for forward-facing staff, except in cases of approved exceptions, in keeping with existing policy.
* We recommend eligible team members receive COVID-19 boosters per CDC guidance, including the updated booster, with specific protection for Omicron variants, but vaccination is not a requirement of employment.
* Masks are required regardless of vaccination status unless you are eating, drinking, or are working in an office alone.
Use your skills to make an impact
Required
* Successful completion of MA school/training program or a Certified/Registered Medical Assistant or 5+ years of experience and approval from Provider
* High school diploma or equivalent
* CPR Certified
* This role is considered patient facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB
Preferred
* Certified or Registered - (Arizona, Indiana, & South Carolina candidates require Medical Assistant Certification or Registration)
* Phlebotomy experience• Medication/vaccine administration experience
* 1+ years MA experience
* Value Based Care experience including knowledge of HEDIS, CPT/ICD coding, and CAHPS/HOS Patient Experience.
* Bilingual proficiency in English and Spanish - must pass proficiency exam prior to foreign language communication
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$40,000 - $52,300 per year
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 CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's 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.
$40k-52.3k yearly 17d ago
Medical Review Nurse (RN)- Itemized Bill Review
Molina Healthcare 4.4
Elizabethtown, KY job
Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care.
ESSENTIAL JOB DUTIES:
Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made, or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing.
Reevaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of relevant and applicable state and federal regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions.
Validates member medical records and claims submitted/correct coding, to ensure appropriate reimbursement to providers.
Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues.
Identifies and reports quality of care issues.
Assists with complex claim review including diagnosis-related group (DRG) validation, itemized bill review, appropriate level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team; makes decisions and recommendations pertinent to clinical experience.
Prepares and presents cases representing Molina, along with the chief medical officer (CMO), for administrative law judge pre-hearings, state insurance commissions, and judicial fair hearings.
Reviews medically appropriate clinical guidelines and other appropriate criteria with medical directors on denial decisions.
Supplies criteria supporting all recommendations for denial or modification of payment decisions.
Serves as a clinical resource for utilization management, CMOs, physicians and member/provider inquiries/appeals.
Provides training and support to clinical peers.
Identifies and refers members with special needs to the appropriate Molina program per applicable policies/protocols.
REQUIRED QUALIFICATIONS:
At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice.
Experience demonstrating knowledge of ICD-10, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC).
Experience working within applicable state, federal, and third-party regulations.
Analytic, problem-solving, and decision-making skills.
Organizational and time-management skills.
Attention to detail.
Critical-thinking and active listening skills.
Common look proficiency.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software program(s) proficiency.
PREFERRED QUALIFICATIONS:
Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care certifications.
Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics.
Billing and coding 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: $29.05 - $67.97 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$29.1-68 hourly 4d ago
Principal Data Scientist
Humana 4.8
Humana job in Frankfort, KY
**Become a part of our caring community and help us put health first** The Principal Data Scientist uses mathematics, statistics, modeling, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions. The Principal Data Scientist is highly skilled with broad, advanced technical experience and provides strategic advice and guidance to functional teams.
The Consumer Digital organization at Humana develops innovative digital capabilities that empower people with personalized guidance and solutions to achieve their best health.
We are seeking a Principal Data Scientist to lead advanced analytics initiatives and provide strategic insights that shape enterprise-wide decisions. This role combines deep technical expertise with leadership and advisory responsibilities, working closely with senior leadership to drive functional strategies across the organization.
