Project Management Lead in Nationwide

Become a part of our caring community As a Project Management Lead, in a Shared Services capacity supporting the Insurance organization, you will manage all aspects of cross-functional, varying degrees of complexity programs and/or projects to deliver sustainable business outcomes on time and within budget. Your business outcomes focus fosters flexibility in how to achieve the desired results in the most efficient way possible. You will utilize structured and organized ways of working to consistently deliver high quality results yet embrace business agility to adapt plans when necessary. Working in a team-based environment, you will use influencing skills to hold others accountable for their parts while also offering suggestions for continual improvement. Your expertise will enable you to participate and contribute to the Project Management and Change Management Centers of Excellence. Location: remote The Project Management Lead will work closely with business owners/project sponsors to understand the scope of a project, create a charter with defined milestones to develop an implementation approach and project plan. The candidate will secure resources by identifying impacted stakeholders, facilitate meetings, and coordinate the activities to achieve business objectives within established timeframes. As a business partner in the implementation of new initiatives, the Project Management Lead is responsible for managing all phases of the project life cycle and includes feasibility (business case), design (planning), build (oversee delivery of planned work), test (quality), deploy (transitional activities), and close (archive documented knowledge). Apply internal processes and enforce project standards (such as but not limited to Charter, RACI Matrix, Status Reports, Project Plan, Risk/Issues Tracking, etc.) </

Become a part of our caring community The Senior HR Business Partner will lead the people management agenda aligned to Medicaid RFP/RFI/RFA responses. Their work will align to standing up markets and supporting current markets in collaboration with the aligned HR Business Partner Lead (HRBPL) and act as a facilitator for the company's management team. They will need to apply broad experience in various Humana Resources (HR) areas of expertise. Work assignments will involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior HR Business Partner acts as a single point of contact for a broad range of business and HR partners across the Retail segment. Work will focus cyclically on the support of Medicaid RFA/RFI/RFP responses and the subsequent stand up or change of markets and work across partners in Medicaid, HR and other shared services to ensure the successful bid and stand up/operation of new and existing plans. In addition this work is closely aligned with the work of HRPBLs on this team and others to lead a strategy that ensures the successful growth and operation of our Medicaid line of business and facilitate superior member care delivery in all states. Responsibilities will include the identification, documentation, and implementation of best practices and support of the delivery of HR processes across Medicaid. This role will be accountable for identifying gaps, proposing and implementing changes necessary to cover risks and will act as a performance improvement driver and provoke positive changes in people management, lead change management projects and facilitate HR related internal and external communication. The successful candidate will influence our department’s strategy, make decisions on moderately complex to complex issues regarding technical approach for project com

Become a part of our caring community The Clinical Programs Pharmacist Lead will be a part of a collaborative Pharmacy Stars team which is accountable for Humana’s Stars patient safety measure performance. The Clinical Pharmacist Lead autonomously develops, implements, and manages clinical program strategies to improve Medicare members' medication adherence and appropriate medication use. The Clinical Pharmacist lead exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works under minimal supervision, and analyzes variable factors to determine the best course of action. Use your skills to make an impact Required Qualifications Degree of Doctor of Pharmacy (PharmD or RPh) from an accredited School of Pharmacy Active, unrestricted pharmacy licensure 5&#43; years of clinical experience in managed care or pharmacy related field, or equivalent Proficient in Microsoft Office applications (especially Word, Excel, and PowerPoint) Excellent written and oral communication skills Thrives in a fast paced, multi-project work environment while still ensuring attention to detail Successful track record in facilitating and consulting across teams and managing projects Strategic thinking and planning capabilities, organized, and detail-oriented Ability to learn quickly, work under pressure and timeline, work with ambiguity, and make complex decisions as necessary to meet business need Ability to assimilate, analyze, draw conclusions, and make recommendations from complex data Preferred Qualifications Previous experience in Medicare Stars Managed care and/or community pharmacy experience or residency/fellowship Previous experience in clinical program development and leader

Become a part of our caring community The Senior Process Improvement Professional analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Humana Pharmacy Benefits Management (PBM) Strategy Enablement team partners with PBM teams to improve processes that will help our members improve their lives through better health outcomes. This role, within the Process Improvement (PI) team of Strategy Enablement, will work closely with PBM leaders, as well as key partners in leading and delivering on initiatives and process capabilities that enable improved effectiveness, efficiency, and experiences (member, provider and associate). The Senior Process Improvement Professional: Researches best business practices within and outside the organization to establish benchmark data. Defines and leads business improvement projects aligned with business strategies and operational priorities. Collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on member experience, increased productivity and efficiency and reduced cost. Determines how new information technologies can support re-engineering business processes. May specialize in one or more of the following areas: benchmarking, business process analysis and re-engineering, change management and measurement, and/or process-driven systems requirements. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is perf

Become a part of our caring community Humana, a Fortune 60 Healthcare Company Humana is a publicly traded, Fortune 60 health benefits company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in the ’60s, to the largest US hospital corporation in the ’80s, to a leading health benefits company beginning in the ’90s. Today, Humana is a leader in consumer-focused health solutions and is one of the largest health benefits organizations in the country. The Consumer Product s Enablement & Solutions department supports Humana’s businesses by ensuring co nsumer products are competitive and meet consumer needs. The team also enables growth across the organization and ensures timely CMS and state filing timelines. The team has a strong dotted-line partnership with the Medicare and Medicaid organization, Humana’s largest , which comprises over 80% of the company’s total revenue and the majority of its earnings . Team members partner broadly with leaders throughout the enterprise, as they provide oversight and strategic direction of all Medicare and Duals products. Humana is seeking an experienced team member to help drive strategic direction and ensure execution on the end-to-end proces ses and projects critical for transformation across our business . As a Consultant , you will <

