A C Operator in United States

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 Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. The Inbound Contacts Representative serves as a primary point of contact for customers, providing support through phone, digital, and written channels. This role handles a variety of customer inquiries, resolves issues, and delivers accurate information while ensuring a positive customer experience. The position performs moderately complex customer service, administrative, and operational support activities, manages semi-routine assignments with minimal guidance, and exercises sound judgment to support quality service and customer satisfaction. As an Inbound Contacts Representative, you will: Respond to customer inquiries by phone, digital, or written channels, including benefits questions, issue resolution, and member education. Accurately document customer interactions, requests, concerns, and resolutions in applicable systems. Research and resolve customer issues, escalating complex or unresolved matters as appropriate. Apply established policies, procedures, and resources to deliver accurate and timely support. Use critical thinking and sound judgment to address customer needs and recommend solutions. Manage workload effectively, prioritize tasks, and meet quality and service expectations. Work independently within established guidelines while supporting customer satisfaction and business objectives. Use your skills to make an impact Required Qualifications 3

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 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 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®

Become a part of our caring community Humana is seeking a Lead Product Manager, Medication Experience & Pharmacy Solutions to lead the strategy, discovery, delivery, and optimization of digital experiences that help members understand, manage, and maximize the value of their prescription benefits. This highly visible role sits at the intersection of pharmacy, health insurance, member experience, and digital product innovation. The Lead Product Manager will own the product lifecycle end-to-end, from identifying customer and business opportunities through defining features and stories, partnering across Design and Engineering, driving delivery, and measuring outcomes. Success requires strong strategic thinking, customer obsession, analytical rigor, and the ability to influence cross-functional stakeholders in a highly matrixed environment. The role directly supports Humana's goals of improving member experience, increasing digital engagement, reducing friction in medication-related journeys, and helping members make informed healthcare decisions. Why Join This Team This role offers a unique opportunity to solve meaningful healthcare problems at scale. You will help millions of members better understand their benefits, manage medications, reduce prescription costs, and make more informed healthcare decisions. Unlike many product organizations, our Product Managers own the entire product lifecycle, providing an uncommon level of ownership, accountability, and impact from strategy through implementation and measurement. Responsibilities Define and execute product strategy, vision, and roadmap for Medication Experience and Pharmacy Solutions Identify member, business, and operational opportunities through research, analytics, VOC, and stakeholder insights Lead product discovery efforts to validate problems, oppor

Become a part of our caring community The Director, HR Business Partner leads the people agenda for Humana Healthy Horizons by aligning talent strategy with business strategy and converting business priorities into organizational, leadership, workforce, talent, and culture outcomes. The role is accountable for enabling performance across both the run the business and grow the business agendas. This includes ensuring the Medicaid organization has the workforce capacity, leadership depth, organizational capability, and talent strategies required to deliver current commitments, compete for new business, implement awarded business, and scale successfully. The Director serves as a trusted accountability partner to senior leaders, shapes business decisions through workforce and organizational insight, represents the voice of the business across HR, and orchestrates integrated support from HR Centers of Excellence. The role maintains disciplined ownership of assessment, strategy, execution, and measurable outcomes rather than defaulting to advisory or transactional HR delivery. Primary Responsibilities and Accountabilities 1. Business Strategy and Growth Own translation of business strategy into workforce, leadership, talent, culture, and organizational strategies that enable current business performance and future growth. Assess business priorities, growth opportunities, operating challenges, and organizational risks to determine the people and organizational actions required to achieve business objectives. Establish and execute integrated plans that support market performance, business expansion, procurement activity, awarded business, implementation, and long-term scalability. Ensure workforce and organizational implications are identified, tested, and addressed as strategic choices and growth opportunities

Become a part of our caring community The Principal Product Owner / Architect is a dual-mandate leadership role that unifies product strategy and solution architecture across CenterWell's four core business segments: Pharmacy, Primary Care Organization (PCO), Home Solutions, and Humana Military. This senior individual contributor serves as the connective tissue between business vision and technical execution—owning cross-segment product roadmaps while simultaneously authoring and governing the architectural blueprints that underpin them. You will operate within CenterWell IT – Cross-CenterWell Architecture, partnering with segment product leaders, engineering teams, EA Activation, security, data, and compliance to deliver integrated, interoperable health solutions that serve members, providers, and partners across the full care continuum. Your decisions shape what gets built, how it gets built, and the standard by which all four segments measure delivery readiness. DAY-TO-DAY Key Activities Define and own a unified cross-segment product roadmap that balances segment-specific priorities against shared platform investments, and communicates trade-offs clearly to leadership. Establish and maintain reference architectures, design patterns, and integration standards applicable across all four CenterWell segments. Conduct cross-segment discovery sessions, design workshops, and architecture reviews to surface shared needs, resolve competing priorities, and prevent duplicative build. Own and prioritize top-level product backlogs for shared platforms, partnering with segment product owners to decompose initiatives into delivery-ready user stories with clear acceptance criteria and non-functional requirements (NFRs). Define integration contracts, API standards, and domain boundaries for cross-segment data flows spanning pharmac