**Key Responsibilities**
+ Develop, maintain, and collect structured and unstructured data sets for analysis and reporting
+ Apply machine learning, mathematics, statistics, and business analysis to transform large, complex data into actionable insights
+ Build advanced models, projections, and presentations to support business strategy and tactics
+ Collaborate with senior executives to develop and drive segment- or enterprise-wide strategies
+ Mentor and guide junior data science talent
**Use your skills to make an impact**
**Required Qualifications**
+ Master's Degree or Ph.D. in machine learning, computer science, statistics, mathematics, data science, engineering, or a related quantitative field
+ 10+ years of hands-on experience applying machine learning and creating advanced analytics solutions to solve complex business problems
+ 2+ years of project and/or people leadership experience
+ Proficient in Python and PySpark, including libraries such as scikit-learn, TensorFlow, Keras, and Spark ML
+ In-depth knowledge of machine learning techniques such as regression, decision trees, ensemble models, neural networks, deep learning, clustering, and forecasting
+ Experience in working with high volumes of structured and unstructured data to develop tactical and strategic insights
+ Experience with cloud platforms (e.g., Azure, GCP, or AWS)
+ Strong analytical and critical thinking skills with a track record of delivering data-driven solutions in fast-paced environments
+ Experience with providing strategic advice and guidance to functional teams
+ Exceptional verbal and written communication skills, with the ability to explain complex concepts clearly to diverse audiences, including non-technical stakeholders
+ Demonstrated success in providing strategic guidance and working with senior executives on enterprise-wide initiatives
+ Experience mentoring and developing junior team members
**Preferred Qualifications**
+ Knowledge of the healthcare domain
+ Experience in e-commerce analytics
+ Experience with NLP and Generative AI techniques and applications
+ 3-5 years of project and/or people leadership experience
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$172,200 - $236,900 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**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$60k-77k yearly est. 16d ago
Analyst, Compliance (Sales)
Molina Healthcare Inc. 4.4
Louisville, KY 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.
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 30d ago
Associate Director - Data Platform Operations and Administration
Humana 4.8
Humana job in Frankfort, KY
**Become a part of our caring community and help us put health first** The Associate Director, Database Administration manages and maintains all production and non-production databases. Responsible for standards and design of physical data storage, maintenance, access and security administration. The Associate Director, Database Administration requires a solid understanding of how organization capabilities interrelate across department(s).
The Associate Director will lead the design, reliability, scalability, and operational excellence of Humana's enterprise data platforms across multi cloud and on-prem environments. This role is responsible for ensuring high availability, performance, security, compliance, and cost efficiency for mission-critical data systems supporting analytics, AI/ML, and customer-facing applications.
This leader will partner closely with Application, Data Engineering, Analytics, Product, Security, Finance, and Platform Engineering teams to define and operate standardized, resilient, and automated database platforms across technologies such as SQL Server, Oracle, PostgreSQL, MongoDB, Snowflake, Databricks, and other modern data services.
In addition, this role will spearhead the application of AI and Generative AI to database operations and data platform reliability-driving predictive insights, automated remediation, intelligent observability, and operational copilots that reduce manual overhead while maintaining strict healthcare compliance (HIPAA, PHI).
**Key Responsibilities:**
**Data Platform Strategy & Operations Leadership**
+ Define and execute the enterprise database and data platform operations strategy across cloud and on-prem environments.
+ Provide senior-level guidance on platform standards, architectural decisions, lifecycle management, and modernization of relational and non-relational databases.
+ Establish short-, mid-, and long-term roadmaps for data platform reliability, scalability, automation, and cost optimization.
+ Lead the operational maturity model for data platforms, aligned with SRE and platform engineering best practices.
**Reliability, Availability & SRE for Data Platforms**
+ Own 24/7 availability and performance of mission-critical database and analytics platforms.
+ Lead escalated incident, problem, and root cause analysis for data platform outages, performance degradation, and data integrity issues (24/7/365).
+ Define and improve MTTD / MTTR through proactive monitoring, automation, and AI-assisted diagnostics.
+ Establish SLOs, SLIs, and error budgets for database and analytics platforms.
**Database Operations & Managed Services**
+ Lead and govern Managed Service Providers (MSPs) supporting database operations across cloud and on-prem environments.
+ Build and maintain L2/L3 SOPs for database operations, backup/recovery, patching, failover, and disaster recovery.
+ Oversee change planning, release coordination, and operational readiness for database platform upgrades and migrations.
+ Support and guide cloud and on-prem database migrations, including legacy modernization initiatives.
**Observability, Monitoring & Automation**
+ Establish enterprise-grade observability for data platforms, including metrics, logs, traces, query performance, and capacity forecasting.
+ Partner with observability teams to implement event correlation, anomaly detection, and intelligent alerting for databases and data pipelines.
+ Identify manual operational tasks and drive automation through scripting, APIs, and platform tooling.
+ Partner with DevOps and Platform Engineering on CI/CD for database changes, schema management, and infrastructure-as-code.
