Human Engineer in United States

Become a part of our caring community The Strategy Advancement Advisor is a member of Humana’s People Innovation team, which helps shape and advance the future of HR by translating enterprise and workforce priorities into focused strategies and measurable outcomes. This role partners with HR and business leaders to frame complex challenges, develop fact-based recommendations, and move high-priority initiatives from strategy through execution. The Advisor will work across a varied portfolio of enterprise people priorities and transformation efforts, bringing structure to ambiguity, connecting work across functions, and helping leaders make informed decisions that improve business, workforce, and associate outcomes. Humana is seeking an experienced strategy professional to join the People Innovation team. The team serves as a strategic partner to HR and the business, helping identify, shape, and advance high-impact opportunities that support Humana’s people strategy and broader enterprise transformation. Our work spans emerging workforce priorities, talent and organizational strategies, operating model and work redesign, and other cross-functional initiatives that require enterprise perspective, disciplined problem solving, and coordinated execution. As a Strategy Advancement Advisor, you will lead and support a portfolio of complex, high-visibility initiatives from early problem definition through recommendation and activation. You will work with senior leaders, HR partners, subject matter experts, and cross-functional teams to clarify business needs, synthesize internal and external insights, evaluate strategic choices, and translate direction into practical plans. The role requires the ability to move between strategy and execution, build alignment across a matrixed organization, and produce clear, executive-ready recommendations that enable timely decisions and

Become a part of our caring community *(Selected candidate will be required to live within 60 mins of one of the following metro locations OR be willing to relocate to within 12 months of hire date: Louisville KY, NYC Metro, Dallas Metro, Charlotte NC Metro, Tampa, Miami, Washington DC metro, Chicago, Boston, Atlanta, Nashville) The Senior Security Architect for AI works with EIP Department leaders and Humana enterprise stakeholders to identify, define, and develop security architecture requirements and secure designs for AI technology solutions across Humana's business, information technology, and security domains. The Security Architect leads the development of technical architecture & designs, develop security requirements, perform threat modeling and ensures alignment of security & risk imperatives with business priorities. The Security Architect is responsible for the high-level design and patterns of security program infrastructures to enable the protection of Humana tools, data, systems, and networks. Working with EIP Leaders, the security architect drives alignment between the EIP security strategy, security architecture and infrastructure, and Humana's overall business and technology strategic priorities. In this capacity, the role is responsible for planning, designing, and proposing architectural patterns or security enhancements for Humana's information security and technology infrastructures. The role works with EIP and Humana leaders to review and reconcile Humana business priorities with EIP security requirements. The role 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 sec

Become a part of our caring community The Transition Coordinator (Care Coach 2) evaluates member's needs and requirements. This evaluation aims to achieve and/or maintain an optimal wellness state. The Coordinator does this by guiding members/families toward resources and facilitating interaction with them. These resources are appropriate for the care and wellbeing of members. The Care Coach 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Position Responsibilities: Support the ongoing member transitions in and out of the Indiana Medicaid programs, the Contractor's enrollment, and among care settings. Complete transitions and assists with the planning and preparation for them, and the follow-up care after. Works with the Member Advocate Coordinator and other member-focused departments of the plan. This collaboration ensures continuity and coordination of care and member and provider communication through the initial transition, ongoing benefit plan, and MCE transfers. Ensure the transfer and receipt of all outstanding prior authorization decisions, utilization management data, and clinical information such as prevention and wellness programs(s), care management and complex case management notes. Help with transitions from the custodial setting to the home and community-based setting. We ask that you have telephonic and in-person meetings within an assigned region. The purpose of these meetings is to work with various stakeholders, including long-term care members, hospital/rehab staff discharge planners, family members/POA's, PCP's, and other healthcare professionals. The ultimate goal is to prevent custodial placements whenever possible. Assess and evaluate member's needs to establish a member specific car

Become a part of our caring community CenterWell is looking for dedicated, compassionate, and experienced candidates with Medical Receptionist experience who want to grow with the company and being a part of something great! Location : CenterWell Senior Primary Care BVL office address: 2577 Simpson Road, Kissimmee, FL 34744 Medical Receptionist Role Overview: The Medical Receptionist operates a switchboard or multi-line phone and maintains long distance call logs. Take and distribute accurate messages. Greet visitors and determine the nature of their visit, issues visitor passes and maintain visitor logs, alerts appropriate party of visitor arrival or directs visitors to appropriate office, department or employee. Respond to routine inquiries from internal or external sources such as our location, hours of operation, phone numbers, and email address. Additional responsibilities may include miscellaneous administrative activities such as booking meeting rooms, typing, organizing and distributing mail, receiving and sending courier packages. Decisions are limited to defined parameters around work expectations, quality standards, priorities and timing, and works under close supervision and/or within established policies/practices and guidelines with minimal opportunity for deviation. Use your skills to make an impact Additional Information Required Qualifications Experience in a fast pace/high volume environment Minimum of 1-year professional experience as a Medical Receptionist in 'front-office' direct patient care contact Bilingual (English/Spanish) Experience with MS Outlook Basic Computer knowledge Must be a team player with excellent communication skills Willingness to learn an

