Human Resources Administrator Jobs

Become a part of our caring community Become a valued member of Humana's Internal Review Team as a Grievances & Appeals Representative 2, where you will play a critical role in addressing client concerns and denials. You will perform thorough reviews of clinical documentation to assess whether grievances, appeals, or additional requests are justified. Then, you will provide final determinations utilizing your expertise and collaboration with clinical and other Humana teams. Your contributions will directly support Humana's commitment to delivering high-quality service and making a positive difference in the lives of those we serve. Must be passionate about contributing to an organization focused on continuously improving consumer experiences. Key Responsibilities: Assign cases to team members for submission to an independent entity for 2nd level review. Monitor and record the number of cases assigned to the team, as well as the distribution of cases among individual associates. Operate within established guidelines to maintain work expectations and quality standards, while exercising discretion in prioritizing tasks and managing timelines with minimal supervision. Demonstrate flexibility and resilience in adapting to evolving processes and a fast-paced work environment. Use your skills to make an impact Required Qualifications Minimum of 1 year of customer service experience Minimum of 1 year of data entry experience Experience in a production-driven environment Must have strong experience using multiple Microsoft systems simultaneously (Teams, SharePoint, Excel, etc.) Ability to manage large volume on inventory daily Preferred Qualifications Previous inbound call center or related customer service experi

Become a part of our caring community The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Your work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Actuarial Analyst 2, Analytics/Forecasting will report to the Actuary, Analytics/Forecasting. You will play a key role in the Medicare actuarial forecasting process. This position entails the maintenance of the provider revenue and expense projection model and associated tools supporting the projection model. The Actuarial Analyst 2, will be responsible for integrating value-based provider impacts into financial and bid forecasts, managing tools associated with these impacts, and providing guidance on effective risk modeling practices. The Actuarial Analyst 2, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. You will collaborate with stakeholders to understand business needs/issues, troubleshoots problems, conduct root cause analysis, and develop cost effective resolutions for data anomalies. You will understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. You will make decisions regarding own work methods, occasionally in ambiguous situations, and require minimal direction and receives guidance where needed. You will follow established guidelines/procedures. Use your skills to make an impact Required Qualifications Bachelor's Degree Successful completion of at least 3 actuarial exams<

Become a part of our caring community The Director, Product Management Conceives of, develops, delivers, and manages products for customer use. The Director, Product Management requires an in-depth understanding of how organization capabilities interrelate across the function or segment. The Director, Product Management Leads all phases of the product life cycle, from inception to introduction into the marketplace, by developing products to meet specific customer needs and achieve specific cost and success outcomes. Once products are launched, monitors efficacy of products and uses customer and business partner feedback to ensure products are meeting customer needs across each customer segmentation, adjusting products over time to continue to achieve the desired outcomes. 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, andimplements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy. This is a remote position that reports to the Associate VP, Mail Order Pharmacy Distribution. Use your skills to make an impact Required You will be a Certified SAFe® 5 Product Owner/ Product Manager You will have 5&#43; years of Product Owner/Product Manager experience You will have 3&#43; years of leadership experience You will have a Bachelor's degree Preferred You will have an ability to drive significant transformation You will have competence working on very large and most complex assignments You will have asStrong ability to drive cross functional teams to alignment in the midst of ambiguity You will have an abili

Become a part of our caring community Help shape practical, responsible AI solutions that improve healthcare experiences and outcomes. Humana’s Enterprise AI organization develops safe, scalable AI solutions across our Insurance and CenterWell businesses. We bring together product managers, data scientists, engineers, policy experts, and business leaders to apply emerging technology to meaningful healthcare challenges. As Associate Director of Applied AI, you will lead teams that design, build, and deploy enterprise AI solutions, with a focus on generative AI and intelligent agents. You will connect technical strategy to business needs, guide responsible delivery in a regulated environment, and help teams turn promising ideas into measurable outcomes for members, patients, and associates. Key Responsibilities Lead and mentor teams developing production-ready AI solutions that improve healthcare delivery, member experiences, and business operations. Help define and execute the roadmap for applied AI initiatives in alignment with enterprise priorities and business needs. Guide the evaluation and adoption of machine learning, generative AI, large language models, multimodal models, and intelligent agent technologies. Oversee scalable APIs, frameworks, data pipelines, retrieval-augmented generation solutions, and agent orchestration capabilities. Partner with product, data science, engineering, architecture, security, and business teams to translate requirements into reliable solutions. Establish standards for AI evaluation, obse