**AI & GenAI for Database and Data Platform Operations**
+ Lead research, prototyping, and adoption of AI/GenAI to enhance database and data platform operations.
+ Design AI-driven capabilities for:
+ Predictive capacity and performance forecasting
+ Automated incident detection and triage
+ Query and workload optimization recommendations
+ Intelligent root cause analysis and log summarization
+ Develop AI copilots and natural-language tools to support database engineers and operations teams.
+ Integrate LLMs and ML models into observability platforms for real-time insights and self-healing actions.
**Security, Compliance & Governance**
+ Ensure database platforms adhere to security best practices, regulatory requirements, and healthcare compliance standards (HIPAA, PHI).
+ Partner with Security and Risk teams to continuously assess vulnerabilities, access controls, encryption, and audit readiness.
+ Define governance standards for data access, retention, backup, and recovery across platforms.
**Cost Optimization & FinOps for Data Platforms**
+ Lead cost transparency, optimization, and forecasting for cloud and on-prem database platforms.
+ Implement chargeback/showback models for database and analytics consumption.
+ Partner with Finance and stakeholders to optimize storage, compute, licensing, and usage patterns.
+ Analyze usage, utilization, and growth trends to reduce total cost of ownership.
**Reporting, Metrics & Continuous Improvement**
+ Define and publish operational dashboards and executive-level reporting for data platform health, cost, and performance.
+ Analyze operational data to identify trends, risks, and improvement opportunities.
+ Drive standardization and platform consistency across teams to improve efficiency and reliability.
+ Act as a trusted advisor on data platform capabilities, limitations, and best practices.
**AI / GenAI & Advanced Capabilities**
+ Experience or strong interest in AI/ML or GenAI applications for operational intelligence.
+ Familiarity with LLMs, vector databases, predictive analytics, or AI-driven monitoring solutions.
Ability to move rapidly from concept → pilot → production for AI-enabled operational enhancements.
**Use your skills to make an impact**
**Required Qualifications:**
+ Bachelor's Degree
+ 10+ years of experience in database, data platform, or infrastructure engineering/operations, with 5+ years in a senior leadership role.
+ Deep hands-on experience with enterprise database and analytics platforms, such as:
+ SQL Server, PostgreSQL, MySQL
+ MongoDB or other NoSQL platforms
+ Snowflake, Databricks, or similar analytics platforms
+ Strong understanding of SRE, ITIL/ITSM, and operational best practices for data platforms.
+ Proven experience operating 24/7, high-availability, mission-critical systems.
+ Experience applying automation and infrastructure-as-code (Terraform, Ansible, scripting).
+ Advanced understanding of observability for data platforms (performance, capacity, query analysis).
+ Strong analytical, reporting, and stakeholder communication skills.
+ Experience integrating new technologies with existing technologies
+ Experience implementing technologies with enterprise-wide impact
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Familiarity with Agile methodologies
+ Healthcare industry experience
+ Cloud certifications (Azure, AWS, GCP) and/or database platform certifications
+ Experience with CI/CD pipelines for database and analytics platforms
+ ITIL, SRE, or Platform Engineering certifications
**Additional Information**
**Work-At-Home Requirements**
+ WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
+ A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
+ Satellite and Wireless Internet service is NOT allowed for this role.
+ A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information\#LI-Remote
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$142,300 - $195,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$142.3k-195.7k yearly 15d ago
Informaticist
Humana 4.8
Humana job in Frankfort, KY
**Become a part of our caring community and help us put health first** The Provider Analytics organization's vision is to improve member healthcare through innovative analytics and actionable insights, which empower members, and providers to drive higher quality, lower cost of care, and improved health outcomes. Provider Analytics develops and applies actionable analytics and insights, which are integral to business needs, to drive informed provider network strategy and is looking for an Informaticist 2 to join their team.
