Mount Carmel Health System Remote jobs - 71 jobs

**Become a part of our caring community and help us put health first** The Client Manager is responsible for growing membership within existing accounts and for directly managing business relationships with client accounts. The Client Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. **Job Responsibilities:** + Meets retention and growth objectives for assigned Professional Employer Organizations (PEOs) and Insurtech broker partners. + Acts as a strategic business partner to PEOs/ Insurtech partners for positioning Humana's ancillary solutions to their members, while meeting membership objectives. + Seeks opportunities to execute cross sell strategies by adding new Humana lines of business. + Conducts strategic planning alongside key stakeholders. Work collaboratively with various departments for recommendations to support the client's strategic goals. + Coordinates the renewal process, including the formal Request for Proposal process with internal partners: Underwriting, Corporate Proposal Team, Account Installation, Service, Humana Leadership team. This includes reviewing the proposal; leading the internal strategy call with the proposal team; developing proposal strategy; reviewing proposal responses; developing Executive Summary and timely submission. + Maintains the contractual obligations and reporting requirements, including Performance Guarantees and works with the Humana functional areas to provide the required data. Will also work with the regulatory, compliance and legal departments to complete and execute agreements. + In-depth analysis of reporting to consult clients with benefit and service solutions. + Main group contact for account installation, benefit plan changes, audits and special service requests, working alongside the service and customer service teams to meet client's expectations. + Works closely with dedicated internal teams for assigned clients- On Site representatives, Open Enrollment Hotline, Billing & Enrollment Single Point of Contact, or others to set and meet client expectations. + Represents Humana at community events, associations and industry organizations related to our organizational goals. + Liaison between assigned clients and Humana internal areas for escalated issues requiring special handling. + Leads the Open Enrollment discussion and strategy for assigned clients. Coordinates resources for client Open Enrollment, on site events and activities. + Co-creates custom communications alongside Marketing and the client for materials such as Open Enrollment materials, educational flyers, marketing events and onsite programs + Strong understanding of market dynamics, including competition, trends, influencers and history. **Use your skills to make an impact** **Job Requirements** + Bachelor's degree or equivalent experience + 5+ years' experience managing clients or selling within the Ancillary or Healthcare continuum + Understands the business model and regulatory and procurement requirements of PEOs. + Experience working with Insurtech partners or broker partners. + Consultative selling background and experience + Experience influencing C-suite Executives either directly or through a broker medium + Executive presence + Business and Financial Acumen + Strong communicator- written, verbal and presentation skills + Develops positive, collaborative client relationships + Active life and health license **Additional Information** **WAH Information** To ensure Hybrid Office/Home associates' ability to work effectively, the self-provided internet service of Hybrid Office/Home 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 and computer 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 \# LI-KR1 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. $93,400 - $127,300 per year This job is eligible for a commission 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** The Claims Processing Representative 1 reviews and adjudicates complex or specialty claims, submitted via paper. The Claims Processing Representative 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments. **Where you Come In** The Claims Processing Representative 1 determines whether to return, deny, or pay claims following organizational policies and procedures. Decisions are limited to defined parameters around work expectations, quality standards, priorities and timing, and works under close supervision and/or within established policies/practices and guidelines with minimal opportunity for deviation. **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** **Required Qualifications - What it takes to Succeed** + Proficiency in all Microsoft Office Programs including Word, PowerPoint, Excel, and Access + Experience in a fast paced, metric driven operational setting + Previous experience with coordinating and leading projects and tasks + Demonstrated capability with coaching and developing associates formally and informally + Capacity to maintain confidentiality + Ability to use multiple systems and strong attention to detail + Requires a high level of problem-solving and analytical skills + Ability to manage and prioritize multiple task initiative + Proficient verbal and written communication **Preferred Qualifications** + CAS claims processing experience + CIS pro and CIS experience + Medicare experience + CMS experience **Additional Information - How we Value You** - Benefits starting day 1 of employment - Competitive 401k match - Generous Paid Time Off accrual - Tuition Reimbursement - Parent Leave **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 **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting 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. 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. $39,000 - $49,400 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-28-2026 **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 Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. 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. **Use your skills to make an impact** + Additional Job Description **WORK STYLE:** Remote/work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **WORK HOURS:** Typical business hours are Monday-Friday, 8 hours/day, 5 days/week, scheduled between 6AM-6PM. Some flexibility might be possible, depending on business needs. **Required Qualifications | What it takes to Succeed** - RHIA, RHIT or CCS Certification (should have held at least one of these qualifications for 4 years) - MS-DRG coding/auditing experience - Experience reading and interpreting claims - Experience in performing inpatient coding reviews/ audits in health insurance and/or hospital settings - Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel - Strong attention to detail - Can work independently and determine appropriate course of action - Ability to handle multiple priorities - Capacity to maintain confidentiality - Excellent communication skills both written and verbal **Preferred Qualifications** - Experience in APR DRG coding/auditing - Experience in Financial Recovery - Experience in a fast paced, metric driven operational setting **Additional Information** **Work at Home Requirements** - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-25-2040 **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 Associate Actuary will be a key member of the Enterprise Growth Finance team. The Associate Actuary 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 trends to forecast the organization's short, medium and long-term financial position. The Associate Actuary's 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 will work as part of the Enterprise NPV team under Enterprise Growth Finance. The Associate Actuary ensures data integrity by developing and executing necessary processes and controls around the flow of data and associated modeling. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts drilldown analysis, and develops resolutions for data anomalies. 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. The Associate Actuary will focus primarily on: + LTV/NPV Modeling - Maintenance and enhancement of MA-IND NPV models, and creation of NPV modeling for CenterWell lines of business + Ad Hoc Analysis - Deep-dives into NPV modeling to provide new insights needed for utilization of the model in business situations **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree + Associate of Society of Actuaries (ASA) designation + MAAA + Strong communication skills, with experience in collaborative work across functions + Advanced Excel and SAS/SQL skillset + Must be passionate about contributing to an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Prior Humana MA and/or CenterWell experience + Prior Experience with LTV/NPV modeling + Databricks and Power BI experience **Additional Information** This position can work from home from anywhere in the US. 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: 01-30-2026 **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 Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. **Role Responsibilities** Tasks include, but are not limited to: **70%:** Performing utilization management activities for assigned areas. Ensures full compliance with contract requirements, policies and procedures, and performance standards. Coordinates and implements contingency operations when needed. + Perform accurate and timely initial and ongoing treatment reviews with documentation in MSR reflecting determination of appropriateness of level of care according to established Humana Government Business contractual requirements and guidelines. + Uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, understanding moderately complex to complex issues and policies and procedures to determine the best and most appropriate treatment, care, or services for ACD participants. + Review ABA TPs for policy compliance + Review pend queues for pended authorizations + Approve clinically necessary and appropriate ABA services + Review outcome measures to ensure compliance with ACD policy + Coordinates, conducts outreach, and communicates with providers, beneficiaries, or other parties to facilitate optimal care and treatment, when necessary, to educate and address clinical necessity concerns and ACD policy compliance requirements. + Facilitating communication as needed between all departments within Humana Government Business and Humana corporate to resolve escalated issues and ensure the enterprise understand the function of the ACD team. Understanding and engaging in risk management procedures and analysis. + Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas, as well as need for overtime, weekend, and holiday coverage when necessary to maintain contractual performance standards for referral and authorization processing. **15%:** Collaborate with all Humana operations departments to operate and improve processes related to specialty team(s) effectiveness with the highest degree of attention to beneficiary and provider experience. + Optimize staff productivity surrounding process management. + Strategical look for interventions and methods to improve performance. **10%:** Strategize with all leaders within the ACD team and Specialty team to make recommendations to the DHA or Humana Government Business to improve policy which may relate to better case management outcomes, improved utilization management, prevention or identification of fraud waste and abuse, and trend data. **5%:** Other tasks as assigned **Use your skills to make an impact** **Required Qualifications** + Our Department of Defense Contract requires U.S. citizenship for this position + Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services) + HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico. + BCBA (Board Certified Behavior Analyst) Certification + 3 or more years of experience as a Board-Certified Behavior Analyst + 3 or more years of applied behavioral analysis (ABA) with ASD (Autism Spectrum Disorder) experience + Proficiency in Microsoft Office programs specifically Word, Excel, and Outlook + Ability to handle multiple projects simultaneously and to prioritize appropriately **Required Work Schedule** + Training is mandatory for the first 4 - 6 weeks from 8:00 AM - 5:00 PM Eastern time, Monday - Friday. + Following training, must be able to work an 8-hour shift between the hours of 8:00 AM - 6:00 PM Eastern time, Monday - Friday. + Overtime, weekends, and holidays may be required, based on business needs. **Preferred Qualifications** + Prior experience with the TRICARE Autism Care Demonstration + Knowledge of and experience with applied behavior analysis and integrated care needs for those with autism + Prior experience with Utilization Review, Utilization Management, Peer Reviews and/or Quality Management + Knowledge of CPT codes that apply to ABA and/or experience with DMS-5 criteria + Prior experience with outcome measure assessments to include PDDBI, Vineland, SRS and/or PSI-SIPA + Experience with interpreting medical policy + Direct or indirect military experience a plus **Work at Home Guidance** 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 and Wireless Internet service is NOT allowed for this role** + 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. 