Become a part of our caring community The Actuarial Analyst 2, Analytics/Forecasting supports value-based initiatives within the HealthCare Economics team, partnering across actuarial, finance, analytics, and business teams to develop actionable financial insights and forecasting solutions. This role will play a key part in the design and development of a holistic modeling solution, building new methodologies and frameworks from the ground up to support performance measurement, financial reconciliation, and strategic decision-making across multiple value-based care programs. You work assignments are varied and frequently require interpretation of complex business issues, independent judgment, and the ability to recommend and execute appropriate courses of action with limited guidance. The Actuarial Analyst 2, Analytics/Forecasting will be responsible for analyzing and forecasting claims and revenue trends, developing innovative forecasting methodologies, and translating complex business requirements into scalable analytical solutions. This individual must be able to independently evaluate data, identify gaps, propose holistic approaches, and develop end-to-end solutions that integrate financial, operational, and claims-based insights. Responsibilities include designing forecasting methodologies, establishing reporting metrics, validating model results, and supporting the evolution of value-based care analytics. You will understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas. You will make decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Use your skills to make an impact Required Qualifications Bachelor's Degree Successful completion of

Become a part of our caring community The Senior Portfolio Enablement Lead is a strategic portfolio transformation role responsible for shaping and enabling Humana's portfolio operations, Agile Release Train (ART) design, and Ways of Working across the portfolio. Acting as a trusted advisor to senior executives (SVPs, VPs, and portfolio leaders), the role translates transformation strategy into scalable execution by diagnosing portfolio delivery challenges, guiding organizational design, and improving alignment, flow, and value delivery. As a Senior Portfolio Enablement Lead, you will: Partner with portfolio and organization leadership to develop and enable portfolio, aligned to enterprise portfolio operations to achieve portfolio initiatives their outcomes. Perform quantitative and qualitative assessments, including stakeholder analysis and change impact assessments, to develop data-driven change strategies for key stakeholder groups. Build and manage portfolio transformation roadmaps to drive executive buy-in and sponsor engagement across technology and business/product leadership and leadership to drive understanding and adoption of key changes Develop Release Train Engineers to our Humana Ways of Working and enterprise tooling subject matter experts for Agile Release Trains and Scrum Teams Measure effectiveness of change interventions through defined metrics and continuously evolve plans to optimize adoption outcomes Regularly report activity status to organizational, portfolio and transformation leadership; proactively escalate and help resolve risks and issues Partners with leaders to align all continuous improvement goals and objectives Partner with Release Train Engineers in the portfolio to monitor activity level of continuous improvement, adoption of Humana Ways of Working, risks patterns

Become a part of our caring community We are seeking a highly experienced Lead Full Stack Engineer to drive engineering excellence across front-end, back-end, API, and data layers. This role is responsible for setting technical direction, ensuring consistent delivery across teams, and aligning engineering solutions with business priorities. The ideal candidate will be a strong technical leader who thrives in complex environments, drives modernization initiatives, and develops high-performing engineering talent. This role offers the opportunity to shape the future of our engineering landscape, influence enterprise-scale decisions, and lead transformation initiatives that directly impact customer experience and business growth. Location : Louisville, KY or Dallas, TX (Work At Home with occasional office visits) Key Responsibilities Engineering Leadership & Strategy Lead full stack engineering strategy and execution across UI, APIs, and data platforms Define architectural direction and ensure high standards for code quality, scalability, and maintainability Select frameworks, languages, and platforms across front-end, back-end, APIs, and data layers Approve architectural patterns (monolith vs. microservices, cloud strategy, and integrations) Identify opportunities to refactor, modernize, or retire legacy systems Delivery Execution & Prioritization Drive consistent delivery across multiple engineering teams through: Sprint planning and execution Dependency management Risk mitigation Removal of technical and organizational blockers Prioritize feature development, platf