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 Medical Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. You will report to the Manager, Medicare Risk Adjustment. As the Medical Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and interventions. Work with teams to improve documentation, data integrity, and workflow processes Use your skills to make an impact Required Qualifications AHIMA or AAPC CPC (Certified Professional Coder) Certification 3 or more years of medical coding education or auditing in a healthcare setting experience Proficiency with data analytics tools (such as Excel, Power BI, or similar) and experience interpreting large data sets Demonstrated knowledge of healthcare risk adjustment, including HCC coding and CMS-HCC model version 28. Experience speaking with leadership, webinars public speaking or presentation skills with healthcare providers Live in NC, SC, GA, VA or TN Preferred Qualifications Bachelor's Degree Value-based care Primary care Medicare Risk Adjustment kn

Become a part of our caring community The Field Service Coordinator (Care Coach 1) assesses and evaluates member's needs and requirements. This is done to achieve and/or maintain optimal wellness state by guiding members/families toward resources appropriate for their care and wellbeing. The Service Coordinator work assignments are often straightforward and of moderate complexity. Your role will involve meeting members in their location, spending quality time assessing their needs and barriers and then connecting our members with quality services to promote their ultimate well-being and guide health outcomes. Responsibilities include: Administer ongoing long-term services and support (LTSS) related assessments through person-centered thinking approaches. Contacts members both telephonically and/or in-person to establish goals and priorities. This involves evaluating resources, developing a plan of care, and identifying LTSS providers and community partnerships. The goal is to provide a combination of services and supports that best meet the needs and goals of the member and caregiver through person-centered thinking approaches. Development and modification of Service Plan and involve applicable members of the care team in care planning (Informal caregiver coach, PCP) Support members through navigation of their LTSS and related environmental and social needs Use available information about member to prevent the need for administration of duplicative assessments. Focus on supporting members or caregivers in accessing long-term services and support, social, housing, educational and other services, regardless of funding sources to meet their needs. Assist members in maintaining Medicaid eligibility Collaborate with Medical Director/Geriatrician/Care Coordinator as deemed necessary to ensure cohesive, holist

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. This role is field based, and you will be out and about in the field in the Oklahoma, NW AR and Central AR markets working with your team and meeting members face to face. You must reside in the Oklahoma City, OK area or be willing to relocate. In this field position, you will; coach, mentor, educate, motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a solid understanding of the market they serve, how to resolve operational problems and provide creative solutions to increase sales while following CMS guidelines. This role also involves cultivating, maintaining, and building relationships with Humana’s customers, both internal and external business partners, along with the community we serve through telephonic, virtual, and face-to-face interactions with individuals and groups. Other responsibilities include developing marketing budgets, and looking for branding opportunities. Benefits include: Medical, Dental, Vision, and a variety of other supplemental insurances Paid Time Off (PTO) and Paid Holidays 401(k) retirement savings plan with a company match Tuition reimbursement and/or scholarships for qualifyi

Become a part of our caring community Job Description Summary The Lead Solutions Architect provides architecture leadership for CenterWell Home Health programs and platforms, shaping conceptual and reference architectures, governing solution designs, and aligning delivery teams to cloud and data strategies. The scope includes high-priority initiatives as well as interoperability and provider-data integrations that span CenterWell and Humana Insurance. As Lead Solution Architect, you'll be the senior individual contributor on a team with broad accountability across CenterWell's dispensing pharmacy portfolio — mail order, specialty, retail, and associated platforms. You'll own the architectural vision for complex, multi-system initiatives, shape how technology decisions get made, and act as a connective force between business strategy, engineering execution, and enterprise standards. You will operate within CenterWell IT – Cross-CenterWell Architecture. You will collaborate with product, engineering, EA Activation, security, data, and operations. You will engage governance forums to enable Integrated Health across CenterWell and Humana Insurance. Key Activities Quickly conduct structured knowledge transfer with existing architects and relevant stakeholders to capture critical in-flight designs and decisions. Review current initiatives and establish an architectural roadmap aligned with organizational priorities. Develop or refine reference architectures and design patterns for core platforms and solutions. Collaborate with governance and compliance teams to validate designs against enterprise standards and regulatory requirements. Define integration strategies and solution blueprints for key systems and data flows. Establish architecture review processes and decision forums to support de

Become a part of our caring community Humana invites MBA and other advanced-degree students to join its Summer 2027 Internship Program. This immersive experience allows students to contribute to meaningful, enterprise-level work across a range of business functions, engage with executive leaders, and develop the skills and perspective needed for a successful healthcare career after graduation. We are seeking purpose-driven leaders who demonstrate intellectual curiosity, agility, sound judgment, and a high degree of emotional intelligence. Strong candidates embrace complex challenges, navigate ambiguity confidently, and are motivated to shape the future of healthcare. MBA Primary Care & Clinical Innovation Internship opportunities are available across several strategic areas, including: Clinical Performance & Innovation CenterWell Primary Care Organization Primary Care Organization Practice Technology Portfolio & Change Management Value Based Care Enablement Medical Specialty Operations Across these strategic areas, interns help translate priorities in primary care and clinical innovation into action through strategic planning, business case development, cross-functional coordination, process improvement, portfolio execution, and transformation support. They may contribute to initiatives that strengthen clinical performance, advance technology-enabled care, improve operational efficiency, and deliver greater value for patients and the enterprise while supporting sound governance and continuous improvement. Location and work arrangement : This is a 12-week, in-person internship based primarily at Humana’s headquarters in Louisville, KY, with limited opportunities in Arlington, VA; Chicago, IL; Fort Lauderdale, FL; Boston, MA; Nashville, TN; and New York