Humana

  • Louisville, KY, USA
Jan 14, 2022
Humana Atlanta, GA, United States
Job Description The Provider Engagement Executive represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. Required Qualifications Bachelor's Degree Experience with end to end Strategic Provider Relationship Management 8 or more years of Health care or managed...
Apr 27, 2021
Humana Montpelier, VT 05602, USA
**Description**The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.**Responsibilities****Develop and Own Key Component of Humana's Trend Analytics Process****Goal:** Leverage Actuarial Methods, business acumen, and modern technology to predict and communicate future unit price. Collaborate with key stakeholders across the organization.+ Increase accuracy+ Automate Inputs for Hospital, Physician, and...
Apr 27, 2021
Humana Sandy, UT, USA
DescriptionThe Credentialing Assistant 3 obtains and reviews documentation to determine status in a health plan. The Credentialing Assistant 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.ResponsibilitiesThe Credentialing Assistant 3 reviews the applicant's education, training, clinical privileges, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence. Reviews the information and documentation collected, as well as verification that the information is accurate and complete. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and...
Apr 27, 2021
Humana Montpelier, VT 05602, USA
**Description**The Lead for CRM & Contact Center Technology is responsible for defining comprehensive solution roadmap for the Sales CRM and other technologies leveraged by the MarketPoint Contact Centers. This position would partner in the development of CRM use cases for implementation and integration with Humana enterprise solutions as well as serve in cross-departmental workgroups interacting with other departments such as legal, privacy, compliance and marketing. The lead would be responsible facilitating and support complex design discussions with both business and IT partners. This position would be key in our transition to the SAFe Agile Methodology through supporting work intake documenting a standard intake process and as well as support the implementation across work streams.How we Value YouBenefits starting day 1 of employmentCompetitive 401k matchGenerous Paid Time Off accrualTuition ReimbursementParent LeaveGo365 perks for well-being**Responsibilities**The CRM and...
Apr 27, 2021
Humana Atlanta, GA, USA
**Description**The Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Director, Problem, Incident and Event Management requires an in-depth understanding of how organization capabilities interrelate across the function or segment.**Responsibilities**Humana is seeking an experienced professional to lead a critical user acceptance testing and production support team with broad impact and scope across Humana Pharmacy, Clinical Operations, and ECOM. This position will work and collaborate with leaders across the Humana enterprise, Segment CIOs, and also with vendor partners.This position develops and executes the technical strategy and execution of manual and automated user acceptance testing and first line production support teams for the Salesforce Healthcloud application and all interfacing Clinical and Pharmacy applications. The automated and...
Apr 27, 2021
Humana Troy, MI, USA
**Description**The Senior Technology Implementation Professional delivers new technological solutions to meet business needs within a specified scope while aligned to enterprise objectives. The Senior Technology Implementation Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.**Responsibilities**The Senior Technology Implementation Professional gathers and documents business system and functional requirements, influences system design to optimize support and ensures solutions meet the business objectives and requirements. Completes and/or coordinates implementation of design and requirements, testing, operational readiness, and transition to the appropriate production support team. 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...
Apr 27, 2021
Humana Fargo, ND, USA
**Description**The Director, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives. The Director, Technology Solutions requires an in-depth understanding of how organization capabilities interrelate across the function or segment.**Responsibilities**The Director, Technology Solutions acts as a liaison and collaborates with the business and functional stakeholders to identify and deliver strategic enablement solutions. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.We're looking for someone to lead the delivery of our futuristic Member Administration and Enrollment platform for all of our Insurance products including Medicare, Medicaid and Commercial Group. To enable our...
Apr 27, 2021
Humana Albuquerque, NM, USA
**Description**The Actuary, Pricing is responsible for setting pricing assumptions, submitting bids, filing and gaining approval of premium rates and rate certifications with regulatory agencies. Supports implementation of rates, new plans and benefit changes. Provides guidance to Product Development on new product/benefit cost impacts. Develops and maintains pricing tools that price standard and custom benefits. The Actuary, Pricing works on problems of diverse scope and complexity ranging from moderate to substantial.**Responsibilities**The Actuary, Pricing establishes market level financial metrics to align with segment profitability goals, analyzes market level results and projections and develops recommended pricing actions to address gaps to targeted metrics. Leverages market level projections and experience data tools to research root cause and capture insights. Researches and understands competitors in marketplace and collaborates with sales and other partners supporting the...
