Humana jobs in Santa Fe, NM - 129 jobs

**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. 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. **In addition, the Associate Actuary will:** + Support long term projects aimed at advancing technical maturity, process efficiency, and forecasting accuracy. We are looking for creativity, curiosity, and a desire to explore and influence uncharted territory. + Conduct independent research, collaborate across many teams/departments, and require strong communication skills to be successful in the job. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + Associate of Society of Actuaries (ASA) designation + Meets eligibility requirements for Humana's Actuarial Professional Development Program (APDP) + MAAA + Strong communication skills + Demonstrated ability to communicate technical information with audiences not in the actuarial space + Must be passionate about contributing to an organization focused on continuously improving consumer experiences + 3+ years health industry experience with ASA, or 1+ years health industry experience with FSA + 2+ years SQL experience, or equivalent skillset **Preferred Qualifications** + Medicare Advantage background + Creative, high degree of self-accountability + Experience in Python, PowerApps, and PowerBI 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: 02-15-2026 **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 ***************************************************************************

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.

JOB DESCRIPTION Job SummaryProvides medical oversight and expertise related to behavioral health and chemical dependency services, and assists with implementation of integrated behavioral health care programs within specific markets/regions. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Provides behavioral health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and decrease costs. - Facilitates behavioral health-related regional medical necessity reviews and cross coverage. - Standardizes behavioral health-related utilization management, quality, and financial goals across all lines of businesses. - Responds to behavioral health-related requests for proposal (RFP) sections and reviews behavioral health portions of state contracts. - Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric diagnoses and treatment. - Provides second level behavioral health clinical reviews, peer reviews and appeals. - Supports behavioral health committees for quality compliance. - Implements behavioral health specific clinical practice guidelines and medical necessity review criteria. - Tracks all clinical programs for behavioral health quality compliance with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS). - Assists with the recruitment and orientation of new psychiatric medical directors. - Ensures all behavioral health programs and policies are in line with industry standards and best practices. - Assists with new program implementation and supports for health plan in-source behavioral health services. Required Qualifications - At least 3 of relevant experience, including 2 years of medical practice experience in psychiatry/behavioral health, or equivalent combination of relevant education and experience. - Doctor of Medicine (MD) or Doctor of Osteopathy (DO). License must be active and unrestricted in state of practice. - Board Certification in Psychiatry. - Working knowledge of applicable national, state, and local laws and regulatory requirements affecting medical and clinical staff. - Ability to work cross-collaboratively within a highly matrixed organization. - Strong organizational and time-management skills. - Ability to multi-task and meet deadlines. - Attention to detail- available to work PST zone. - Critical-thinking and active listening skills. - Decision-making and problem-solving skills. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications - Experience with utilization/quality program management. - Managed care experience. - Peer review experience. - Certified Professional in Healthcare Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of America (CMSA) or other health care or management certification. 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: $186,201.39 - $363,093 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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.