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 MarketPoint Career Channel Team is looking for skilled Medicare Field Sales Agents. This is a field-based role, and candidates must live in the designated territory to effectively serve their local community. As part of a collaborative team of 8–12 Medicare Sales Agents, you’ll work under the guidance of a Senior Manager and Regional Director who are committed to your success. Together, you’ll help bring Humana’s strategy to life: Deliver on the fundamentals, differentiate through exceptional service, and grow by expanding our reach and impact. What You’ll Do in This FIELD Based Role: Deliver : Build trust and educate individuals on Humana’s Medicare Advantage plans and additional offerings like Life, Dental, Vision, and Prescription coverage. Differentiate : Create meaningful, face-to-face connections through grassroots marketing, community events, and in-home visits—providing a personalized experience that sets Humana apart. Grow : Drive self-generated sales, meet performance goals, and expand Humana’s presence in the market by becoming a valued resource in your community. You’ll engage with customers in the FIELD through a mix of in-person, virtual, and phone interactions. Face-to-face visits in prospective members’ homes a

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 Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Care Manager, Telephonic Behavioral Health 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. 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. Reports to the Regional CM Manager. Use your skills to make an impact Required Qualifications Must have an active, unrestricted SC Licensed Masters Social Worker (LMSW), Licensed Professional Counselor (LPC) OR an active, unrestricted compact Registered Nurse (RN) license . 2 or more years of experience working as a behavior

Become a part of our caring community 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 Enterprise Growth Strategy team is a newly created organization supporting growth across Humana’s businesses. 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 with the senior leaders of the business unit, and more broadly with leaders throughout the enterprise, as they deliver strategy projects addressing some of the businesses’ most important opportunities and challenges. These high-profile strategy projects place the team at the forefront of helping to define the future of Humana’s largest businesses. Humana is seeking an experienced team member to support delivering some of Medicare and Medicaid’s highest priority projects and initiatives, with an emphasis on Medicare Advantage strategy development. As a Manager, you will deconstruct issues and challenges, perform targeted research and analysis, and craft sound, logical solutions and recommendations. You will also shape implementation considerations, and work with business owners as appropriate to transition analysis into execution. While doing so, you will have the opportunity to collaborate with fellow team members, subject matter experts, members of Humana’s executive Management Team, and corporate, functional, and business unit leaders. </s

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 We are looking for a highly motivated Senior Technology Leadership professional to join our IT Operations team. You will support the Lead of the Application Operations Center and Enterprise Post Production Validation teams, with a focus on process automation, innovation, and continuous improvement. You will work with both onshore and offshore resources, ensuring in daily tasks, enhancing application support, and driving improvements in monitoring and validation processes. Main Responsibilities: Collaborate with the Lead to provide operational and strategic support for Application Operations Center and Post Production Validation teams. Identify, evaluate, and implement automation opportunities to increase efficiency and reduce manual workload. Drive process innovation by recommending and deploying advanced tools and methodologies for application operations and validation activities. Analyze existing workflows and develop documentation for standard operating procedures and best practices. Oversee daily application support and monitoring activities to ensure system stability, performance, and reliability. Partner with onshore and offshore teams to coordinate task execution and promote consistent adoption of new processes and technologies. Develop and maintain dashboards and reports to track key performance indicators and present findings to leadership. Ensure automation and process improvements comply with organizational standards and regulatory requirements. Facilitate knowledge sharing, training sessions, and change management activities to support team development and successful project implementation. Engage with stakeholders to gather requirements, understand challenges, and communicate progress on automation initiatives. Ability to create

Become a part of our caring community The Care Coach 1 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Coach 1 work assignments are often straightforward and of moderate complexity. Reports to the Regional Care Coach Manager. Looking for motivated Care Coach in COLLIER county FLORIDA!! We are looking for dynamic case managers that enjoy making a difference in the lives of others! You must live in Collier county in Florida. This rewarding role allows you to spend time connecting with our members to ensure they receive the services they need. The Care Coach 1 employs a variety of strategies, approaches and techniques to support a member's optimal wellness state by coordinating services & resources. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversations with member, and active care planning. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. The Care Coach 1 Visit Medicaid members in their homes, Assisted Living Facilities, and/or Long Term Care Facilities and other care settings – 75-90% local travel Assesses and evaluates member's needs and requirements in order to establish a member specific care plan Ensures members are receiving services in the least restrictive setting in order to achieve and/or maintain optimal well-being Planning and implementing interven