Become a part of our caring community With over 10 million sales interactions annually, Humana understands that while great products are important, it’s the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. The Manager, Sales Support plays a vital leadership role in enabling sales success and operational efficiency across the field sales organization. This role is responsible for managing a team of Sales Support Professionals, partnering with regional and channel leadership, and aligning cross-functional support across compliance, operations and other HQ partners. This individual supports effective execution of sales strategies and drives continuous process improvement to maximize field productivity and performance. Primary Duties and Responsibilities: Strategic Sales Support Serve as the lead point of contact for field execution of strategic initiatives. Support field execution of channel initiatives, product launches, and training deployments. Guide field teams through workflows and escalate issues when necessary. Support the deployment of career field channel initiatives to drive regional performance. Operational Execution & Performance Management Lead sales operations activities such as territory alignment, resource allocation, and performance reporting. Prepare reports and presentations for sales leadership, including performance dashboards and forecasts. Leverage in-market data to identify trends, opportunities, and risks, and translat

Become a part of our caring community The HR Business Partner 2 leads the people management agenda in a business unit/area, and acts as a facilitator for the company's management team. Applies broad experience in various Humana Resources (HR) areas of expertise. The HR Business Partner 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The HR Business Partner 2 acts as a single point of contact for the employees and managers in the business unit/area in the Medicaid RFP Response and Implementation team and their people management agenda. Possesses a deep knowledge of the business unit / area, key employees and business processes. Builds a strong business relationship with the business unit/area and transfers HR requests and solutions to/from the business unit. Implements best practices and supports the delivery of HR processes at the business unit/area. Identifies gaps, proposes and implement changes necessary to cover risks. Acts as the performance improvement driver and provokes positive changes in the people management. Leads the change management projects and manages the HR related internal and external communication. 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. This position will focus primarily on the HR related activities tied to a response for RFPs and the subsequent stand up of new business. The position will work across the HR organization to build, run and analyze data in support of RFPs and stand up of new business and ensure the alignment and timing of resources key to the operational stand up of

Become a part of our caring community The Counsel provides a full range of legal advice and services on litigation, arbitration, and related legal matters and strategy. The Counsel will collaborate internally and with outside counsel on case strategy, discovery, and resolution of disputes. The Counsel will exercise independent judgment and decision-making on litigation issues and related tasks and work under modest supervision. This role requires applying in-depth and broad knowledge of litigation practices, frequently taking full ownership of legal matters, and organizing and managing individual litigation matters from inception through trial. Use your skills to make an impact Required Qualifications Juris Doctor degree from an ABA-accredited law school Active and licensed membership in a state bar association At least 4 years of experience in litigation Strong project management and organizational skills across all facets of litigation from inception through trial Ability to organize and successfully manage a number of case matters simultaneously Strong skills in communicating complex legal issues to various stakeholders Ability to mitigate risk by acting as a trusted advisor whose strategic thinking, pragmatic problem-solving, and proactive counsel are sought by clients Ability to work independently under general supervision and in team settings Experience with large-scale e-discovery Preferred Qualifications Experience with provider disputes and healthcare reimbursement disputes Experience with alternative dispute resolution (ADR), including arbitration Understanding of Medicaid/Medicare laws and regulations Work at Home Requirements:

Become a part of our caring community The Network Operations Coordinator 4 manages provider data for health plans including but not limited to demographics, rates, and contract intent. Manages provider audits, provider service and relations, credentialing, and contract management systems. Executes processes for intake and manage provider perceived service failures. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals, and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology. Works within broad guidelines with little oversight. Use your skills to make an impact Required Qualifications Minimum of 2 years of provider relations experience, healthcare services or related experience Minimum of 1 year of experience managing mid to large scale projects Intermediate experience in Microsoft Word, Outlook, Excel (VLOOKUP’s, lateral lookups & ability to manipulate data) and TEAMS Ability to accommodate a work schedule following Central Standard Time zone hours Preferred Qualifications Advanced experience with Microsoft Excel Provider contract interpretation experience Previous account management or project management Knowledge of medical claims Work at Home Requirements: To ensure Home or Hy

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 Do you thrive on designing secure, enterprise-scale solutions that protect critical systems, data, and networks? As a Lead Security Architect in Humana, you will play a key role in shaping the security blueprint for the organization by aligning security architecture and infrastructure with enterprise business and technology priorities. In this role, you will partner with EIP and business leaders to assess emerging threats, identify architectural gaps, and design forward-looking security solutions that strengthen Humana's overall security posture. You will also lead security assessments, vulnerability analysis, and product security reviews while helping develop innovative testing approaches and mitigation strategies for evolving risks. This is a high-impact opportunity to influence enterprise architecture, guide secure technology design, and help protect the business through strategic, modern security architecture. The Lead Security Architect engages with relevant EIP stakeholders to identify current and emerging security threats and works to design security architecture elements to mitigate threats as they emerge. Additionally, the role actively works to identify gaps within existing EIP reference architecture and designs updates to impacted security architecture elements to mitigate emerging threats. Performs and oversees efforts to conduct vulnerability testing, risk analysis, and security assessments of relevant enterprise / EIP infrastructure. Ensures EIP and Humana stakeholder security requirements are necessary to protect Humana's business functions and are adequately addressed in all aspects of enterprise architecture. The Lead Security Architect role is aligned to a segment (line of business) to proactively discover security issues during solution design and prevent vulnerabilities during development.