Human Factors Engineer in United States

Become a part of our caring community The Associate Vice President, Model & AI Governance, is the enterprise leader responsible for establishing and overseeing the organization’s framework for model governance, artificial intelligence (AI) risk management, responsible AI and AI governance. Reporting to the Chief Audit & Risk Officer, this executive provides independent second-line oversight and challenge of the organization’s use of models, advanced analytics, machine learning, generative AI, and emerging AI technologies. The role establishes the governance, risk-management, control, monitoring and escalation framework necessary to ensure AI models are deployed in a manner that is safe, ethical, transparent, explainable, compliant, secure and aligned with the organization’s mission and risk appetite. The Associate Vice President, Model & AI Governance, partners closely with executive leadership, technology, data and analytics, clinical/business leaders, compliance, legal, privacy, cybersecurity, information security, internal audit, enterprise risk management and other control functions to ensure AI-related risks are identified, assessed, governed, monitored, and appropriately reported. This leader will serve as an advisor to executive management on emerging model and AI risks, while maintaining appropriate independence from the teams developing and deploying models and AI solutions. Key Responsibilities Own and continuously enhance the enterprise model governance framework, including model identification, inventory, classification, risk tiering, development, validation, approval, implementation, monitoring, change management, retirement and documentation. Define model risk appetite, risk taxonomy, minimum control standards, governance requirements and escalation thresholds. Provide effective challenge over model

Become a part of our caring community The Regional Senior TRICARE Community Liaison (TCL) is an important Humana Military representative committed to operational excellence, consistency, and accountability in the administration of TRICARE services within a defined territory in the East Region. You will provide expert guidance to nationally contracted healthcare providers and support facilities who have footprints across both East and West Regions. The primary focus of the Regional Senior TCL is to develop and sustain strong, collaborative relationships with all National Health System providers in the East Region. You will be cover all National contracted providers and large health systems regardless of location or type of care provided. Through clear and concise written and verbal communication, the Regional Senior TCL ensures provider understanding of the TRICARE health plan, TRICARE Policy and Regulations and how to navigate the Military Health System. The Regional Senior TCL is self-directed and uses independent, critical decision-making in managing time, setting priorities, addressing general inquiries, and resolving both straightforward inquiries, complicated problems and concerns raised by providers. This position upholds rigorous operational standards and ensuring consistent, high-quality delivery of TRICARE services. You will support customer service, conduct outreach, maintain network adequacy and access to care. You will manage provider relations and education, and ensure effective provider management within the assigned area. You will lead the review of TRICARE inquiries, complaints, and concerns from beneficiaries, providers, and government personnel, ensuring a resolution through professionalism and integrity. Additional responsibilities involve supporting the implementation of Alternative Payment Methodologies and Demonstration Pilots that adv

Become a part of our caring community The Financial Analytics Professional 2 manages data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues. The Financial Analytics Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Financial Analytics Professional 2 collates, models, interprets and analyzes data in order to identify, explain, influence variances and trends. Explains variances and trends in clinical and financial data and enhances modeling techniques to improve forecast accuracy. May possess financial or actuarial background. 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 1&#43; years SQL and Python experience Microsoft Office (Excel, Power BI, etc.) Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends Explain variances and trends and enhance modeling techniques Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Business Intelligence, Financial, or Actuarial background Azure Databricks experience</

Become a part of our caring community Join our Payment Integrity Letters team at Humana where you will help draft and implement outbound communication templates for the Payment Integrity Operations teams as a Payment Integrity Professional 2. You will help ensure compliance with state contractual requirements and Humana brand standards in drafting communication templates and working with the approvers and developers. You will report to the Associate Director, Business Systems Analysis. Main responsibilities: Collaborate with business partners to draft new communications Review existing communications on an annual basis to ensure compliance with all state requirements and Humana brand standards Ensure intake requests are completing all required steps in a timely manner and escalate off track tasks as needed Work with the EMME development team to ensure communication requirements are documented clearly and implemented correctly Validate communications in QA and Production environments on a regular basis to identify gaps Use your skills to make an impact Required Qualifications 2&#43; years' experience tracking process deliverables Experience editing documents with Microsoft Office Programs Word, PowerPoint, and Excel Experience handling multiple priorities Experience with com

Become a part of our caring community The Field Care Manager Nurse 2 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. You will report to the Manager, Care Management of Behavioral Health. The Field Care Manager Nurse 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. In this role, you will travel up to 50% of the time to support collaboration, conduct face-to-face meetings, and engage directly with staff, providers, members, and their families. NOTE: You should reside close to the Midlands OR Upstate area where your region will be. Use your skills to make an impact Required Qualifications Bachelor's in nursing (BSN) and have an active license in the state of South Carolina without disciplinary action. Must reside in the State of South Carolina 2 or more years of experience of case/care management 2 or more years working with the behavioral health population Knowledge of community health and social service agencies and additional community resources Use a variety of electronic information applications/software programs including electronic medical recor

Become a part of our caring community The Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The Pre-Authorization Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Pre-Authorization Nurse completes medical necessity and level of care reviews for requested services using clinical judgment, and refers to team members for review depending on case findings. Educate providers on utilization and medical management processes. Enter and maintain relevant clinical information in various medical management systems. Understand 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 2&#43; years of RN experience Active RN license in the state of Indiana Ability to be licensed in multiple states without restrictions Previous experience in utilization management, case management, discharge planning and/or home health or rehab Proficient with MS Office products including Word, Excel and Outlook Ability to work independently under general instructions and with a team Preferred Qualifications Bachelor's degree MCO experience Health Plan experience working with large carriers Previous Medicare/Medicaid experience Outpatient or home health experience in Utilization Manageme

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 &amp; designs, develop security requirements, perform threat modeling and ensures alignment of security &amp; 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