The Informaticist 2:
+ Designs and constructs models to estimate impact of contractual changes tied to ancillary and industry leading innovative care delivery models
+ Collates, models, interprets and analyzes data in order to identify, explain, and influence variances and trends
+ Explains variances and trends and enhances modeling techniques
+ Utilizes multiple data sources such as SQL, Power BI, Excel, etc., to create advanced analytics to facilitate contracting initiatives
+ Uses a consultative approach to collaborate effectively with the markets, and other customers, building productive cross-functional relationships
+ Extracts historical data, performs data mining, develops insights to drive provider contracting strategy and reimbursement terms for National Ancillary Contracting
+ Develops tools and automates processes to model financial implications of ancillary contracted rate changes, including changes in capitated arrangements
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
+ Medical Benefits
+ Dental Benefits
+ Vision Benefits
+ Health Savings Accounts
+ Flex Spending Accounts
+ Life Insurance
+ 401(k)
+ PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
+ And more
**Use your skills to make an impact**
**Required Qualifications**
+ 3+ years of demonstrated healthcare analytical experience
+ 1+ years SQL experience
+ 1+ years' experience in data visualization (ie. Power BI, Tableau, etc.)
+ Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends
+ Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues
+ Possess a working knowledge and understand department, segment and organizational strategy
**Preferred Qualifications**
+ Bachelor's Degree in analytics or related field
+ Advanced Degree
+ Understanding of healthcare membership, claims, and other data sources used to evaluate cost and other key financial and quality metrics
**Additional Information**
Work at Home/Remote Requirements
**Work-At-Home Requirements**
+ To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
+ Wireless, Wired Cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
+ Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
**Our Hiring Process**
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging, and/or Video Interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone or computer. You should anticipate this interview to take approximately 10-15 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
\#LI-LM1
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$73,400 - $100,100 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 01-21-2026
**About us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
$73.4k-100.1k yearly 6d ago
Inventory Specialist
Walgreens 4.4
Hodgenville, KY 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.
$17 - $19 / Hourly
$17-19 hourly 60d+ ago
Business Office Manager
Unitedhealth Group 4.6
Louisville, KY job
**Explore opportunities with Caretenders,** a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.**
The Home Health Business Manager is responsible for managing, coordinating, and directing the administrative support and non-clinical operations of the agency, and for ensuring that all duties are performed in a timely manner. The Business Manager is also responsible for ensuring that all administrative support to the Executive Director and/or Clinical Director functions are operating effectively and efficiently.
**Primary Responsibilities:**
+ Overseeing and maintaining contracts, binders, and HR/medical files for all agency employees and contract staff in accordance with policy and applicable regulations
+ Reviewing, reconciling, and submitting invoices to Home Office in accordance with LHC Group policy. This also includes ensuring payment is issued timely, following up on concerns, and maintaining a positive relationship with all vendors
+ Performs and or manages billing audits per policy and follows-up with corrections
+ Manages clerical staff and manages all non-clinical workflow and process in the office. This includes timely completion of all clerical tasks, as well as providing input into hiring, disciplinary, and separation decisions
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Must possess at least one of the following:
+ 3+ years of healthcare experience
+ 3+ years of experience in an office administration role
+ Bachelor's Degree
+ Computer proficiency, including Microsoft Office suite
**Preferred Qualifications:**
+ Demonstrated solid organizational, written, verbal communication, and time management skills
+ Demonstrated computer proficiency, including Microsoft Office suite
+ Demonstrated ability to work independently
+ Demonstrated solid process and people leadership abilities
+ Experience with payroll process, supply management, and basic financial knowledge
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
$20-35.7 hourly 23d ago
Beauty and Wellness Consultant
Walgreens 4.4
New Albany, IN 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.
**Job ID:** 1741106BR
**Title:** Beauty and Wellness Consultant
**Company Indicator:** Walgreens
**Employment Type:** Full-time
**Job Function:** Retail
**Full Store Address:** 200 LAFOLLETTE STA S,FLOYDS KNOBS,IN,47119
**Full District Office Address:** 200 LAFOLLETTE STA S,FLOYDS KNOBS,IN,47119-09776-09710-S
**External 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
**Shift:**
**Store:** 09710-FLOYDS KNOBS IN
**Pay Type:** Hourly
**Start Rate:** 16
**Max Rate:** 21
$26k-30k yearly est. 9d ago
Pharmacy Technician / Pharm Tech Apprenticeship
Walgreens 4.4
Charlestown, IN job
Our pharmacy technician positions have undergone an exciting transformation, moving from a transaction-based environment to a much more patient-centric one. As a Walgreens Pharmacy Technician or Pharmacy Technician Apprentice, you'll be front and center - interacting with our customers and developing strong patient relationships. Pharmacy is the core of our business, and our pharmacy technicians enjoy all the tools and support - including the latest technology - to grow their careers and reach their goals.