Apr 27, 2021
Humana Bridgeport, CT, USA
**Description**The Senior Compensation Professional develops, implements, and administers compensation programs. The Senior Compensation Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.**Responsibilities**As a Senior Compensation Professional, you will guide and assist the incentive compensation, and rewards plan design, implementation and assessment process as part of the Incentive Compensation team. The successful candidate will utilize best practices in working with the Design Compensation Lead to create and implement incentive plans that drive results and help Humana attract and retain key talent in a number of roles within Humana aligned to incentive plans. This role will have responsibility to support plan governance by developing quarterly analytics and reports for business leaders .+ Lead the design of sales incentive plans to ensure competitiveness, equity...
Apr 27, 2021
Humana Tulsa, OK, USA
**Description**This position will report to the VP of Specialty Pharmacy within Humana Pharmacy Solutions. It will lead a team of approximately 60 sales associates- leaders, field sales agents, and telephonic sales agents.**Responsibilities**The _Market VP, Specialty Sales_ is a key role in enabling HPS's Specialty Pharmacy growth strategy. This executive leader will leverage targeted geographic analysis and develop strategies to engage with Physician offices to influence physicians to route patients' prescriptions to Humana Pharmacy for fulfillment. The _Market VP, Specialty Sales_ requires an in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide. This leader will develop Sales Strategy, organize supportive resources, and focus on sales incentives to ensure annual sales targets are met. This leader also is responsible for retaining and growing a team that is capable of educating providers and their staff on HPS benefits, to...
Apr 27, 2021
Humana Louisville, KY, USA
**Description**The Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.**Responsibilities****Location:** work at home anywhereHumana's Enterprise Clinical Management (ECM) team needs your business, healthcare and research acumen to solve for the healthcare challenges of today. The Clinical Analytics and Trend team uses advanced analytic techniques, and clinical acumen to identify clinical opportunities to improve health outcomes and improve the value of care for our members. In this exciting start-up environment, you'll have the opportunity to support trend investigation processes from the ground up, while working collaboratively with clinicians, data-scientists, actuaries and...
Apr 27, 2021
Humana Portland, ME, USA
**Description**The Clinical Trend and Analytics team leverages advanced scientific techniques, forecasting, and machine learning to predict financial and clinical outcomes in order to guide investments that improve health outcomes and reduce costs. In this exciting start-up environment, you'll have the opportunity to develop data science processes from the ground up and work directly with decision-making executives to shape the future of Humana's most important strategic initiatives.The Senior Data Scientist uses mathematics, statistics, machine learning, business analysis, and technology to transform high volumes of complex data into advanced analytic solutions. The Senior Data Scientists' work assignments involve moderately complex to complex issues where the analysis of situations and data requires an in-depth evaluation of variable factors. The Senior Data Scientist uses machine learning and artificial intelligence to develop sophisticated models based on large structured and...
Apr 27, 2021
Humana Sandy, UT, USA
**Description**Are you a proven sales leader looking for an opportunity to join a leading Healthcare organization? We are looking for a strong business minded individual who are highly motivated and self-driven leaders to join our sales team.**Responsibilities**The DMS Sales Manager will be responsible for leading and developing a highly engaged, top- performing team of 15-25 Inside Sales Agents who sell the portfolio of products offered to prospects and members over the phone. Additional responsibilities include providing ongoing training, monitoring sales results and trends, and implementing tactical operations for projects and initiatives.+ Responsible for achieving Retail Sales goals for all individual product lines+ Responsible for Human Capital growth and development, investment in culture, engagement and well-being+ Strategic planner and thinker**Required Qualifications**+ Bachelor's Degree+ Active Health Insurance license in the residing state (OR the willingness AND ability...