Community Manager in United States

Become a part of our caring community Professional member of patient’s treatment team who provides skilled nursing visits in patient’s home under the direction of plan of treatment stablished with physician and input from patient/caregiver. Provides supervision for Aide and LPN as needed DUTIES AND RESPOSIBILITIES: • Provide initial and on-going assessment of client needs using the OASIS data elements incorporated into the Comprehensive Assessment. • With input from patient/caregiver and in conjunction with physician, formulates and implements plan of care. • Evaluate effectiveness of care plan and make necessary adjustments. • Provides for emotional and physical comfort and safety of client taking into consideration their rights and cultural background. • Receives and transcribes physician orders. • Notify physician and Agency supervisor of unusual reactions and/or changes in client’s condition. • Documents all appropriate observations and treatments in keeping with Agency policies and procedures. • Participates in case conferences, team meetings, staff meetings and Performance Improvement activities as assigned. • Provide supervision for Licensed Practical Nurses and/or Home Health Aide as assigned. • Provide any skilled nursing service for which appropriately trained which is prescribed under the plan of care. • Provide monthly summary of skilled services and clients outcomes to physician and Agency supervisor in keeping with Agency policies and procedures. Provides information for 60-day progress reports. • Adhere to all Agency policies and procedures including but not limited to HIPPA Privacy rule. • Maintains strict confidentiality of all patients, employee and Agency

Become a part of our caring community The Senior Business Intelligence Engineer describes the tools, technologies, applications, and practices used to collect, integrate, analyze, and transform data into insightful and actionable business information. This position is a strategic analytics contributor responsible for developing complex, cross-functional reporting from conception through delivery in partnership with stakeholders to ensure insightful solutions align with organizational objectives and operational priorities. The ideal candidate demonstrates mature judgment, strong governance discipline, and ability to lead with ambition and scale. The Senior Business Intelligence Engineer role works assignments involving moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Business Intelligence Engineer describes the tools, technologies, applications and practices used to collect, integrate, analyze, and present an organization's raw data to create insightful and actionable business information. Key Responsibilities Design and maintain BI dashboards and analytic solutions from end-to-end Partner with leaders to define KPIs and reporting that support business operations and strategy Ensure data accuracy, auditability, and traceability for regulatory reporting Optimize SQL queries and BI models for large-scale datasets Implement data governance standards including metric definitions and documentation Improve delivery processes, tools, and metrics to increase efficiency Serve as a trusted advisor to leaders, enabling informed decision-making through clear, data-driven communication and reporting Use your skills to make an impact Requi

Become a part of our caring community The Telephonic Quality Outreach Professional supports the EPSDT program requirements in a telephonic outreach environment by evaluating member needs and helping families achieve or maintain an optimal state of wellness. The Telephonic Outreach Care Coach Professional 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically work on straightforward moderate complexity assignments that are routine and structured in nature. The Telephonic Quality Outreach Professional employs a variety of strategies and techniques to coordinate services and resources that facilitate HEDIS gap closure and improve pediatric health outcomes. The supervisor limits decisions to defined parameters around work expectations, quality standards, priorities and timing, and supervises closely and/or works within established policies/practices and guidelines with minimal opportunity for deviation. Position Responsibilities: Telephonic outreach to close HEDIS gaps for Medicaid pediatric population Assist members in addressing barriers to care, including scheduling challenges and transportation needs, to support access to primary care and overall well-being Collaborate with EPSDT Senior Quality Improvement Professional and Coordinator related to strategic outreach to maximize HEDIS outcomes Collaborate with other departments Provide vaccine awareness and education following Bright Futures and EPSDT preventive health guidelines Empower member independence through education and outreach that promote ongoing self-sufficiency in managing preventive and primary care needs Other responsibilities as assigned Use your skills to make an impact Required Qualifications Unrestricted Licensed Practical Nurse (LPN) in

Become a part of our caring community The Automation Engineer identifies and implements solutions (hardware and software) for improvement of the high-quality automation infrastructure. The Automation Engineer work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Automation Engineer designs, programs, simulates, and tests automated processes, and is responsible for detailed design specifications and other documents. 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 Required Qualifications Bachelor's degree or relevant and equivalent years of experience in lieu of degree requirement. 4&#43; years of technical experience related to automation. Strong knowledge and understanding of Claude code Experience using AI coding assistants such as Claude code, Github, Copilot, or similar developer productivity tools. Hands-on experience leveraging Claude Code for test automation development, debugging, script generation, and software quality engineering. Experience developing automation using Java, Python, or JavaScript. Experience with Selenium, Playwright, Cypress, or equivalent frameworks. Experience testing REST APIs and backend services. Experience with CI/CD pipelines and automated deployments. 2&#43; years of experience in Software QA testing in a SAFe Agile environment. Strong experience with black box, web-service integration and server back-end testing.</

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 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 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 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 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 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 The Medical Assistant 2 is the first point of contact for patient care. Responsible for administrative responsibilities in addition to patient care. The Medical Assistant 2 performs varied activities and moderately complex administrative, operational, and customer support assignments. Typically work on semi-routine assignments. The Medical Assistant 2 performs clinical duties such as discussing symptoms, obtaining vital signs, medication/vaccine administration, phlebotomy, collecting specimens, performing diagnostic screening tests, sterilizing/cleaning equipment, maintaining examination rooms, and documenting information into the electronic medical records system. Collaborate with Physicians and Advanced Practice Providers. Deliver direct patient care dependent on what active certification allows. Decisions typically focus on interpretation of area/department policy and methods for completing assignments. Work within defined parameters to identify work expectations and quality standards, but has latitude over prioritization/timing, and works under minimal direction. Follow standard procedures that allow opportunity for interpretation/deviation or independent discretion. Use your skills to make an impact 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 This role is considered patient facing and is part of the company's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB Bilingual proficiency in English and Spanish - must pass proficiency exam prior to foreign language communication Preferred Certified o

Become a part of our caring community The Care Coaching Assistant 2 (Transition Coordination Support Staff) employs a variety of strategies and techniques to support a member's wellness state by coordinating services and resources. The Care Coaching Assistant may support multiple responsibilities including Transitions. You/applicant/employee typically focuses decisions on interpretation of area/department policy and methods for completing assignments. Work within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works. Follow standard practices that allow for some opportunity for interpretation/deviation or independent. Position Responsibilities: Contribute to administration of care coordination, for transitions and custodial prevention teams. Provide non-clinical support to the assessment and evaluation of members' needs and requirements. This support helps achieve and/or maintain an optimal wellness state by guiding members/families toward resources appropriate for their care and wellbeing. Additionally, it facilitates interaction with these resources. Perform varied activities and moderately complex administrative/operational/customer support assignments. Perform computations. Typically work on semi-routine assignments. Use your skills to make an impact Required Qualifications Less than 3 years of technical experience Must reside in the State of Indiana Proficiency in Microsoft Word, Excel and Outlook Excellent verbal and written communication skills Must Reside in the State of Indiana Preferred Qualifications Clerical support background in a healthcare environment Associate or Bachelor's Degree </