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. **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 Senior Payment Integrity Professional - Inpatient Coding Disputes on the Disputes Team consults and collaborates with coding professionals across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance and quality. + Will be a SME (Subject Matter Expert) medical coder with in-depth experience in inpatient coding audits (MSDRG/APDRG) + Contributes to overall accuracy and compliance of coding disputes reviews ensuring that all appropriate coding guidelines are adhered to and will be able to speak to inpatient coding review outcomes to a variety of audiences + Leverages advanced auditing expertise to guide onshore and offshore DRG coding disputes auditors, reviews disputes escalations and clarification requests + Manages multiple priorities, collaborates across teams, and ensures timely, accurate inventory management In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits + Health Savings Accounts + Flex Spending Accounts + Life Insurance + 401(k) + PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time + And more **Use your skills to make an impact** **Required Qualifications** + 5+ years holding **one** of these Coding Credentials from AHIMA: **CCS/** **RHIT/ RHIA** + 5+ years' work experience reading and interpreting claims + 2+ years verifiable experience in MSDRG disputes/audits + Comprehensive knowledge of Microsoft Office Programs Word, PowerPoint, and Excel + Excellent communication skills both written and verbal + High level of productivity with the ability to turn-around requests quickly and effectively + Strong attention to detail **Preferred Qualifications** + 2+ years of verifiable SME and/or leadership experience within the last few years in provider/payer inpatient auditing + Verifiable experience working with and supporting onshore and offshore MSDRG vendors/ staff + Experience leading people, projects, and/or processes + Experience in Financial Recovery + Experience in a fast paced, metric driven operational setting **Additional Information** Work at Home/Remote Requirements **Work-At-Home Requirements** + To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate. + Wireless, Wired Cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.) + Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Our Hiring Process** As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging, and/or Video Interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone or computer. You should anticipate this interview to take approximately 10-15 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. \#LI-LM1 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $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: 01-30-2026 **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** Are you ready to make a tangible impact at the intersection of technology and business operations? In this pivotal role, you'll work with talented teams and serve as the technical liaison for BPO operations, influencing Major Incident, Problem, and Change Management functions across the organization. Your expertise will be valued as you collaborate with technical and non-technical stakeholders, drive resolution of moderately complex issues, and help minimize business disruption. This is your opportunity to showcase advanced skills in networking, telecom, and application support while building lasting partnerships across internal and external teams. Join us and shape the future of operational excellence through your leadership and technical acumen. The Senior Technology Leadership Professional works with internal and external technical stakeholders to expedite restoration of major incidents, conduct problem reviews, and oversee change reviews. Works with a team to ensure timely and efficient operational activities. Provides technical guidance and makes decisions to resolve moderately complex issues. Advises leaders on technical trends and operational improvements to reduce IUMs. Exercises independent judgment requiring analysis of variable factors and determining best courses of action under minimal supervision. + **Required Qualifications** + 5 or more years of technical experience + Experience managing major incident outage bridges + Strong technical knowledge across networking, telecom, and application support + Ability to manage multiple priorities and deadlines with attention to detail + Proven ability to communicate effectively + Experience producing metrics, measurements, and trend reports + Passion for driving continuous improvement in consumer experience + **Preferred Qualifications** + Bachelor's degree or higher + Demonstrated ability in large-scale, highly visible programs + Solid understanding of operations, technology, and processes + ITIL certification + Six Sigma certification **Use your skills to make an impact** **Why Humana?** **You'll experience the following perks as a full-time Humana employee:** Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: + Health benefits effective day 1 + Paid time off, holidays, volunteer time and jury duty pay + Recognition pay + 401(k) retirement savings plan with employer match + Tuition assistance + Scholarships for eligible dependents + Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development opportunities **Interview Format:** As part of our hiring process for this opportunity, we will be 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. **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees 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 employees 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. \#LI-Remote **Social Security Task** Humana values personal identity protection. Please be aware that applicants 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. 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 ***************************************************************************

**Become a part of our caring community and help us put health first** Be part of Medicaid's D-SNP Center of Excellence. This role is responsible for supporting Quality and Stars within Medicaid DSNP markets, serving as a subject matter expert for Stars-related initiatives, and ensuring their effective activation and integration throughout the Insurance Operations organization. This role will be focusing on advancing quality outcomes and access. Medicaid DSNP Operations encompasses critical functions including care coordination, quality measurement, billing, claims processing, and customer service, each essential to delivering a comprehensive and high-quality member experience. In this role, you will identify and engage with Quality and Stars-related initiatives within Medicaid DSNP markets to understand the business strategy, scope, and goals, building a working knowledge to inform identification and validation of potential synergies, business-specific requirements, risks, and integration paths. This role will manage relationships and builds trust with key enterprise partners critical for integrated D-SNP; gaining alignment on cross-asset integration opportunities, identify and implement new initiatives. Scales best practices and creates standardization opportunities across integrated states. In addition, this role will support the optimization of Stars measures and initiatives that impact integrated D-SNPs; identifying gaps and opportunities for greater collaboration across Medicaid and Medicare segments. This role requires a deep understanding of operations and how it connects with enterprise Stars governance and initiatives. **Role Responsibilities:** + Oversight of related budget, vendor relationships, and program/ project management + Serve as the primary liaison for Stars initiatives within Medicaid D-SNP, building deep operational knowledge of core functional areas (care coordination, quality, billing, claims, and customer service). + Supports prioritization