**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: 01-29-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**Become a part of our caring community and help us put health first** The Program Delivery Lead manages the development, operations, and results of the Pacific Southwest Region market performance under direction of the Market President. The Program Delivery Lead manages the development, operations, and results Pacific Southwest Region market performance under direction of the Market President. The Program Delivery Lead works on problems of diverse scope, including but not limited to, maintaining key provider relationships, tracking and monitoring innovative pilot programs deployed in the region, and supporting the Market President on community, state and federal government engagement aligned to Humana priorities. **Key Duties Supporting External Relationships and Performance:** + Work with Pacific Southwest Market President and regional leadership team to monitor strategic provider relationships needed for network adequacy, Stars performance, and market expansion. + Assist in developing and refining key characteristics and data for the market provider priorities including Stars performance, utilization management performance, value-based care arrangements and snapshot of contract terms. + Track and maintain status of pilot programs proposed or deployed in the region for the Market President and regional leadership team, including return on investment, quality of care impacts, administrative costs, and ability to expand into additional markets. + Monitor and track national providers with a regional footprint and monitor relationships at an enterprise level, along with regional performance. The Program Delivery Lead also serves as the operations manager for the Region and acts as the "right hand person" for the Region President. Works hand in hand with the Regional President to execute business reviews, market meetings, external meetings and internal strategy sessions. **Key Duties Supporting Regional/Market Operations:** + Coordinate weekly regional leadership meetings and agenda, and track follow-up items for completion + Coordinate regional Town Halls and other market-level presentations and events + Lead coordination of market responses to corporate data requests when requested by Market President + Manages Market Reviews and strategy presentations + Manages external strategic meetings + Facilitates aspects of the bid process including tracking benefit changes, and tracking follow-ups + Additional duties as assigned by Market President **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree or 5 years equivalent experience in Operations + 5+ years proven program, project and/or people leadership within Humana in an operations role + Ability to influence regional leadership team to facilitate completion of projects + Executive level presentation and communication skills, both written and oral + Ability to work with division team + Independent thinker who can problem solve and operate autonomously + Ability to influence and collaborate at Sr. Levels within the organization + Ability to convey significance, cause and opportunity of initiatives + Success in developing working relationships within a highly matrixed business environment + Ability to understand and aggregate incomplete data from various sources to make informed recommendations + Experience working with sensitive and confidential information + Up to 15% travel within the region monthly 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: 02-03-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**Become a part of our caring community and help us put health first** Humana's Clinical Analytics Team is seeking a Research Scientist 2 (Remote). Healthcare is rapidly changing, and our members are living longer, often with more chronic conditions and behavior health needs. The Clinical Strategy & Analytics team identifies opportunities and builds solutions to improve clinical outcomes and lower costs for millions of Medicare Advantage beneficiaries through an evidence-based approach using data analytics, clinical expertise, strategic mindset, and rigorous study designs. In this multi-disciplinary team, you will have the opportunity to work closely with strategy partners and clinicians to shape Humana's enterprise clinical strategies and initiatives. The Research Scientist 2 applies mathematical, statistical, and epidemiologic principles to identify trends, assess variable associations or cause-effect relationships, and size potential opportunities using high volumes of complex data. The Research Scientist 2 work assignments are varied and frequently require interpretation of data/information and independent judgement. **Responsibilities** As a Research Scientist 2, you will: + Collaborate with analytic and data teams to set objectives, approaches, and work plans + Develop and implement study protocols, including the ability to design observational studies, randomized controlled trials, and cohort studies + Leverage a wide range of analytics methods ranging from descriptive to prescriptive to transform high volumes of complex data into analytics solutions and actionable insights + Collaborate with clinicians and clinical informaticists to define various clinical concepts and extract clinical information from medical, pharmacy, and lab claims for analytics and modeling purposes + Translates analytic results into key takeaways and communicate to business partners + Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas + Make decisions regarding own work methods, occasionally in ambiguous situations with general guidance **Use your skills to make an impact** **Required Qualifications** + Master's Degree in a quantitative discipline such as Epidemiology, Biostatistics, Economics, Statistics, Clinical Informatics, and/or related fields + Demonstrated strong analytical thinking and problem-solving skills + Demonstrated strong interest in healthcare and desire to make a positive impact on population health + Flexible, dynamic personality who can work independently and collaboratively within a multi-disciplinary team + 2+ years of experience in applying mathematics, statistics, epidemiologic principals to transform high volumes of complex data into actionable insights + Clear and concise oral and written communication skills, with a proven ability to translate complex methodologies and analytical results to higher-level business insights and key takeaways + Experience manipulating and analyzing data using SAS, Python, R, or similar software **Preferred Qualifications** + Healthcare or managed care working experience + Experience working with medical, pharmacy, lab claims + Demonstrated familiarity with clinical concepts related to a broad range of clinical conditions and disease states - experience with oncology, behavioral health and chronic conditions would be particularly valuable + Demonstrated familiarity with hypothesis testing, statistical methods, and/or comparative effectiveness study design and modeling techniques + Experience using Pyspark, DataBricks, and/or Microsoft Azure Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-05-2026 **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 ***************************************************************************

Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. **Job Duties** + Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made, or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. + Reevaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of relevant and applicable state and federal regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions. + Validates member medical records and claims submitted/correct coding, to ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. + Identifies and reports quality of care issues. + Assists with complex claim review including diagnosis-related group (DRG) validation, itemized bill review, appropriate level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team; makes decisions and recommendations pertinent to clinical experience. + Prepares and presents cases representing Molina, along with the chief medical officer (CMO), for administrative law judge pre-hearings, state insurance commissions, and judicial fair hearings. + Reviews medically appropriate clinical guidelines and other appropriate criteria with medical directors on denial decisions. + Supplies criteria supporting all recommendations for denial or modification of payment decisions. + Serves as a clinical resource for utilization management, CMOs, physicians and member/provider inquiries/appeals. + Provides training and support to clinical peers. + Identifies and refers members with special needs to the appropriate Molina program per applicable policies/protocols. **Job Qualifications** **REQUIRED QUALIFICATIONS:** + At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse (RN). License must be active and unrestricted in state of practice. + Experience demonstrating knowledge of ICD-10, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC). + Experience working within applicable state, federal, and third-party regulations. + Analytic, problem-solving, and decision-making skills. + Organizational and time-management skills. + Attention to detail. + Critical-thinking and active listening skills. + Common look proficiency. + Effective verbal and written communication skills. + Microsoft Office suite and applicable software program(s) proficiency. **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care certifications. + Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. + Billing and coding experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $29.05 - $67.97 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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.

Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion within Provider Network department. Help facilitate corporate markets with obtaining SAI goals. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is project/program management. **Job Duties** + Provide project summaries that will be senior leadership facing with ties to market SAI goals. + Active collaborator with people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. + Plans and directs schedules as well as project budgets. + Monitors the project from inception through delivery. + May engage and oversee the work of external vendors. + Focuses on process improvement, organizational change management, program management and other processes relative to the business. + Leads and manages team in planning and executing business programs. + Serves as the subject matter expert in the functional area and leads programs to meet critical needs. + Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. Delivers the appropriate artifacts as needed. + Works with operational leaders within the business to provide recommendations on opportunities for process improvements. + Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations. + Generate and distribute standard reports on schedule **JOB QUALIFICATIONS** **REQUIRED EDUCATION** : Bachelor's Degree or equivalent combination of education and experience. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + 3-5 years of Program and/or Project management experience. + Operational Process Improvement experience. + Healthcare experience. + Experience with Microsoft Project and Visio. + Excellent presentation and communication skills. + Experience partnering with different levels of leadership across the organization. **PREFERRED EDUCATION** : Graduate Degree or equivalent combination of education and experience. **PREFERRED EXPERIENCE** : - 5-7 years of Program and/or Project management experience. - Provider Network and SAI - Excel and PowerPoint - Managed Care experience. - Experience working in a cross functional highly matrixed organization. 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 - $155,508 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

JOB DESCRIPTION Job SummaryProvides support for medical records collection activities. Supports quality improvement activities through outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Outreaches to providers via phone call, fax, mail, electronic medical record system retrieval and direct on-site pick up for collection of medical records. - Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. - Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. - Provides project management support to leadership via coordination, identification, pursuit and collection of medical records and other required data with other HEDIS staff. - Participates in meetings with vendors related to the medical record collection process. - Some medical records collection related travel may be required. Required Qualifications- At least 1 year customer service experience, preferably in an administrative support capacity in a health care setting, or equivalent combination of relevant education and experience. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements. - Excellent customer service and active listening skills. - Proficiency with data analysis tools (e.g., Excel). - Ability to manage files, schedules and information efficiently. - Ability to effectively interface with staff, clinicians, and leadership. - Strong prioritization skills and detail orientation. - Strong verbal and written communication skills, including professional phone etiquette. - Microsoft Office suite/applicable software program(s) proficiency, and ability to learn new programs. Preferred Qualifications - Registered Health Information Technician (RHIT). - Medical records collection experience. - Managed care experience. - Basic knowledge of Healthcare Effectiveness Data Information Set (HEDIS) and National Committee for Quality Assurance (NCQA). - Project planning experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $21.65 - $31.71 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**Become a part of our caring community and help us put health first** The Senior Digital Forensics and Incident Response Engineer provides forensics technical expertise and investigations support to EIP CyberSecurity defense stakeholders to assist with incident response, remediation, and root-cause identification. The Senior Digital Forensics and Incident Response Engineer 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 Forensics and Incident Response (E-Discovery) supports the ongoing development and improvement of the organization's E-Discovery function. This position is responsible for the operational execution of E-Discovery processes that facilitate legal, compliance, and investigative initiatives. The Senior Digital Forensics and Incident Response Engineer actively assesses and correlates incident data to enable vulnerability identification and provide forensics analysis recommendations for remediation activities. Manages a real-time forensic capability that collects, assesses, and analyzes data correlations and facilitates the creation of reports for EIP leadership consumption that provide in-depth investigative analysis into possible root causes of high-profile incidents within Humana infrastructures and assets. 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. · Assist with the design and implementation of E-Discovery workflows, ensuring processes meet regulatory and organizational best practices. · Provide technical expertise and support the E-Discovery team in daily activities to promote operational excellence and collaboration. · Collaborate with Legal, Compliance, IT Security, and EIP stakeholders to help ensure the integration and efficiency of E-Discovery capabilities. · Contribute to the development and maintenance of documentation, playbooks, and training materials related to E-Discovery procedures and technologies. · Support the evaluation, deployment, and optimization of tools used for electronic data identification, preservation, collection, processing, review, and production. · Monitor E-Discovery activities and prepare reports for management and relevant stakeholders. · Ensure E-Discovery operations adhere to internal policies, legal standards, and data protection regulations. **Use your skills to make an impact** **Required Qualifications:** · Bachelor's degree in Computer Science, Information Security, or related field. · Substantial experience in digital forensics, incident response, and E-Discovery. · Solid understanding of legal and regulatory frameworks relevant to E-Discovery. · Strong technical, analytical, and communication skills. **Preferred Qualifications:** · eDiscovery certifications (Certified E-Discovery Specialist, etc.) · Security certifications (CISSP, CCSP, GIAC, etc 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: 02-02-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**This posting features an increased salary range of $73.80 - $81.20, 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. **Job ID:** 1733856BR **Title:** Pharmacist - Starting at $73.80/hr and Up **Company Indicator:** Walgreens **Employment Type:** Full-time **Job Function:** Retail **Full Store Address:** 525 W ZIA RD,SANTA FE,NM,87505-06910-06346-S **Full District Office Address:** 525 W ZIA RD,SANTA FE,NM,87505-06910-06346-S **External 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 **Shift:** **Store:** 06346-SANTA FE NM **Salary Range:** Pharmacist Hourly Pay Range $61.50-$81.20