Become a part of our caring community The Consumer Experience Lead ensures optimized interaction between a company and members. The Consumer Experience Lead works on the remediation of identified issues from the Resolution team root cause hub to resolve member abrasion points on a diverse scope. You will report to the Director, Strategy Advancement. As the Consumer Experience Lead you will Lead strategic and operational initiatives that improve business performance, organizational effectiveness, and cross-functional execution Analyze complex issues to identify root causes, uncover improvement opportunities, and recommend sustainable solutions. Build relationships, influence decision-making at all levels, and communicate recommendations Manage escalations, resolve issues, and accountability for commitments, deliverables, and action items across teams Strengthen operations through documentation, strategies, self-service resources, process optimization, and decision-support materials for leadership Use your skills to make an impact Required Qualifications Bachelor's degree 3 or more years of experience in Healthcare operations 3 or more years of project management experience 3 or more years of project leadership experience Demonstrated analytical with experience identifying root cause and implementing sustainable solutions Live in EST or CST time zone Preferred Qualifications Experience supporting executive leadership teams or enterprise-wide strategic initiatives Experience with operation excellence, process improvement methodologies, or business transformation efforts Demonstrated Executive leadership experience with communication strategy skills <p style="text-align:inheri

Become a part of our caring community Services represent one of the organization’s most consequential sources of capability, capacity, transformation and external spend. The Associate Vice President, Services Procurement will lead the enterprise strategy for contingent workforce, outsourcing and offshoring, consulting and clinical services, converting third-party services into measurable business outcomes, workforce agility, operating leverage and sustainable value. The AVP will serve as the senior Procurement partner to leaders across the Insurance segment and Corporate Services, helping shape operating-model, workforce and transformation decisions before sourcing begins or a supplier solution is selected. The leader will bring deep expertise in global business services, business process outsourcing, workforce solutions and complex professional services. The mandate is to strengthen business-case quality, establish clear make, buy, build, automate and partner choices, create fit-for-purpose commercial models, manage transitions and hold providers accountable for committed outcomes. Success will be measured by whether business leaders make better services and workforce decisions, transformations deliver their promised value, and suppliers improve performance and innovation. Key Responsibilities Serve as the Strategic Services Partner to Business Leaders Serve as the senior Procurement relationship leader and trusted commercial advisor to Insurance segment and Corporate Services leadership. Develop a deep understanding of business strategy, operating plans, transformation roadmaps, workforce needs and financial commitments, and translate them into integrated services, workforce and supplier strategies. Engage upstream of supplier selection to frame the problem, test demand and assess make, buy, build, automate, offshore, outsource

Become a part of our caring community The Grievances and Appeals Representative 4 role in the Internal Review Team is responsible for managing appeal denials, by reviewing clinical documentation, determining whether further action is needed, and validating final determinations in coordination with clinical and internal Humana partners. Key Responsibilities: Manage Level 1 appeal cases , ensuring accuracy, completeness, and compliance with CMS requirements Review clinical documentation to support appeal determinations and escalation decisions Coordinate with clinical teams and internal partners to finalize appeal outcomes Investigate and resolve member and provider issues with a focus on timely resolution Maintain high productivity and quality standards in a production-driven environment Ensure strict adherence to confidentiality and compliance regulations Independently prioritize and manage multiple high-volume case assignments Proactively embraces change and supports smooth transitions in a dynamic work environment Use your skills to make an impact Required Qualifications: 1&#43; year of grievance & appeals and/or customer service experience Strong data entry skills Proficiency in Microsoft Office Applications Experience in a production-driven environment Experience prioritizing and delivering multiple assignments Strong commitment to confidentiality and high-quality results Preferred Qualifications: Associate's or Bachelor's degree 2–4 years of grievance and appeals experience Medical claims processing experience Previous inbound call center experience Experience wi

Become a part of our caring community As a Care Management Support Assistant, you will help members take the next step toward better health and well-being. You will do this by connecting with them over the phone, completing important non-clinical assessments, identifying barriers to care, and helping them access resources and benefits. We are looking for people who show compassion and document customer issues in detail, can work in a call center environment, and motivate themselves through work that directly supports members and care teams. This is a remote position, and the assigned shift will be 11:30 AM–8:00 PM Eastern Standard Time. Job Description What You Will Do Engage members by phone to encourage participation in care management programs. Complete required assessments and questionnaires to help identify health risks, care needs, and opportunities for clinical team follow-up. Assist members who need support scheduling doctor’s appointments or connecting with appropriate care resources. Identify and help address barriers to preventive screenings, benefits, and health-related services so members can close gaps in care. Support members in understanding, retaining, and accessing benefits that contribute to their overall health and well-being. Manage both inbound and outbound calls in an auto-dialer environment while documenting member information. What Success Looks Like You create a positive member experience by treating each interaction with respect, patience, and professionalism You demonstrate compassion, integrity, and sound judgment when supporting members with sensitive health-related needs You listen to