and resolution of market issues working across Medicare and Medicaid market teams and Medicare and Medicaid centralized services + Be the primary business partner with Medicare Stars organization to identify, understand, and align Stars-related business strategies, objectives, and operational requirements to drive D SNP member experience. + Enhances and aligns data sharing processes between Medicare and Medicaid Evaluate business processes across Insurance Operations to identify synergies, integration opportunities, and operational risks related to Stars performance and compliance. + Scales best practices and creates standardization opportunities across integrated states + Coordinate with analytics and reporting teams to generate actionable insights, enabling data-driven prioritization of operational improvements that directly impact Stars measures. + Advances integrated care-team approaches across Medicare and Medicaid + Partner with segment and enterprise Stars leaders to advance cross-functional initiatives, ensuring alignment between operational execution and Stars strategy. + Maintain a comprehensive inventory of Stars initiatives within Insurance Operations, identifying gaps and facilitating collaboration to maximize impact across all operational areas. + Lead and support the design, implementation, and optimization of Stars-related programs and processes within Insurance Operations, including performance monitoring and continuous improvement. + Oversee test-and-learn pilots to validate solutions and measure operational effectiveness, using results to inform broader implementation. + Develop and deliver regular reports on Stars operational performance to executive leadership, providing clear visibility into progress, challenges, and opportunities. + Manage budgets, vendor relationships, and project plans to support the successful delivery of Stars-focused operational initiatives. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + 5 + years of quality improvement, developing & advancing enterprise strategy, insurance operations experience, i.e.: claims, UM, CM, call center, enrollment, etc. + 3+ years of CMS Stars program experience + Previous leadership experience as a people leader, leading through influence, or leading complex projects with engagement from multiple areas of the company + Demonstrated track record of ability to tell the story, influence leaders and drive improvement activity in a matrixed organization + Strong executive presence + Ability to navigate business intelligence tools to review data insights & making data driven decisions + Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint **Preferred Qualifications** + D-SNP experience + Medicaid and MLTSS experience **Additional Information** This position is open to working remote with a preference in KY, FL, IL, WI, IN, VA and/or MI **Work at Home Guidance** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees 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. Employees 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 employees 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 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. 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. $138,900 - $191,000 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: 02-05-2026 **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 ***************************************************************************

**Become a part of our caring community and help us put health first** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors. **Location:** **Remote - United States** **Schedule: This is a VSP (Variable Service Provider) role. The hours will vary between 24-40 hours per week.** **The s** **hift for training will be 10:00AM-630PM ET.** **After training, a shift of either 11:00AM-730PM ET, 12:00PM-830PM, or 1:00PM-930PM will be assigned based on business need.** **Some weekend coverage may be required. Mandatory overtime during peak season.** **Job Description:** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical professional responsible for conducting comprehensive reviews of medication care plans. This includes evaluating medical necessity, analyzing overall utilization, and identifying unusual usage patterns. The pharmacist may intervene and provide clinical guidance to patients and providers to support cost-effective medication use and promote high-quality patient outcomes. **Use your skills to make an impact** **Required Qualifications:** + **Bachelor's degree or Doctor of Pharmacy (Pharm.D.) from an accredited college of pharmacy** + Active pharmacist license in the state of residence + Eligibility to participate in federal prescription programs (e.g., Medicare/Medicaid) + Self-directed with the ability to work effectively both independently and in a team environment + Strong problem-solving skills and the ability to foster collaborative solutions + High attention to detail with a strong work ethic focused on accuracy and productivity + Excellent verbal and written communication skills + Proficiency with computer systems, including but not limited to: + Microsoft Office Suite (Word, Excel, Outlook) + Clinical decision support tools (e.g., Micromedex, Lexicomp) + Pharmacy benefit management (PBM) platforms + Electronic health records (EHRs) + Passion for contributing to an organization focused on continuously improving the consumer experience **Preferred Qualifications:** + Experience in managed care pharmacy, particularly in utilization management review **Interview Format** : As part of our hiring process for this opportunity, we will be 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. **WAH Requirements:** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees 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 Employees 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 employees 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. **SSN Statement:** Humana values personal identity protection. Please be aware that applicants 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. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 1 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $104,000 - $143,000 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. Application Deadline: 01-30-2026 **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** TThe Senior Financial Planning and Analysis Professional collects, compiles and is responsible for analyzing multiple sources of data to identify emerging trends or gaps in expectations of the financial performance for the WI Medicaid segment. Analyses will help define efforts to mitigate claims costs or optimize top line revenue, working in partnership with key functional areas such as clinical, provider development, and operations. The Senior Financial Planning and Analysis Professional work assignments involve moderately complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. This work may involve financial modeling and reporting and may support inputs used in the financial budget and forecasting models. Begins to influence department's strategy. Makes decisions on moderately complex issues regarding technical approach for project components, and work is performed with minimal direction. Exercises considerable latitude in determining objectives and approaches to assignments. **Use your skills to make an impact** **Required Qualifications** + Bachelor's Degree in Finance, Accounting or a related field + 5 or more years experience in finance/accounting or related field + Comprehensive knowledge of all Microsoft Office applications, and Access, SQL, and multi-dimensional databases + Ability to manage multiple priorities + Experience with financial analysis + Strong analytic skills with attention to details + Excellent oral and written communication skills + Must be passionate about contributing to an organization focused on continuously improving consumer experiences and growth in the market **Preferred Qualifications** + Master's Degree in Business Administration or a related field + Previous health insurance industry experience + Experience with SAS or other relational databases + Experience working with large data sets + Medicaid or Medicare experience **Additional Information** Interview Format As part of our hiring process for this opportunity, we will be 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. WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees 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 employees 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. 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. $86,300 - $118,700 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: 01-30-2026 **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 Innovation Portfolio Strategy Advisor reports to a Behavioral Health portfolio director and drives the product lifecycle for assigned products within that portfolio. This position is responsible for executing the product strategy developed by the portfolio director by translating strategy into actual product delivery. The Portfolio Strategy Advisor works actively across business units to form colleague teams that can support overall design and delivery of a product, sets prioritization, maintains alignment of effort, and ultimately owns successful delivery. The Innovation Portfolio Strategy Advisor works to execute the Product strategy set forward by the Portfolio Director. In this role, an individual will take the high-level strategic vision and formulate the tactics necessary to take the vision from ideation to reality. This individual will own multiple products at a given time and ensure that the work steps necessary for final execution are being properly defined and delivered by the product team, some of whom may be direct reports and others positioned in various business units within the enterprise. This position works to identify the resources required throughout the product lifecycle, barriers that need to be removed, guidance that may be needed by the product team to adhere to timelines, stakeholder interface at various levels of authority, customer interface to ensure the product will meet the ultimate need set forth and is open and available to feedback. This role is guided by data, both during the development phase, and following implementation, sharing outcomes transparently with leadership. **Key Responsibilities** + Hire, train, and build a product build team that may include direct reports and non-directs + Carefully understand the product vision needed for each assigned product + Work with the portfolio director to translate the vision into clear, defined steps within the overall product lifecycle + Drive delivery of the product, ensuring timely delivery, accuracy, and quality + Assess the outcomes of the product along financial, operational, quality, and customer satisfaction dimensions + Demonstrate professionalism, collaboration, drive a positive brand image + Demonstrate clear and impactful oral and written communication **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree + 3 years of experience working in a healthcare environment + Product-led model expertise and experience + Ability to manage individuals and teams to deliver high quality, timely outcomes + Adept at interpreting data and translating it into opportunities + Proven organization, planning, and prioritization skills to collaborate with multiple internal stakeholders concurrently + Communicates with clarity and professionalism across both written and verbal channels + Independently driven with strong urgency of execution **Preferred Qualifications** + Master's degree in mental health field or RN with background in psychiatric nursing + Product certification and/or LEAN or Six Sigma certification **Additional Information** **Work-At-Home Requirements** + WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. + A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Interview Format** As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice 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. 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: 02-27-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**Explore opportunities with CPS,** part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind **Caring. Connecting. Growing together.** As a 340B Solutions, Specialist you will provide 340B Drug Pricing Program technical and analytical support to the 340B Solutions division of CPS and all clients. Assist the 340B Solutions team performing administrative tasks related to current CPS 340B agreements, consulting engagements, and prospective clients. Provide support functions to the Analysts, Managers, Directors and President of the 340B Solutions team. Regularly communicate with all staff involved with the 340B Solutions services to be sure that processes remain efficient and to address any problems or suggestions for improvement. Travels to and performs work at client sites up to 10% of work time. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. **Primary Responsibilities:** + Work alongside 340B Solutions Analysts, Managers and Directors to assist with the day to day operations of the team + Perform claim review and capture for 340B Referral Capture clients + Assist with generation of reports and invoices for referral capture services + Performs review of key elements as part of the Audit and Remote Monitoring service, such as review of clients' 340B registration, Medicaid Exclusion File, and policies and procedures + Work with 340B business development team to generate sales proformas + Perform routine maintenance related to the upkeep of the 340B Solutions SharePoint site, such as removing and deleting PHI, reviewing for expired documents, identifying SOP documents that require updates, and setting up folder structure for new clients + Analyze 340B/WAC/GPO/orphan drug purchasing transactions to optimize program savings + Manage the compilation and distribution of 340B Solutions publications such as the Newsletter and Newsflash articles You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + High School Diploma or equivalent + Experience with 340B Drug Pricing Program and pharmacy purchasing activities + Experience with Pharmaceutical purchasing/inventory control procedures + Familiarity with general pharmacy operations and processes **Preferred Qualifications:** + 3+ years of experience as a Pharmacy Technician + Experience as 340B Coordinator or Buyer + Expertise in other areas of pharmacy practice or management *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 to $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

**Become a part of our caring community and help us put health first** The Lead, Technical Product Owner requires someone known for creative problem solving. This role solves complex business problems and issues using data and custom software from internal and external sources. The role works on problems of diverse scope and complexity ranging from moderate to substantial. It is responsible for leading, defining and delivering on the roadmap of multiple data and business application products. This role bridges product ownership, data and software engineering, and regulatory healthcare data requirements, ensuring that data ingestion, transformation, and delivery are optimized for quality measurement, reporting, and compliance with CMS standards. We are seeking an individual with a growth mindset, who is a highly experienced Technical Product Owner to drive the development of data products specifically related to CMS Stars and HEDIS quality measures. The ideal candidate has deep expertise in Stars/HEDIS data, regulatory requirements, and agile product development, and 3 tier software development and technical support for critical systems. In this role, you will teach and collaborate with business stakeholders, data engineers, and IT teams to translate complex requirements into actionable product features that support quality measurement, reporting, and compliance. **Key responsibilities:** + **Technology strategy and roadmap of Business and Data Products:** Define and maintain the vision, strategy, and roadmap for data products that enable CMS Stars and HEDIS reporting. Ensure alignment with enterprise goals and departmental priorities. + **Backlog management:** Own, groom, and prioritize the product backlog for one or more agile teams, ensuring it reflects business needs, regulatory changes, and technical dependencies. + **Requirements translation:** Elicit detailed requirements from stakeholders (e.g., business, compliance, and analytics) and translate them into clear user stories with defined acceptance criteria for development teams. + **Cross-functional collaboration:** Act as the primary liaison between business stakeholders and technical teams. Facilitate communication and alignment across data engineering, analytics, compliance, and QA teams. + **Technical guidance:** Work closely with data architects and engineers to design and validate data flows, mappings, and transformations. Provide guidance to ensure technical solutions are feasible and aligned with the product vision. + **Data quality and compliance:** Collaborate with governance teams to establish data quality benchmarks and implement testing protocols. Ensure data products adhere to CMS mandates and NCQA standards. + **Technical debt management:** Advocate for the resolution of technical debt and architectural improvements, balancing short-term feature delivery with long-term product sustainability. + **Stay current:** Monitor evolving CMS, NCQA, and HEDIS requirements and coordinate necessary updates in response to specification changes. + **Travel for this role is quarterly** **Use your skills to make an impact** **Role Essentials** + Bachelor's degree + 8 or more years of experience in data flow & analysis and software application building & enhancements + 2 or more years of project leadership experience + Strong experience with healthcare data, particularly clinical and claims data used in **HEDIS measurement** + Familiarity with **CMS Stars programs** , NCQA standards, and quality performance metrics. + Advanced experience working with big and complex data sets within large organizations + Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction + 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 + Proficiency in verbal/written communication to senior and executive leadership **Role Desirables** + Advanced Degree in a quantitative discipline, such as Mathematics, Economics, + Finance, Statistics, Computer Science, Engineering or related field + Knowledge of NCQA, CMS, and health plan quality measurement programs. + Deep understanding of healthcare interoperability standards (e.g., HL7, FHIR, X12). + Advanced in SQL, SAS and other data systems + Expertise in data mining, forecasting, simulation, and/or predictive modeling + Experience creating analytics solutions for various healthcare sectors **Additional Information** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees 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 employees 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. As part of our hiring process for this opportunity, we will be 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 you. Humana values personal identity protection. Please be aware that applicants 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. 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: 02-26-2026 **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 ***************************************************************************

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** Looking for a chance to drive measurable and meaningful improvement in the use of evidence-based medicine, patient safety, practice variation and affordability? You can make a difference at UnitedHealth Group and our family of businesses in serving our Medicare, Medicaid and commercial members and plan sponsors. Be part of changing the way health care is delivered while working with a Fortune 6 industry leader. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Work to improve quality and promote evidence-based medicine + Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement + Support initiatives that enhance quality throughout our national network + Ensure the right service is provided at the right time for each member + Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review + Success in this technology-heavy role requires exceptional leadership skills, the knowledge and confidence to make autonomous decisions and an ability to thrive in a production-driven setting You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications** + MD or DO degree + Active, unrestricted physician state license + Current board certification in ABMS or AOA specialty in Oncology or Radiation Oncology + 5+ years of clinical practice experience post residency + Solid understanding of and concurrence with evidence-based medicine (EBM) and managed care principles **Preferred Qualifications** + Hands-on utilization and/or quality management experience + Project management or active