Walgreens is proud to invest & champion an "earn while you learn" Pharmacy Technician Training Program recognized by ASHP & Department of Labor. This apprenticeship program gives you an entry point to a career in health care by guiding you in taking steps towards becoming a Pharmacy Technician Certification Board (PTCB) Certified Pharmacy Technician and helping you maintain the high level of skill required in the pharmacy care industry. Arming you with a nationally recognized, portable credential that will help you advance your career.
Whether you are new to working in pharmacies or are an experienced Pharmacy Technician Apply Now! Walgreens will train you to use your skills and talents to serve and care for our patients and customers. The courses, learning activities, and resources provided to you in our pharmacy technician training program are designed to give you foundational and advanced knowledge, skills, and on-the-job experiences you need to prepare to become a certified pharmacy technician.
* In accordance with state and federal regulations, assists the pharmacist, under direct supervision, in the practice of pharmacy. Assists the pharmacist in the performance of other Pharmacy Department duties in accordance with Company policies and procedures.
* Responsible for using pharmacy systems to obtain patient and drug information and process prescriptions. If PTCB certified, assists with and coaches pharmacy technicians in the operation of pharmacy systems and cashiers in the operation of the pharmacy cash registers.
* Models and delivers a distinctive and delightful customer experience.
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.).
* Develops strong relationships with most valuable customers.
Operations
* Under the supervision by the pharmacist, assist in the practice of pharmacy, in accordance with state, federal, and company policy. Reviews and complies with the Walgreen Co. Pharmacy Code of Conduct.
* Performs duties as assigned by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered correctly, filling prescriptions by retrieving, counting and pouring pharmaceutical drugs, verifying medicine is correct, and checking for possible interactions. Assists pharmacists in scheduling and maintaining work flow.
* Reports, immediately, prescription errors to pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program.
* Strictly adheres to the Walgreen Co. policy regarding Good Faith Dispensing during all applicable prescription dispensing activities.
* Responsible and accountable for registering all related sales on assigned cash register, collects and handles cash as required. Takes customer to OTC aisle when possible to assist in locating products.
* Handles telephone calls that do not require personal attention of the pharmacist, including those to physicians.
* Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs other clerical duties, as assigned by the Pharmacy Manager.
* Assists and supports Pharmacy Department on inventory management activities, such as, ordering, unpacking, checking and storing shipment of pharmaceuticals. Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages (merchandise billed, but not received), order errors or damaged goods involving Rx drugs.
* May assist pharmacist in administering clinical services including the collection and proper labeling of blood/urine samples from patients and other clinical services as required; assists pharmacy staff in coordination of clinical services, Walgreens healthcare clinics and external providers.
* Assists Pharmacy Manager and Staff Pharmacist in developing and maintaining good relationships with the local medical community, including physicians, nurses, and other health care providers, by medical provider detailing and outreach to health groups, retirement homes, nursing homes, and other forums for enhancing growth opportunities.
* Assists with exterior and interior maintenance by ensuring the Pharmacy Department is stocked with adequate supplies, clean, neat and orderly in 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
* Earns and maintains PTCB certification through the designated PTCB training program and/or state required certification/registration. Otherwise, earns PTCB certification as condition of promotion to senior technician.
* Attends training requested by Manager and acquires continuing education credits. Maintains knowledge and skill in healthcare and pharmacy, including latest news and developments.
Basic Qualifications
* Must be fluent in reading, writing, and speaking English. (Except in Puerto Rico)
* Requires willingness to work flexible schedule, including evening and weekend hours.
Preferred Qualifications
* Prefer six months of experience in a retail environment.
* Prefer to have prior work experience with Walgreens.
* Prefer good math skills so they can fill prescriptions accurately, including counting, measuring and weighing medications.
* Prefer good computer skills.
* Prefer the knowledge of store inventory control.
* Prefer PTCB certification.
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 - $20.5 / Hourly