Become a part of our caring community Humanas Enterprise Quality Engineering organization transforms how software quality is engineered across the enterprise. We are building an AI-native quality engineering ecosystem that combines intelligent platforms, enterprise knowledge, automation,
Become a part of our caring community The Associate Vice President, Medical Risk Adjustment and Provider Engagement, is responsible for providing clinical leadership and strategic direction to support the organization’s STARS and Risk Adjustment initiatives. This
Become a part of our caring community As a Home Health Facility Licensure & Regulatory Compliance Analyst, you will report directly to the Manager, Home Health Licensure & Regulatory Compliance. You will be responsible for overseeing
Become a part of our caring community The Senior Process Improvement Professional analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. Claims Oversight Senior Process Improvement Professionals
Become a part of our caring community The Associate Director, Actuarial Analytics/Forecasting leads a team responsible for delivering Medicaid healthcare trend insights and strategic advisory services that support business decision-making. This role combines advanced analytical expertise,
Become a part of our caring community The Associate Actuary, General provides actuarial support across a broad range of actuarial and business needs for the IL Medicaid Market. The Medicaid Associate Actuary will be responsible for
Become a part of our caring community As a remote Clinical Programs Pharmacy Technician Representative, you will support Pharmacists and patients and report to a Clinical Programs supervisor. You will do this by accomplishing programs developed
Become a part of our caring community Healthcare is rapidly changing, and our members are living longer, often with more chronic conditions. Consumers expect more personalized and holistic experiences from their health partners. Humana is committed
Become a part of our caring community The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data
Become a part of our caring community Are you passionate about building strong agent relationships and driving sales growth in the Medicare and insurance space? We are seeking a Regional Sales Executive to support and expand
Become a part of our caring community The Senior RX Clinical Programs Pharmacist integrates programs developed to improve overall health outcomes with a focus on prescription drugs. The Senior RX Clinical Programs Pharmacist work assignments involve
Become a part of our caring community As a Senior Associate, Adobe Journey Optimizer Developer, you will play a hands-on role in translating strategy into real-time journeys using Adobe Experience Platform (AEP) and Adobe Journey Optimizer
Become a part of our caring community The Grievances & Appeals Representative 3 (Part Time 24 hours a week) manages members and provider denials and concerns through conducting a comprehensive analytic review of clinical documentation to
Become a part of our caring community The Counsel provides a full range of legal advice and services. The Counsel work assignments involve moderately complex to complex issues where the analysis of situations or data requires
Become a part of our caring community The Utilization Management Clinical Pharmacist 2 (VSP/PT) is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Utilization Management Clinical Pharmacist 2
Become a part of our caring community We are seeking a health care attorney with expertise in PBM and pharmacy operations and contract structuring. This Senior Counsel role is responsible for providing counsel on a wide
Become a part of our caring community The UM Administration Coordinator 1 contributes to administration of utilization management. The UM Administration Coordinator 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments. The
Become a part of our caring community The Senior Counsel provides a full range of legal advice and services. The Senior Counsel works on problems of diverse scope and complexity ranging from moderate to substantial. The
Become a part of our caring community The Actuary, Pricing will play a key role in developing and executing pricing strategies for Medicare Advantage products. You will establish pricing assumptions, prepare and submit bids, supports regulatory
Become a part of our caring community The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized