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Humana jobs in Madison, WI - 362 jobs

  • Fraud and Waste Investigator

    Humana 4.8company rating

    Humana job in Madison, WI

    **Become a part of our caring community and help us put health first** The Fraud and Waste Professional 2 conducts investigations of allegations of fraudulent and abusive practices. The Fraud and Waste Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. **Where You Come In** The Fraud and Waste Professional 2 coordinates investigation with internal and external entities including compliance, internal business partners, and law enforcement. Assembles evidence and documentation to support successful adjudication, where appropriate. Prepares complex investigative and audit reports. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **What Humana Offers** We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education **Use your skills to make an impact** **WORK STYLE:** Remote anywhere in US, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **WORK HOURS:** Monday-Friday, 8 hours/day, 5 days/week, ideally, associates will work on EST (regardless of their home time zone). Must start between 6AM-9AM (in the employee's time zone), some flexibility might be possible, depending on business needs. **Required Qualifications - What it takes to Succeed** + Bachelor's degree or equivalent work experience + Minimum 2 years of investigative and/or claims experience + Knowledge of healthcare payment methodologies + Strong organizational, interpersonal, and communication skills + Inquisitive nature with ability to analyze data to metrics + Computer literate (MS Word, Excel, Access) + Strong personal and professional ethics + Ability to travel up to 5%, to attend trainings and meetings, as required **Preferred Qualifications** + Bilingual in Spanish + Bachelor's degree and/or additional degrees and/or certifications (MBA, J.D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI). + Understanding of healthcare industry, claims processing and investigative process development. + Experience in a corporate environment and understanding of business operations **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. $65,000 - $88,600 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 ***************************************************************************
    $65k-88.6k yearly 3d ago
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  • Associate Actuary, SPA-Rx

    Humana 4.8company rating

    Humana job in Madison, WI

    **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 25d ago
  • Pharmacist - Newly Increased Salary Range

    Walgreens 4.4company rating

    Madison, WI job

    Newly Increased Salary Range $69.05 - $75.95 per hour Join Our Team at Walgreens as a Pharmacist! Why Walgreens - For You, For Your Family, For Your Future At Walgreens, pharmacists are medication experts and trusted healthcare providers reshaping the future of patient-focused care. With industry-leading resources, career advancement opportunities, and a strong commitment to work-life balance, we invest in you so you can invest in your patients. For You - Competitive Pay & Flexible Scheduling Competitive pay - Competitive wage offered based on geography and other business-related factors Paid Time Off (PTO) - Available after three months of service (subject to state law) because work-life balance matters Flexible scheduling - Flexible scheduling options to fit your lifestyle For Your Family - Comprehensive Health & Wellness Benefits Comprehensive benefits package including medical, prescription drug, dental, vision, disability and life insurance for qualifying team members. Plus free flu shots for all team members and other voluntary benefits 365 Get Healthy Here & Life365 Employee Assistance Program (EAP) - Mental health support and wellness programs Family-forming support - Walgreens provides financial support for fertility treatments, including medical procedures and prescription medications. Eligible team members can also receive reimbursement for qualified adoption and surrogacy-related expenses For Your Future - Growth, Education & Exclusive Perks Opportunities for growth - Many pharmacists advance quickly into leadership roles in pharmacy operations, retail management, multi-site leadership, and corporate support functions Walgreens University - Free training, certifications, and leadership development, plus tuition discounts at 30+ universities Employee discounts - 25% off Walgreens brands and 15% off national brands, plus exclusive savings on electronics, travel, and more 401(k) with company match - Contribute to your retirement, and Walgreens provides matching contributions after one year and 1,000 hours of service. Additionally, Walgreens matches qualifying student loan payments as if they were 401(k) contributions What You'll Do Provide compassionate, expert-level pharmacy consulting services to patients Educate and consult patients on medication usage, side effects, and cost-effective options Deliver clinical healthcare services, including immunizations, diagnostic testing, and medication therapy management Ensure medication safety through accurate compounding, dispensing, and regulatory compliance Mentor and train pharmacy team members in a collaborative and supportive environment Who You Are Patient-focused & service-driven - You're committed to making healthcare personal A collaborative team leader - You support, inspire, and uplift those around you A lifelong learner - You stay ahead of industry advancements and professional growth A problem-solver - You navigate challenges, from insurance claims to medication management, with ease Apply Today & Build Your Future with Walgreens! This is more than just a job-it's a career with purpose. See below for more details! About Us Founded in 1901, Walgreens (****************** proudly serves more than 9 million customers and patients each day across its approximately 8,000 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 211,000 team members, including roughly 85,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities. Basic Qualifications BS in Pharmacy or Pharmacist Degree from an accredited educational institution. Current pharmacist licensure in the states within the district. Experience performing prescription dispensing activities that demonstrate a strong working knowledge of applicable state and federal controlled substance laws. Certified Immunizer or willing to become an immunizer within 90 days of hire. Preferred Qualifications At least 1 year experience as a pharmacist in a retail setting including prescription filling and verification, records and legal compliance, pharmacy operations, pharmacy software and technology systems and insurance. We will consider employment of qualified applicants with arrest and conviction records. An Equal Opportunity Employer, including disability/veterans. The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits Salary Range: Pharmacist Hourly $64.60-$71.05
    $69.1-76 hourly 8d ago
  • Pharmacy Operations Manager