Provides lead level support in the execution of merger and acquisition transactions and actively contributes to the advancement of Molina Healthcare's overall growth strategy. Duties include strategically identifying, sourcing, evaluating, and executing Molina Healthcare's inorganic growth initiatives, including acquisitions, divestitures, joint ventures, and strategic partnerships. Collaborates closely with Molina Healthcare's Mergers and Acquisitions (M&A) and operational leadership to evaluate and execute meaningful growth initiatives. **Job Duties** + Partners with internal stakeholders to research and assess potential acquisition opportunities. + Develops financial and valuation models and perform comprehensive analyses to assess potential transaction opportunities and influence decision-making. + Coordinates all aspects of the M&A process, including due diligence, data rooms, transaction documents, internal updates, and senior management/board presentations. + Coordinates deal activities among internal cross-functional teams and external parties. + Embraces ad-hoc assignments and projects across Corporate Development and in support of post-acquisition integration efforts. + Actively participates in reviewing and negotiating transaction agreements. + Establishes a robust understanding of customer segments, industry trends, market positioning, and emerging opportunities. **Required Qualifications** + At least 5 years' experience in investment banking, private equity, management consulting, corporate development, or similar environments, or equivalent combination of relevant education and experience + Exceptional financial modeling, interpersonal, and project management skills. + Attention to detail. Strong work ethic. Proactive self-starter. Calm under pressure. Able to adapt to fast-paced, ambiguous environments. High learning agility. Consummate teammate. + Excellent written communication skills. Strong spoken communication skills. **Preferred Qualifications** + Bachelor's degree in Finance, Economics, Mathematics, or a similar field. + Previous healthcare 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: $88,453 - $206,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Database Developer is responsible for the overall development, maintenance, and integrity of various reporting database. You will be responsible for testing, reviewing SQL queries, stored procedures and facilitating code reviews for improving and maintaining new and existing datasets. You will be required to collaboratively work with other infrastructure and business stakeholders to adhere to data governance and ensure system integrity. **Job Duties** + Responsible for integrity of data as utilized by the department + Develops framework for the automation of data processes across platforms. + Prepares data for use in reporting and business intelligence systems for internal and external stakeholders + Creates policies and procedures documenting the technical and business criteria underlying the use of data by the department + Ensures the propagation of Molina data management process for the department across functional units. This includes the collection of data, the sharing of data, and utilization of data across teams. + Conduct periodic code review + Ensure all database programs meet company and performance requirements + Keep abreast of new technology to keep our platform current + Conduct data analysis, Gap analysis, Root cause analysis and provide recommendations based on findings. **Job Qualifications** **REQUIRED EDUCATION** : Bachelor of Science (BSc) degree in Computer Science or relevant field. 4-5 years working in Data Development in in lieu of degree. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + Minimum of 2 years hands on **experience with SQL and database development, one of the BI analytics tool (Power BI, Tableau etc), MS Azure, Datalake, Databricks** + Minimum 2 years hands on experience using SSIS and SSRS. + Knowledge of software development and application program interface. + Ability to understand users' requirements and a strong problem-solving skillset. **PREFERRED EDUCATION** : Master of Science (MSc) degree in Computer Science or System Analysis. **JOB PROFILE** **PREFERRED EXPERIENCE** : + Minimum of 5 years hands on experience with SQL and database development. + Experience working in a **Medicare environment is highly preferred** . + Experience working with **Python is highly preferred.** 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.