project participation experience + Substantial experience in using electronic clinical systems *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $269,500 to $425,500 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start **Caring. Connecting. Growing together** The RN Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting members' medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. This is a home-office based position with field responsibilities. You will spend approximately 50% to 75% of the time in the field within an assigned coverage area. Candidates must be in Franklin County, OH and willing to commute to surrounding counties. If you reside in Franklin County, OH or surrounding counties, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs + Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines + Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan + Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health + Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission + Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current, unrestricted independent licensure as a Registered Nurse in Ohio + 2+ years of clinical experience as an RN + 1+ years of experience with MS Office, including Word, Excel, and Outlook + Reliable transportation and the ability to travel up to 75% within Franklin County, OH and surrounding counties in OH to meet with members and providers + Reside in Franklin County, OH and surrounding counties **Preferred Qualifications:** + BSN, Master's Degree or Higher in Clinical Field + CCM certification + 1+ years of community case management experience coordinating care for individuals with complex needs + Experience working in team-based care + Background in Managed Care *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

**Become a part of our caring community and help us put health first** The Senior Database Engineer leads important projects in design, development, implementation and management of databases. The Senior Database 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 Database Engineer** develops database architectures to address business requirements, ensuring system scalability, security, performance and reliability. Designs database applications such as interfaces, data transfer mechanisms and data partitions to enable efficient access of the generic database structure. Creates plans for architecture updates and integrates new systems with existing warehouse structure to refine performance/functionality. Generally has in-depth knowledge and expertise of database technologies, along with solid programming, design and system analysis skills. 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** cription **Required Qualifications** + 3 years of technical experience with a primary focus on ETL + Comprehensive knowledge of applications including SSIS and/or SSMS + Advanced knowledge and experience with SQL and/or Python/PySpark + Technical proficiency with Databricks and/or a Databricks Certification + Experience designing, developing, and testing of software applications and/or infrastructure + Demonstrated ability to communicate technical information to non-technical professionals + Proven experience with consulting with and building relationships with business partners + Self-starter that can work independently with minimal direction and takes ownership and anticipates future consequences and trends accurately + Critical thinker who can anticipate team needs and take initiative to present ideas, ask the right questions and deliver the highest quality work **Preferred Qualifications** + Experience with Azure and/or other cloud reporting systems or experience in Cloud design + Experience in the development of interactive reports using Power BI and/or similar product **Additional Information** **Work Style** : Remote **HireVue Statement** : As part of our hiring process for this opportunity, we will be using an exciting 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. **Work at Home/Remote Requirements** To ensure Hybrid Office/Home associates' ability to work effectively, the self-provided internet service of Hybrid Office/Home 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 and computer 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 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 ***************************************************************************

Physician Pathways: Prepare for Day One at your practice up to one year in advance of completing your resident of fellowship program. As a Pathways Physician, you'll receive a salary, mentoring, and various other learning experiences focused on preparing for your career with the Optum American Health Network with minimal impact on your Resident training time. Interested in learning more about Value Based Care before day one? Getting to know your peers? Ease the stress of your transition to physician provider with an unparalleled head start "virtually" Optum American Health Network Primary Care Physicians -- Ohio Pathways For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. As a part of the Optum network, American Health Network is seeking career-minded Family Medicine or Internal Medicine residents who want to jump start their clinical career. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Position Highlights: * Receive a generous guaranteed salary in your final year of training * Enhance the experience of your final months of training and eliminate the burden of job searching; employment is guaranteed at the completion of your residency * Learn how to practice and thrive in a value-based care model * Gain exposure to the Quadruple Aim framework and various understandings of care settings * Receive mentorship from experienced physicians within your future practice, easing your transition from training into practice * The customized program will be completed at American Health Network facilities in Indiana, or Ohio, and virtually * The program requires a commitment of only a few hours per month What makes Optum different? * Providers are supported to practice at the peak for their license * As one of the most dynamic and progressive health care organizations in the country, Optum consistently delivers clinical outcomes that meet or exceed national standards * We promote a culture of clinical innovation and transformation * We are a top performer nationally of the Quadruple Aim initiative * We are influencing change on a national scale while still maintaining the culture and community or our local organizations You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Key Takeaways: * Optum fosters a collaborative culture focused on growth, innovation and mutually uplifting one another, enabling deep physician satisfaction * Tailored development programs like Physician Pathways smooth the transition from training to practice with expert mentorship * Physicians praise the supportive environment facilitating work-life balance, strong patient connections, and the ability to push care delivery boundaries Required Qualifications: * M.D. or D.O. * Must be transitioning into your final year of residency or fellowship Preferred Qualification: * Preferred candidate will be a local physician resident in Ohio--open to other areas as well Would you thrive with Optum? * Do you strive to practice evidence-based medicine? * Are you seeking a practice focused on patient-centered quality care, not volume? * Are you a team player - comfortable delegating and empowering teams? * Are you constantly seeking better ways to do things? * Do you want to be part of something better? About Optum: At Optum, we've found that putting clinicians at the center of care is the best way to improve lives. Our physician-led organization is one of the most dynamic and progressive health care organizations in the world, serving almost 130 million people through more than 78,000 aligned physicians and advanced practice clinicians. You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality outcomes and driving change through collaboration and innovation. Learn more at ************************************ * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Explore opportunities with CPS, part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind Caring. Connecting. Growing together. As a Senior Corporate Director of Pharmacy with CPS Solutions, LLC Advance Team, you will be deployed as needed to client sites located across the U.S., traveling 100% of the time to work. At the client site you act as a temporary Director of Pharmacy or Consultant in new and existing accounts and are primarily responsible to plan, organize, control and supervise operation activities in a pharmacy practice setting according to facility policies, standards of practice of the profession, and state and federal laws in hospitals with 250-500 licensed beds. Additionally, but not limited to, you will have the opportunity to be an integral team member with implementation of new contracts; performing Pre-Joint Commission and Joint Commission visits on current accounts; helping staff current accounts; putting into practice operational pharmacy improvements and working on special projects. You will be responsible for all aspects of operations, including assisting in recruitment and hiring of personnel; evaluating that all legal, accreditation, and certification requirements are being met; ensuring provision of optimal services; and working with Regional Directors, Directors of Pharmacy, and other hospital personnel to enhance performance of the pharmacy. In addition, you will be expected to work independently and handle challenges appropriately, work cooperatively with other members of Comprehensive Pharmacy Services, hospital and pharmacy staff, handle multiple tasks and adapt to changes in workload and work schedule, set priorities, make critical decisions, and respond to client concerns, foster a team environment by providing orientation and training to Directors of Pharmacy and pharmacy staff, communicate effectively (verbal and written) and demonstrate excellent customer service skills. In this role, you will have a full support team available to you-from a Regional VP, Regional Clinical Director, and 340B Specialist to a Regulatory Specialist, Drug Information Specialist, and more. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * B.S. or PharmD from an ACPE-accredited School of Pharmacy * Obtain/maintain 12+ different state Pharmacy licenses in CPS recommended states * 5+ years of recent hospital pharmacy management experience plus 3+ years hospital Pharmacist experience * Experience working at a Pharmacy Director level at hospitals with 250-500 beds in size * Proficiency with using computer applications including word processing, spreadsheets and pharmacy information systems * Ability to pass company Motor Vehicle (MVR) background check * Ability to travel 100% of working hours, typically 5 days on 2 off with flexibility for a 10 days on 4 off schedule when needed * Ability to travel at 24 hour notice Hospital Requirements: (may be required): * (PPD) TB Skin Test - Proof of negative TB skin test within the last 12 months * (MMR) Measles, Mumps and Rubella or A Blood Titer proving immunity * Varicella - (2) documented doses or A Blood Titer proving * Hep B3 Series (or declination) * (Flu) Influenza-required for hire between Oct 1st-April 30th * COVID Vaccine-Full (required) * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

**Become a part of our caring community and help us put health first** The Senior Application Architect at Humana designs and develops IT architecture solutions that address complex business challenges, ensuring alignment with Humana's enterprise technology standards. This role delivers application modernization, secure automation, and the adoption of reusable architectures. The architect collaborates with enterprise teams to advance security, operational excellence, and cost beneficial solutions across the organization. We are hiring an Application Architect to support solution design and delivery specifically for Humana's corporate Legal technology demands. You will partner with the Lead Application Architect to design modern, secure, scalable applications and guide engineering teams through implementation. **Key Responsibilities** - Design end-to-end application architectures (UI, API, data, integrations, security). - Create architecture diagrams, design docs, and reusable patterns for cloud, SaaS, AI, and legacy modernization. - Provide technical leadership to development teams; conduct design and code reviews. - Ensure all solutions follow enterprise standards for security, scalability, and resiliency. - Support projects across the SDLC and collaborate with DevOps, Security, Cloud, and Data teams. - Participate in POCs and technology evaluations. - Coordinate issue resolution with production support team(s). **Why Join** - Work closely with the Lead Application Architect on high-impact, cross-functional projects; substantial exposure to AI development and other innovative automation **Use your skills to make an impact** **Required Qualifications** - 6+ years in application development, 2+ years in architecture or technical design. - Strong experience with modern stacks (React/Angular, .NET/Java/Python/Node). - Knowledge of Azure cloud services, containers, APIs, and CI/CD. - Understanding of IAM (Azure AD) and secret management (HashiCorp Vault). - Strong communication and documentation skills. **Preferred Skills** - Experience with AI/ML-enabled apps, RAG, or automation platforms. - Experience with cloud migrations, legacy modernization, and event-driven architectures. - Exposure to enterprise domains like Compliance, HR, Finance, Legal, or Risk. **Additional Information** **Work-At-Home Requirements** + WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. + A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $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: 02-19-2026 **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 ***************************************************************************