    Walgreens 4.4company rating

    Sun Prairie, WI job

    Where state and federal laws/regulations allow, accountable for performing day-to-day non-clinical pharmacy operations, administrative activities; Ensures efficient pharmacy workflow and a positive patient experience. Serves as a full-time certified pharmacy technician. Responsible for operating pharmacy systems to obtain patient and drug information and process prescriptions. Under the supervision of a pharmacist, supervising pharmacy technicians and pharmacy cashiers within the guidelines of authorized company policies, laws, regulations and business ethics. Responsible for the selection, scheduling, and development of pharmacy technician personnel. Leads training, coaching, and performance management of pharmacy technicians. Makes decisions regarding performance management including discipline and termination. Customer Experience Engages customers and patients by greeting them and offering assistance with products and services. Resolves customer complaints, helps respond to customers' requests in a timely manner and answers non-clinical questions to ensure a positive customer experience. Models and shares customer service best practices. Develops strong relationships with customers by anticipating customer needs and proactively offering services to provide the best experience possible when using the pharmacy. Enhances customer experience by increasing focus on healthcare services. Operations Responsible for assisting pharmacist in the delivery of patient care including patient registration, prescription data entry, preparation of medications for patients, counting, and verifying (where allowed by law). Completes patient and physician calls under the supervision of a pharmacist (where allowed by law). Under the supervision of a pharmacist assists with healthcare service offerings including administering vaccines, health screenings, and any health services allowed by law. Within the guidelines of authorized company policies, state and federal laws/regulations, exercises independent judgment to delegate, direct, and assign non-clinical work in the pharmacy. Ensures tasks are completed on-time and holds others accountable for efficient workflow. At the direction of the Pharmacy Manager or pharmacist, prepares, and files reports and records required by the company and various government agencies. Manages core pharmacy workflow and drives excellence in pharmacy operations. Coordinates and organizes pharmacy daily schedule of activities. Recommends allocation of pharmacy hours. Assures the pharmacy is clean, neat, orderly, and stocked with adequate supplies. Under the direction of the pharmacist, exercises independent judgment to ensure compliance and execution of all business administrative activities and pharmacy inventory management tasks that do not require pharmacist licensure. Manages annual inventory preparation. Accountable for completion of non-clinical patient calls. Drives new technology/ process roll out, champions change and engages team around action planning. Assures proper operation and maintenance of pharmacy department equipment. In collaboration with Pharmacy Manager, responsible for recordkeeping and ensuring security safeguards are in-place. Under supervision of the pharmacist, strictly adheres to the Walgreen Co. policy regarding Good Faith Dispensing during all applicable prescription-dispensing activities and understands their role in ensuring that the elements of Good Faith Dispensing are met. Maintains and applies knowledge of Company asset protection techniques. Supports Pharmacy Manager with diversion monitoring and reports any concerns that would compromise the security of the pharmacy to the Pharmacy Manager. Communicates prescription errors to the accountable pharmacist, and adheres to Company policies and procedures in relation to pharmacy errors and the Continuous Quality Improvement Program. Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with insurance companies as well as medical providers and conducts or participates in 3rd party audit. Assists and supports Store Manager and Pharmacy Manager in analyzing and seeking to improve pharmacy financials, operational quality and customer service. Manages Community Outreach Portal and coordinates and, at the direction of the Pharmacy Manager, assigns pharmacists to off-site immunization clinics and community events. Builds and sustains relationships with retail partnerships. People & Performance Management Leads performance management of technicians including making decisions and recommendations regarding discipline and termination. Follows constructive discipline policy to discipline, suspend, terminate or effectively recommend the same. Uses constructive discipline policy to ensure pharmacy technicians are compliant with state and federal laws. Holds technician accountable for attendance and timeliness. Maintains and improves performance of pharmacy through team member engagement and action planning. Accountable for technician hiring, on-boarding, training, and scheduling. Monitors and holds pharmacy technicians accountable for timely training completion. Follows established policies and procedures set by the company for scheduling and training. Accountable for identifying gaps in pharmacy operations knowledge among team members and supporting those team members in their training, either through hands-on training or assignment of learning modules. Assists Pharmacy Manager in monitoring that all pharmacy and team member licensures, registrations and certifications are active and in good standing/ compliant with all regulatory and legal requirements. Leverages Walgreens resources such as Walgreens Online Verification System to assist in documenting licensure status. Ensures proper procedures are followed for selection, recruitment, record retention, and training as required by Company policy and local, state and federal laws. Training & Personal Development Maintains PTCB certification through the designated PTCB training program and/or state required certification/registration. Maintains and enhances current knowledge and skills related to pharmacy and healthcare. Obtains necessary certifications, education credits and training such as LTMP e-modules as required by the Company. Follows performance improvement plans offered by Pharmacy Manager. Seeks professional development by monitoring one's own performance, solicits for constructive feedback, and leverages Healthcare Supervisor as mentor and coach. Communication Communicates with pharmacy team, relaying messages from the support center or other key emails as required. Participates in key store/pharmacy meetings, including 5-minute meetings and weekly check-ins with the Store Manager Basic Qualifications High School Diploma, GED, or equivalent. PTCB or ExCPT certification (except in Puerto Rico). Has one year of work experience as a pharmacy technician in a retail or hospital setting. Must be fluent in reading, writing, and speaking English (except in Puerto Rico). Requires willingness to work flexible schedule, including evening and weekend hours. Willingness to obtain active immunization certification within 90 days of hire (except in Community Specialty Pharmacy and Health System Pharmacy locations) Preferred Qualifications Previous people management/ leadership experience. Previous work experience with Walgreens with an Exceeding Expectation on last performance evaluation. We will consider employment of qualified applicants with arrest and conviction records. This information is being provided to promote pay transparency and equal employment opportunities at Walgreens. The current salary range for this position is $22.50 per hour - $31.00 per hour. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits Salary Range: Hourly
    $22.5-31 hourly 2d ago
  • Supervisor, Pharmacy Operations/Call Center

    Molina Healthcare Inc. 4.4company rating

    Madison, WI 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.
    $55.7k-80.5k yearly 23d ago
  • Pharmacy Technician / Pharm Tech Apprenticeship

    Walgreens 4.4company rating

    Madison, WI 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
    $17-20.5 hourly 2d ago
  • Associate Specialist, Appeals & Grievances

    Molina Healthcare Inc. 4.4company rating

    Madison, WI 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. 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.
    $21.7-34.9 hourly 3d ago
  • Case Manager- Eau Claire, WI

    Humana 4.8company rating

    Humana job in Madison, WI

    **Become a part of our caring community and help us put health first** Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: + Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). + Coordinate services that address members' health and safety needs, ensuring support is provided in the least restrictive environment in accordance with the MCP. + Collaborate continuously with a Field Care Nurse (RN) to review and update care plans and address members' evolving needs. + Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence. + Schedule, conduct, and document quarterly in-person visits and maintain monthly contact with members by phone. + Identify, arrange, and monitor support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs. + Engage in clear and empathetic communication with members to better understand their needs, support informed decision-making, and ensure cost-effective service delivery. + Prioritize safety by continuously evaluating risk factors and providing education to members to promote overall health and wellness. + Maintain accurate and timely documentation of activities, including case notes, service authorizations, and updates to the Member Care Plan. + Foster direct collaboration with service providers, natural supports, and other community partners to enhance member outcomes. + Travel is necessary to conduct member visits and fulfill role responsibilities. **Use your skills to make an impact** **Required Qualifications** + Four-year bachelor's degree in human services or related field with one (1) year of experience working with at least one of the Family Care target populations **OR** a four-year bachelor's degree in any other field with three (3) years' related experience working with at least one of the Family Care target populations. + Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications. ***The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities*** **Preferred Qualifications** + Case Management experience + Experience with electronic case note documentation and experience with documenting in multiple computer applications/systems + Knowledge of community health and social service agencies and additional community resources **Additional Information** + **Workstyle:** This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes. + **Work Location:** Eau Claire and surrounding areas + **Travel:** up to 40% throughout Eau Claire and surrounding areas. Mileage reimbursement follows our mileage policy. + **Typical Workdays/Hours:** Monday - Friday, 8:00 am - 4:30 pm CST Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,700 - $72,600 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum. About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $53.7k-72.6k yearly 40d ago
  • Senior Digital Designer

    Humana 4.8company rating

    Humana job in Madison, WI

    **Become a part of our caring community and help us put health first** The Senior Digital Designer responsible for creating, executing, developing, and maintaining digital design elements across multiple platforms. The Senior Digital Designer work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Digital Designer collaborate closely with cross-functional teams to conceptualize, design, and produce digital content, graphics, animations, and user interfaces that align with organizational goals and enhance the user experience. Utilize common frameworks to build and develop interactive and responsive digital solutions that ensure compatibility, efficiency, and maximum value for the end-user. Support various business objectives, including product development, advertising, marketing, media, and communications. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** Typically requires Bachelor's degree or equivalent and 5+ years of technical experience Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $94,900 - $130,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-22-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $94.9k-130.5k yearly 3d ago
  • Analyst, Data

    Molina Healthcare Inc. 4.4company rating

    Madison, WI job

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

    Brookdale Senior Living 4.2company rating

    Madison, WI job

    Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity No Late Nights! Make Lives Better Including Your Own. If you want to work in an environment where you can become your best possible self, join us! You'll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Part and Full Time Benefits Eligibility * Medical, Dental, Vision insurance * 401(k) * Associate assistance program * Employee discounts * Referral program * Early access to earned wages for hourly associates (outside of CA) * Optional voluntary benefits including ID theft protection and pet insurance Full Time Only Benefits Eligibility * Paid Time Off * Paid holidays * Company provided life insurance * Adoption benefit * Disability (short and long term) * Flexible Spending Accounts * Health Savings Account * Optional life and dependent life insurance * Optional voluntary benefits including accident, critical illness and hospital indemnity Insurance, and legal plan * Tuition reimbursement Base pay in range will be determined by applicant's skills and experience. Role is also eligible for team based bonus opportunities. Temporary associates are not benefits eligible but may participate in the company's 401(k) program. Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply. To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year. The application window is anticipated to close within 30 days of the date of the posting. * Operates a dish washing machine to clean dishes, glasses, cups, trays, silverware, and other food service equipment. * Dishwashers keep all food prep and service areas sanitary, empty garbage, and sweep/mop kitchen floors. Responsible for overall cleanliness of the kitchen. * Assists with prep as needed. Brookdale is an equal opportunity employer and a drug-free workplace.
    $23k-27k yearly est. 4d ago
  • Manager, IT Services

    Molina Healthcare Inc. 4.4company rating

    Madison, WI 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 2d ago
  • Business Intelligence Lead - Digital VOC

    Humana 4.8company rating

    Humana job in Madison, WI

    **Become a part of our caring community and help us put health first** The Digital Voice of Customer (VoC) Program Leader & Insights Champion will own and advance the end-to-end VoC strategy across Digital CW, ensuring measurement approaches align with customer experience goals and business priorities. This position is responsible for vendor management (Qualtrics), cross-functional stakeholder collaboration, and driving everyday self-service and adoption of VoC insights throughout the organization. The ideal candidate will develop diverse VoC touchpoints, analyze structured and unstructured data, present findings through effective storytelling, and serve as a thought leader to educate and empower teams for data-driven decision-making. **Key Responsibilities** : + Develop, execute, and continuously refine the comprehensive VoC Program strategy for Digital CW, ensuring alignment with enterprise customer experience objectives and business priorities. + Manage and cultivate the vendor relationship with Qualtrics, representing the interests of Digital CW and collaborating with the Humana Digital lead. + Partner with stakeholders across UX, Product, Business Intelligence, Operations, and other lines of business to strategize, design, and implement optimal VoC touchpoints-including expansion beyond digital channels-to capture actionable customer insights. + Champion the incorporation of VoC metrics into everyday business practices, fostering a pull-driven, self-service engagement model across the enterprise. + Analyze structured and unstructured data to identify trends, friction points, opportunities for improvement, and root causes impacting user experiences. + Synthesize and communicate insights through compelling storytelling to influence cross-functional teams and drive user-backed optimizations. + Stay current with industry trends, emerging tools, and best practices to enhance VoC program effectiveness and operational efficiency. + Serve as a thought leader, educating stakeholders and promoting a culture of data-driven decision-making. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree and 8 or more years of technical experience in data analysis OR Master's degree and 4 years of experience + 2 or more years of project leadership experience **Preferred Qualifications** + Demonstrated experience leading VOC or customer experience programs in a digital environment + Strong vendor management skills, preferably with Qualtrics or similar platforms + Knowledge of current trends and tools in customer experience measurement and analytics + Advanced experience in analysis and synthesis of quantitative and qualitative data + Excellent communication, presentation, and storytelling skills to inform and influence senior and executive leadership + Experience aggregating data across multiple sources (e.g., primary research, secondary research, operational data) + Working knowledge of primary research techniques (e.g., basic survey design) + Advanced Degree in a quantitative discipline, such as **Business, Marketing, Analytics** , Mathematics, Statistics, Computer Science, or related field + Passion for contributing to an organization focused on continuously improving consumer experiences + Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction + Advanced experience working with big and complex data sets within large organizations + Proven ability to work with cross-functional teams and translate requirements between business, project management and technical projects or programs + Proficiency in understanding Healthcare related data + Experience creating analytics solutions for various healthcare sectors + Advanced in SQL, SAS and other data systems + Experience with tools such as Tableau and Qlik for creating data visualizations + Expertise in data mining, forecasting, simulation, and/or predictive modeling 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. $117,600 - $161,700 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. Application Deadline: 04-17-2026 **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 ***************************************************************************
    $117.6k-161.7k yearly 3d ago
  • Adjudicator, Provider Claims-On the phone