**Become a part of our caring community and help us put health first** The IT Audit Professional 2 develops, directs, plans and evaluates internal audit programs for the organization's information systems and related procedures to ensure compliance with the organization's policies, procedures and standards. The IT Audit Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The IT Internal Auditor 2 audits information system applications to ensure that appropriate controls exist, information produced by the system is accurate, and cybersecurity risks are effectively managed. This role includes evaluating security controls, identifying vulnerabilities, and recommending improvements that strengthen the organization's cyber posture. The IT Audit Professional 2 understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Work assignments are varied and frequently require interpretation and independent determination of appropriate courses of action. Detailed role responsibilities include but are not limited to: + Perform IT audit and cybersecurity‑focused consulting engagements, evaluating application, infrastructure, and cloud environments in accordance with established audit methodology and within budgeted timeframes. + Apply professional IT audit concepts, cybersecurity frameworks (e.g., NIST CSF), and established technologies while consistently using standard audit techniques such as control testing, data analysis, and risk assessment. + Participate in audit planning, providing insights on technology risks, threat vectors, and cyber control design to help shape audit scope, objectives, and testing strategies. + Attend and conduct walkthroughs with Humana business and technology teams, focusing on system architecture, authentication mechanisms, data flows, and security controls. + Identify where IT general controls and application controls are designed and operating effectively, including access management, change management, logging/monitoring, configuration management, and vulnerability management. + Identify control weaknesses, cybersecurity vulnerabilities, misconfigurations, and root causes, and prepare clear, actionable draft audit issues that reflect impact, likelihood, and risk alignment. + Recommend security‑focused improvements and follow through on corrective actions until management remediation plans are verified, ensuring risks are appropriately mitigated. + Collaborate with internal audit team members to align IT audit coverage with enterprise cyber risk priorities and support overall department and company objectives. + Develop communication skills to effectively navigate discussions involving security findings, conflict, or risk acceptance decisions. + Clearly and concisely communicate the results of IT audit and cybersecurity engagements through written reports and presentations to management, translating technical risks into business‑relevant impact. **Use your skills to make an impact** Required Qualifications · Bachelor's degree in related field · At least 2 years of IT audit or consulting experience · Successful track record in facilitating and consulting across teams and managing projects · Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint · Excellent organizational skills and attention to detail · Team-oriented; optimistic attitude · Ability to manage multiple or competing priorities · Excellent communication skills, both oral and written · Implementation and execution skills; critical thinking skills · Aptitude for establishing working relationships with associates within the department and the business · Must be passionate about contributing to an organization focused on continuously improving consumer experiences · Self-starter; ability to work independently Preferred Qualifications · Certifications such as CPA, CIA, CISA, CISSP, PMP, CFE · Advanced degree preferred · Data Analytics / Business Intelligence experience a plus. Prior experience with data analytics tools, including but not limited to, PowerBI, Alteryx, Tableau, SQL, R & Python 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: 04-29-2026 **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 ***************************************************************************

Molina's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: - Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; - Help meet or exceed applicable access criteria and adequacy standards for covered services; - Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and - Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' **Knowledge/Skills/Abilities** - Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. - Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. - Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). - Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. - Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. - Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. - Monitors and reports network adequacy for Medicare and Medicaid services. - Develops strategies to improve EDI/MASS rates. - Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. - Works with assigned national vendors to improve contractual terms and maintain positive relationships. - Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. - Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. - Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). - Helps develop and utilize standardized contract templates and Pay for Performance strategies. - Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. **Job Qualifications** **Required Education** Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. **Required License, Certification, Association** N/A **Preferred Education** Master's Degree **Preferred Experience** 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. **Preferred License, Certification, Association** N/A To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

+ 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. **Job ID:** 1734041BR **Title:** Inventory Specialist **Company Indicator:** Walgreens **Employment Type:** Full-time **Job Function:** Retail **Full Store Address:** 1115 N RIVERSIDE DR,ESPANOLA,NM,87532 **Full District Office Address:** 1115 N RIVERSIDE DR,ESPANOLA,NM,87532-02802-05157-S **External 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 **Shift:** **Store:** 05157-ESPANOLA NM **Pay Type:** Hourly **Start Rate:** 17 **Max Rate:** 20

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. **Job ID:** 1745389BR **Title:** Pharmacy Technician / Pharm Tech Apprenticeship **Company Indicator:** Walgreens **Employment Type:** Part-time **Job Function:** Retail **Full Store Address:** 3298 CERRILLOS RD,SANTA FE,NM,87507 **Full District Office Address:** 3298 CERRILLOS RD,SANTA FE,NM,87507-02925-03934-S **External 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 **Shift:** **Store:** 03934-SANTA FE NM **Pay Type:** Hourly **Start Rate:** 16.5 **Max Rate:** 20