Become a part of our caring community The Director, Provider Solutions Engineering devises an effective strategy for executing and delivering on IT business initiatives. We ask that you have an in-depth understanding of how organization capabilities interrelate across the function or segment. The Director, Provider Solutions Engineering serves as the strategic technology leader responsible for defining Humana's Provider engagement and engineering. In partnership with business and operational teams, this role is responsible to identify and implement strategic technology solutions that improve provider engagement, associate effectiveness, and business outcomes. The Director collaborates across a highly matrixed organization to establish technology strategy, drive large-scale transformation initiatives, and deliver modern customer relationship management capabilities that support the end-to-end provider experience. This leader is accountable for translating business priorities into actionable roadmaps, driving execution excellence, strengthening engineering discipline, and ensuring technology investments align with enterprise architecture, regulatory requirements, and organizational objectives. The role is responsible for establishing the future-state Provider engagement vision, accelerating AI-enabled capabilities, modernizing technology platforms, and fostering a high-performing engineering culture that consistently delivers measurable business value. Key Responsibilities Technology Leadership Serve as the strategic technology leader for Provider engagement and related provider experience capabilities. Partner effectively within a matrixed organization to align business priorities, regulatory requirements, architecture standards, and technology investments. Provide strategic dir

Become a part of our caring community As a Medical Assistant, you will be a part of the Clinical Care Team engaging with our patients to develop lifelong well-being and health. The Medical Assistant role makes a difference in the patient care we offer and assists physicians and other clinicians by providing a unique blend of skills to perform prescribed medical treatment. Medical Assistants are multiskilled health professionals responsible for performing administrative and clinical tasks in our primary care facilities while delivering outstanding customer service and maintaining positive patient engagement. Location : CenterWell Senior Primary Care Poinciana office address: 1050 Cypress Parkway; Kissimmee, FL 34759 Medical Assistant Job Tasks: Perform pre-visit planning based on patient visit type Manage the provider's schedule to ensure efficient workflow Obtain and record medical history and vital signs Room patients and assist healthcare providers with medical procedures and treatments Perform specimen collection and point of care testing Prepare and administer medications under the direction of healthcare providers Ensure accurate documentation in the electronic health record (EHR) and electronic medical record (EMR) systems, including documentation of HEDIS and Stars quality measures Maintain established quality control standards Use your skills to make an impact Additional Information Required Successful completion of MA school/training program or a Certified/Registered Medical Assistant or 5&#43; years of experience and approval from Provider High school diploma or equivalent CPR Certified Bilingual proficiency in English and Spanish - must pass proficiency exam befo

Become a part of our caring community As a Medical Assistant you will be the first contact for patient care, responsible for administrative responsibilities in addition to patient care. Working onsite in a clinical environment and reporting to the Center Administrator you will perform varied activities and moderately complex administrative, operational, and customer support assignments. Location Address CenterWell Senior Primary Care office located at: 4886 N Dowlen Rd., Beaumont, TX., 77708 You will be reporting to the: Supervisor, Center Administration Job Responsibilities As a Medical Assistant you will perform clinical tasks such as: You will perform pre-visit planning based on patient visit type You will obtain and record medical history and vital signs You will room patients and assist healthcare providers with medical procedures and treatments You will perform specimen collection and point of care testing You will prepare and administer medication under the direction of healthcare provider You will ensure accurate documentation in the electronic health record (HER) and electronic medical record (EMR) systems, including documentation of HEDIS and Stars quality measures Required Qualifications An active Certified Medical Assistant/CMA or Registered Medical Assistant/RMA certification from one of the following organizations: AAH, AAMA, AMT, ARMA, MedCa, NAHP, NAHT, NCCT, or NHA Successful completion of MA school/training program or a Certified/Registered Medical Assistant or 5&#43; years of experience and approval from Provider High school diploma or equivalent 1&#43; years of MA experience Phlebotomy experience Medication/vaccine administration ex

Become a part of our caring community The Director, Provider Engagement leads a team of Provider Engagement associates responsible for developing and strengthening positive, long-term relationships with contracted physicians, provider groups, health systems, and ancillary providers across Humana's Medicare Advantage network. You drive provider engagement strategies focused on improving provider experience, quality outcomes, Star Ratings performance, value-based care adoption, risk adjustment performance, and operational excellence. You will report to the VP, Network Performance. You will serve as a key market leader, representing Provider Engagement across cross-functional initiatives and ensuring alignment between provider needs and Humana's strategic priorities. Lead, develop, and support a team of up to 13 Provider Engagement associates responsible for managing relationships with contracted providers and healthcare organizations. Establish team strategy, operating processes, and performance expectations aligned with organizational objectives. Conduct regular performance evaluations and provide coaching, mentoring, and professional development opportunities. Foster a culture of accountability, collaboration, continuous improvement, and provider-centric engagement. Monitor performance against established key performance indicators and organizational goals. Build and sustain strong relationships with value-based provider partners. Represent Humana at key provider meetings, association events, market forums, and strategic provider discussions. Develop and execute provider engagement strategies that support Medicare Star Ratings improvement and quality performance objectives. Partner with provider organizations to drive performance within value-based payment arrangements and alternative payment mode