    Molina Healthcare 4.4company rating

    Madison, WI 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 22d ago
  • Medicare Sales Field Agent - Madison, WI

    Humana 4.8company rating

    Humana job in Madison, WI

    Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8-12 Medicare Sales Agents, you'll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you'll help bring Humana's strategy to life: Deliver on the fundamentals, differentiate through exceptional service, and grow by expanding our reach and impact. What You'll Do in This FIELD Based Role: Deliver: Build trust and educate individuals on Humana's Medicare Advantage plans and additional offerings like Life, Dental, Vision, and Prescription coverage. Differentiate: Create meaningful, face-to-face connections through grassroots marketing, community events, and in-home visits-providing a personalized experience that sets Humana apart. Grow: Drive self-generated sales, meet performance goals, and expand Humana's presence in the market by becoming a valued resource in your community. You'll engage with customers in the FIELD through a mix of in-person, virtual, and phone interactions. Face-to-face visits in prospective members' homes are a key part of this role. Why Join Humana? People-first culture that supports your personal and professional growth. Inclusive and diverse environment that values multilingual talent and cultural understanding. Autonomy and flexibility to manage your schedule and success. Purpose-driven mission to help people achieve their best health-and transform healthcare along the way. Benefits include: Medical, Dental, Vision, and a variety of other supplemental insurances Paid Time Off (PTO) and Paid Holidays 401(k) retirement savings plan with a competitive match Tuition reimbursement and/or scholarships for qualifying dependent children And much more! Use your skills to make an impact Required Qualifications Active Health Insurance License or ability to obtain. Must reside in the designated local territory to effectively serve the community. Comfortable with daily face-to-face interactions in prospective members' homes and engaging with the community through service, organizations, volunteer work, or local events. Valid state driver's license and proof of personal vehicle liability insurance meeting at least 25/25/10 coverage limits (or higher, based on state requirements). Preferred Qualifications Active Life and Variable Annuity Insurance License. Prior experience selling Medicare products. Experience in public speaking or delivering presentations to groups. Associate's or Bachelor's degree. Experience using Microsoft Office tools such as Teams, Excel, Word, and PowerPoint. Bilingual in English and Spanish, with the ability to speak, read, and write fluently in both languages. Additional Information This position is in scope of Humana's Driving Safety and Vehicle Management Program and therefore subject to driver license validation and MVR review. Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Schedule: Meeting with members requires appointments and/or event times that may vary on nights and weekends. Flexibility is essential to your success. Training: The first five weeks of employment and attendance is mandatory. Interview Format: As part of our hiring process for this opportunity, we are using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward in the process, you will receive a text message inviting you to participate in a HireVue prescreen. In this prescreen, you will receive a set of questions via text and given the opportunity to respond to each question. You should anticipate this prescreen taking about 15 minutes. Your responses will be reviewed and if selected to move forward, you will be contacted with additional details involving the next step in the process. Pay Range The range below reflects a good faith estimate of total compensation for full time (40 hours per week) employment at the time of posting. This compensation package includes both base pay and commission with guarantee. The pay range may be higher or lower based on geographic location. Actual earnings will vary based on individual performance, with the base salary and commission structure aligned to company policies and applicable pay transparency requirements. $80,000 - $125,000 per year #medicaresalesrep Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
    $37k-45k yearly est. Auto-Apply 60d+ ago
  • Inventory Specialist

    Walgreens 4.4company rating

    Oregon, WI job

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

    Walgreens 4.4company rating

    Dodgeville, WI job

    Provides empathetic pharmacy consulting services to patients regarding the effective use of medications and drug interaction awareness. Offers preventive and clinical healthcare services, including immunizations, diagnostic testing, and patient outcome services. Ensures prescribed medications are compounded, reviewed, dispensed, and verified accurately according to regulatory guidelines and company policies and procedures. Manages an efficient pharmacy workflow and improves pharmacy financials, manages inventory effectively, and enhances patient experience. Manages pharmacy staff performance and engagement. Ensures the professional development of pharmacy staff by overseeing training, focused coaching, and executing formal performance management initiatives. Job Responsibilities: Patient Experience Engages patients by greeting them and offering assistance with products and services. Resolves patient issues in a timely manner and answers questions to ensure a positive patient experience. Models and shares customer service best practices with all team members to deliver a distinctive and joyful patient experience, including interpersonal habits that show care (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., demonstrating curiosity to identify needs and proactively helping, servicing until satisfied, championing empathy and inclusivity, etc.). Connects with patients by anticipating needs and proactively offering services. Leads efforts on enhancing patient experience by increasing awareness of healthcare services offered through Walgreens (e.g. patient consultation, medication management, drug therapy reviews, and perform clinical, or wellness services such as immunizations, diagnostic testing, and patient outcomes services) thereby promoting the shift of the Walgreen's pharmacy role from transactional to interpersonal. Participates and assists in events that reflect the unique communities we serve as requested by Store Manager, Healthcare Supervisor, or District Manager. Operations Counsels patients and answers questions regarding usage of medicine, side effects, interactions, contraindications, patient information privacy, generics, less expensive medicines, and over-the-counter products. Refers to the medical provider, as needed, to ensure medication is taken correctly, health needs are addressed, and patient is satisfied with service. Performs pharmacist tasks including compounding, drug therapy reviews, verification, and medication management. Reviews, interprets, and accurately dispenses prescribed medications, as required. Ensures the pharmacy operates in accordance with regulations, company policies and standards. Establishes procedures that promote the efficient workflow of the pharmacy including overseeing staff scheduling, assigning roles, coordinating activities, and soliciting team member suggestions. Responsible for opening and closing the pharmacy and shift changes. Ensures the use of all elements of the Good Faith Dispensing policy in conjunction with state and federal controlled substance laws when filling prescriptions. The Product Review/Retail Fill Process Pharmacist is responsible for ensuring that elements of Good Faith are present. Collaborates with Store Manager to define and develop new strategic business opportunities. Maintains information technology knowledge of pharmacy systems including workflow, prescription fulfillment, billing, clinical documentation, training, inventory management, and point of sale registers. Supports pharmacy staff and patients with information technology. Finds opportunities to improve productivity Ensures insurance claims are processed accurately to prevent payment rejections. Resolves patient issues by working with insurance companies and medical providers and conducting or participating in third party audits. Follows-up with medical providers to clarify prescribed medications, dosages, refills, interactions, and allergies to suggest alternative medications, and answer medical provider questions. diagnostic testing, disease state management and other healthcare services. Performs clinical and wellness services such as immunizations, diagnostic testing, disease state management, and other healthcare services Partners with centralized support for patient registration, exception resolution, and assists with resolving patient issues. In virtual environments, conducts virtual product review by following specific company procedures and guidelines Manages the maintenance, housekeeping, and improvement of the pharmacy department including repairs, cleaning, new equipment, and layout changes to ensure a functioning, presentable and efficient pharmacy. Prepares and submits all records, reports, and other documentation as required by state and federal laws to run the pharmacy business (e.g., operating statements, performance indicator reports, supervision notes, deletions, transfers.) People & Performance Management Collaborates with Store Manager on pharmacy staff hiring, carries out discipline and termination, as necessary, and ensures compliance with employment laws. Partners with Store Manager to establish expectations and goals, promote teamwork and foster a shared vision. Monitors and recognizes improvements in pharmacy staff by implementing rewards programs. Manages pharmacy staff performance by overseeing the training of pharmacy staff (e.g., using the correct processes and tools) and conducting formal performance reviews. Identifies high potential team members and proactively collaborates with Store Manager to manage career progression. Addresses employee relations concerns. Maintains team member morale by checking on employee welfare, addressing complaints and conflicts, and ensuring positive employee management relationship. Training & Personal Development Maintains required licensing/credentialing/certification as established by federal and state regulations to provide clinical services. Maintains and enhances current knowledge and skills related to pharmacy and healthcare by reading pharmacy related journals and Walgreens publications and communications. Maintains awareness of developments in retail and management areas and pursues best practices to enhance business acumen and pharmacy performance. Completes education credits and training, including learning modules, as required by the Company Seeks professional development by monitoring own performance, solicits constructive feedback, and leverages Healthcare Supervisor and Store Manager as mentors and coaches. Communications • Supports the Store Manager by communicating relevant corporate health and wellness services or strategy information to pharmacy staff. Business Performance Management • Analyzes performance data including pharmacy financials, customer service, and inventory. Manages pharmacy asset protection activities and oversees inventory management. Identifies pharmacy performance trends and opportunities for improvement. Business Planning • Develops and maintains good relationships with local medical community including physicians, nurses, and other health care providers. Reaches out to the community to promote the pharmacy business and further enhance growth opportunities. Supports Store Manager in expanding health and wellness awareness in the community Basic Qualifications BS in Pharmacy or Pharm D Degree from an accredited educational institution. Current pharmacist licensure in the states within the district. Certified Immunizer or willing to become an immunizer within 90 days of hire. At least 1 year pharmacy experience including prescription filling, recordkeeping, legal compliance, pharmacy operations, pharmacy software and technology systems and insurance billing. (Some states may require more specific pharmacy experience in which case those requirements would take precedent). Experience performing prescription dispensing activities that demonstrate a strong working knowledge of applicable state and federal controlled substance laws. An average rating of at least 3.0 on the leadership behaviors on the last performance review if one is on file, and no written disciplinary actions in the last 12 months (Internal candidates only). About Walgreens Founded in 1901, Walgreens (****************** proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 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. Preferred Qualifications Supervisory experience planning, organizing, and directing the work of pharmacy staff. At least 6 months pharmacy experience with Walgreen Co. An average rating of 3.7 or above on the leadership behaviors on the last performance review if one is on file. (Internal candidates only) An Equal Opportunity Employer, including disability/veterans We will consider employment of qualified applicants with arrest and conviction records. The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser Salary Range: Pharmacy Manager $5,863.20-$6,438.20 Bi-Weekly
    $55k-106k yearly est. 2d ago
  • Utilization Management Appeals Nurse