Become a part of our caring community The Dental Recontracting Professional initiates, negotiates, and executes dental provider contracts and agreements for an organization that provides dental insurance. The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. This is a VSP role - work specific hours to meet business needs on a limited term basis. The project is expected to go through mid-2027. The Dental Recontracting Professional - VSP will recontract Humana contracted dentists to our new agreement and as needed will communicates contract terms, payment structures, and reimbursement rates to providers. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. 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 and work special projects as needed. This role is Variable Staffing Pool (VSP), Variable Staffing Pool Humana associates work specific hours to meet business needs on a limited term basis. The project is expected to go through mid-2027. This role is also eligible for limited benefits. Use your skills to make an impact Required Qualifications 2 - 5 years of experience negotiating managed care contracts with physician, hospital and/or other provider contracts and/or working with insurance in a dental office Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures a

Become a part of our caring community Humana Healthy Horizons is looking for a Value-Based Programs Lead who will support successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. You will lead the beginning-to-end operational support of specialty Medicaid value-based payment (VBP) models in alignment with segment strategy and goals. The Value-Based Programs Lead will be a subject matter expert in VBP and have advanced technical knowledge and experience. Develop new innovative VBP models for range of provider types, such as behavioral health, maternity, specialists, and social determinants of health, creating glide paths to move providers from volume to value. Align scope of work with roadmap for new VBP model development to ensure compliance with Medicaid contractual requirements and RFP commitments. Analyze financial, utilization, and performance data to identify opportunities to drive improvements in quality and/or reductions in total cost of care. Creation of VBP payment strategies and model design, such as developing payment model logic, performance metrics and benchmarks, and financial terms, which align with segment goals. Design and contribute to development of provider reporting packages to help providers understand their overall and detailed performance. Partner with finance team to conduct impact analysis and modeling for new VBP models. Collaborate with team members and matrixed teams to operationalize and rollout of new VBP models. Contribute to developing solutions to operational gaps. Monitor VBP model performance KPIs to identify opportunities to enhance model design based on internal and external feedback and performance data. Ability to translate strategy into models that can be piloted and scaled across markets. <

Become a part of our caring community The Senior Full Stack Engineer Performs software engineering activities in all layers of the stack, from setting up the database to programming in the back-end and the appearance at the front-end. The Senior Full Stack Engineer works on problems of diverse scope and complexity ranging from moderate to substantial. You will report to the Associate Director of Software Engineering. The Senior Full Stack Engineer is involved in all stages of software development. This includes front-end development, back-end development, database integrations, network and hosting management, user interface, user experience, and back-end server management. You are experienced with Cloud-based services and development end-to-end. You can work with autonomy while collaborating with others on architectural and process decisions. You are comfortable with giving and receiving feedback from your teammates and others in the organization. You conceptualize what you need to do from incomplete and evolving requirements. Experience communicating updates and resolutions to customers and other partners. On any given day you may: Contribute to technical architecture reviews and design as well as present vision Expertise using advanced data structures and algorithms Possess the ability to evaluate problems in both strategic and tactical terms Mentor and assist in coaching a small team of high-caliber engineers Drive positive change with technical vision and innovative solutions Strong affinity to software-driven engineering & automation Partner with the business and stakeholders to define technical direction & work cross functionally Deliver business-critical systems and compon

Become a part of our caring community The Senior Product Owner is responsible for conveying product vision and roadmap to an Agile delivery team by defining user stories and prioritizing product backlog. The Senior Product Owner 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 Product Owner maximizes value of product created by Agile team. Liaises with stakeholders and the development team ensuring the right product is being built, in the right order, within budget and by the deadline. Serves as the Agile team's primary contact for information, work prioritization, and decision-making. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, andwork is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. This is a remote position and you will report to the Director, Product Management. This position is created specifically to assist with Humana's efforts to secure and, if awarded, transition into a new business opportunity. Please note that continued employment in this role is expressly contingent upon Humana's receipt of the business opportunity and a satisfactory transition into the work. In the event Humana does not pursue the opportunity or determines that a timely and satisfactory transition cannot be achieved, employment may be subject to termination. Use your skills to make an impact Required Qualifications You will have a Bachelors degree or equivalent You will have 3&#43; years of technical experience, product ownership, or project management experience You will be Certified SAFe®