    Humana 4.8company rating

    Humana job in Madison, WI

    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Humana is seeking a Part C Grievance & Appeals (G&A) Nurse who will assist in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The Nurse reviews the medical documentation, researching claims, benefits, as well as prior determinations pertinent to the appeal and provides a written summary of findings using a template for each case. The associate will be working and collaborating with Humana CIT teams, Vendors, G&A specialists, and Humana Medical Directors on submitted G&A cases. The G&A Nurse will participate in initiatives which result in improved member outcomes, operational efficiencies, and process improvement opportunities. + Case preparation of Medicare and/or Duals line of businessinvolving expedited, pre-service and post serviceappeals + Apply and implement Medicare, Medicaid,MCG, claims policy and evidence of coverage guidelines for reviews + Perform outreach to providers and/or members + Utilize multiple systems such as MHK, CGX, MRM, SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action + 3 or more years of clinical experience preferably in an acute care, skilled or rehabilitation clinical setting or broad clinical nursing experience + Comprehensive knowledge of Microsoft Word, Outlook and Excel + Strong organizational and effective time management skills + Ability to work independently under general instructions and with a team **Preferred Qualifications** + Bachelor's degree (BSN) + Appeal Review Experience + Knowledge of MHK + Previous Medicare/Medicaid Experience + Previous experience in utilization management + Previous claims experience **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Additional Information** + Hours are Monday-Friday 9am-6pm EST with a weekend rotation (Your 8-hour shift will fall within this timeframe) + Candidate's must also commit to working on the holidays as needed + This is a remote position, but all candidates must work in the Eastern Standard Time Zone (EST) Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-21-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $71.1k-97.8k yearly 1d ago
  • Channel Development Lead

    Humana 4.8company rating

    Humana job in Madison, WI

    **Become a part of our caring community and help us put health first** The Channel Development Lead supports the execution and optimization of sales and growth communications by translating established strategy into clear, consistent, and timely deliverables. This role enables key stakeholders, supports go-to-market initiatives, and ensures communications are data-informed, compliant, and aligned to enterprise priorities. **Core Responsibilities** **Sales Communications Execution** + Develop and execute multi-channel communications aligned to go-to-market initiatives and enterprise priorities + Ensure messaging accuracy, consistency, and readiness across internal, external, and MarketPoint channels **Program Coordination & Delivery** + Support the rollout of MarketPoint and enterprise initiatives through coordinated communication plans + Manage program calendars, intake documentation, and execution timelines + Track milestones and ensure deliverables are completed on schedule **Reporting & Performance Support** + Collect and analyze engagement, utilization, and adoption metrics related to sales communications + Support dashboard development and reporting to measure communication effectiveness + Identify trends and insights to inform ongoing optimization **Cross-Functional Collaboration & Compliance** + Partner with Sales, Marketing, Compliance, Finance, Operations, and other stakeholders to support aligned execution + Ensure all materials adhere to regulatory, compliance, and brand standards **Adaptability & Continuous Improvement** + Adjust communication plans in response to changing priorities, risks, or stakeholder needs + Incorporate feedback and performance insights to improve communication quality and effectiveness **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + 2 or more years of project leadership experience + Comprehensive knowledge of Microsoft PowerPoint, Word, and Excel + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + Proven track record of developing and executing multi-channel communication campaigns to a large diverse audience **Preferred Qualifications** + Master's degree + 2 or more years of sales experience in the health solutions industry + PMP/Six Sigma Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $115,200 - $158,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-20-2026 **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 ***************************************************************************
    $115.2k-158.4k yearly 1d ago
  • Beauty and Wellness Consultant

    Walgreens 4.4company rating

    DeForest, WI job

    Job Objectives Maximizes sales and brand awareness by providing exceptional customer care to all customers in a friendly, efficient, and professional manner; gives impartial, personalized, expertise and advice regardless of brand and budget. Demonstrates a passion for beauty and wellness and provides inspirational beauty knowledge and know-how. Provides customers with solutions for their beauty and wellness needs, including mini-makeovers and skincare consultations, with an emphasis on the customers' total look. Models and delivers a distinctive and delightful customer experience. Oversees and maintains overall beauty department standards. Job Responsibilities/Tasks Customer Experience * Engages customers by greeting them and offering assistance with products and services. Resolves customer issues and answers questions to ensure a positive customer experience. * Models and shares customer care best practices by proactively offering assistance, asking questions to determine customers' needs, and informing customers of options. * Greets, listens, and engages customers to identify their needs, making them aware of appropriate products and services, and providing warm transfers to other areas of the store when necessary * Provides expertise in product demonstrations and consultations utilizing tools such as the Skin Hydrometer and tablet. * Leads and delivers in-store events to promote brand awareness and loyalty of Owned Brands and total Beauty, Wellness and Personal Care. * Builds relationships with customers; provides authentic closure of customer interaction and builds and fosters relationships. * Engages with omni-channel solutions to enhance customer engagement/experience. * Locates products in other stores or online if unavailable in the store. Operations * Achieves or exceeds predetermined sales goals by assisting customers in the purchase of products and by modeling exceptional customer care. * Reviews beauty business on a regular basis to understand performance within store and district in partnership with store leadership. * Consistently focuses on link-selling and up-selling with customers by showing them sale items and complimentary offerings. * Uses testers and sampling to demonstrate product application and leverage items from beauty promotional programs. * Ensures testers are stocked and maintained in compliance with hygiene standards; maintains a clean and organized department. * Implements company asset protection procedures to identify and minimize profit loss. * Processes sales for customers and/or employee purchases on cash register. * Participates in meetings and conference calls concerning programs and promotions, new items, brand launches, sales goals, and modeling exceptional customer care. * Has working knowledge of store systems and store equipment. * Ensures compliance with state and local laws regarding regulated products (e.g., alcoholic beverages and tobacco products). * Complies with all company policies and procedures; maintains respectful relationships with coworkers. * Completes special assignments as assigned. Training & Personal Development * Seeks self-development by monitoring own performance, setting high personal standards, maintaining awareness of beauty and wellness trends, learning from others, and improving job performance. * Maintains knowledge of competition, new product/brand launches, and overall industry trends * Attends and participates in meetings, seminars, and other knowledge and business-driving opportunities; educates store team on new beauty updates, information, and learnings from training. * Attends training and completes e-learning modules requested by Manager or assigned by Corporate. * Maintains professional appearance and image in compliance with company guidelines at all times. * Models and shares behavior with other Beauty and Wellness Consultants; provides training and assistance to new Beauty and Wellness Consultants. * Works collaboratively with Store Leadership to review goals and maintain product knowledge. About Walgreens Founded in 1901, Walgreens (****************** proudly serves more than 9 million customers and patients each day across its approximately 8,000 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 211,000 team members, including roughly 85,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities. Basic Qualifications * High School Diploma/GED and at least one year of experience working in a retail sales environment that required meeting a defined sales goal OR at least one year of experience proactively selling beauty or cosmetic products and providing customer care * Experience in developing ways to accomplish goals with little or no supervision, depending on oneself to complete objectives and determining when escalation of issues is necessary * Knowledge of products and brands in order to engage and meet the needs of the customer. * Experience building and maintaining relationships within a team. * Basic level PC/tablet skills. * Requires willingness to work flexible schedule including evenings, weekends, and holidays. * Must be fluent in reading, writing and speaking English. (Except in Puerto Rico) Preferred Qualifications * Licensure in Cosmetology or as an Esthetician as granted by appropriate state licensing authority. * Experience establishing & maintaining relationships with individuals at all levels of the organization, in the business community & with vendors. * Experience demonstrating makeup application and providing makeovers to customers. * Experiencing selling Prestige brands. * Degree from Beauty School. * Experience with another retailer in the form of an Externship. We will consider employment of qualified applicants with arrest and conviction records. An Equal Opportunity Employer, including disability/veterans. The actual compensation that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits. If you are applying on a job board or unable to click on the link, please copy and paste this URL into your browser jobs.walgreens.com/benefits Salary Range: $16 - $21 / Hourly
    $16-21 hourly 5d ago

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