Humana

Role Description As a remote Director, Process Improvement, you will report to an Associate VP of Strategy Advancement. - Drive ecosystem strategy, identifying architecture simplifications, provider data quality improvements, operational and quality automations. - Deliver end-to-end efficiency, quality, and modernization through automations, operational processes, and product technology strategies. - Manage provider data business intelligence, including business case and value for supporting efficiency opportunities and ongoing processes improvements across manual and automated provider operations. - Partner across Humana Military products, IT, automation teams, and business partners on data stewardship and data models. - Initiate strategies to leverage new technologies to improve provider data quality and reduce manual touch (AI, BOTs). - Manage UAT processes and automations, including pre and post-deployment testing across product and operations teams. - Ensure quality programs monitor adherence to TRICARE policies. - Monitor provider data incident, escalation, and resolution processes identifying key trends and iterative solution strategies. - Monitor Claim Deferral inventories ensuring provider-related claim dependencies are resolved timely. Qualifications - U.S. Citizenship required due to Department of Defense contract. - Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services). - 7 years in leadership experience over a large operations area. - 7 years direct experience in health plan operations: contract management, claims processing, or provider data management. - 7 years experience in data analysis and/or metrics reporting or auditing for quality. Requirements - Bachelor's degree preferred. - Experience and proficiency with TRICARE operations policy preferred. - Proficiency in SQL data queries and reporting preferred. - Work at Home Requirements: Minimum download speed of 25 Mbps and upload speed of 10 Mbps recommended; wireless, wired cable, or DSL connection suggested. - Associates in California, Illinois, Montana, or South Dakota will receive bi-weekly payment for internet expenses. - Humana will provide telephone equipment appropriate for the position. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. - Occasional travel to Humana's offices for training or meetings may be required. Benefits - Competitive benefits that support whole-person well-being. - Medical, dental, and vision benefits. - 401(k) retirement savings plan. - Time off including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave. - Short-term and long-term disability. - Life insurance and many other opportunities. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full-time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job-related skills, knowledge, experience, education, certifications, etc. $150,000 - $206,300 per year This job is eligible for a bonus incentive plan based on company and/or individual performance. Application Deadline 05-28-2026

Title: Case Manager - Sparta, WI Location:Sparta, Wisconsin Remote Job:Remote Job: Yes widget:Full time Category:Social Worker Humana Job ID:R-417371 Job Description: Join Humana as a Case Manager within the Inclusa/Humana team, where you will serve members in the Wisconsin Family Care (FC) program. Reporting to the Manager of Care Coaching, you will provide comprehensive case management services to frail elders and adults with intellectual, developmental, or physical disabilities. Main responsibilities: · Assess members health and safety needs to identify their strengths, interests, and preferences to develop a comprehensive Member Care Plan (MCP). · Coordinate with a Field Care Nurse to provide services that address members' health and safety needs, ensuring the team provides support in the least restrictive environment following the MCP. · Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence. · Conduct quarterly in-person visits and maintain monthly contact with members by phone. · Arrange support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs. · Ensure cost-effective service delivery. · Evaluate risk factors and provide education to members. · Maintain accurate documentation including case notes, service authorizations, and updates to the MCP. Use your skills to make an impact · A Bachelor's degree in human services or a related field is required, with at least 1 year of experience serving frail elders or adults with intellectual, developmental, or physical disabilities. Alternatively, a Bachelor's degree in another field with at least 3 years of such experience is also acceptable. · Valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits Preferred Qualifications · Case Management experience · Experience with electronic case note documentation · Knowledge of community health and social service agencies and additional community resources Additional Information · Work Location: Sparta, WI (Monroe County) · Travel: up to 40% · Typical Workdays/Hours: Monday – Friday, 8:00 am – 4:30 pm CST Driving This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits. Mileage reimbursement is provided for work-related travel. Eligible mileage includes: · Travel from your home to your first work location of the day. · Travel between client or assignment locations during the workday. · Travel from your final work location back to your home. WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: · At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. · Satellite, cellular and microwave connection can be used only if approved by leadership. · Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. · Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. · Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,700 - $72,600 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Lead Software Engineer Location: Louisville United States Job Description: Become a part of our caring community We are seeking a Lead Software Engineer (Full Stack) to drive the architecture, delivery, and quality of critical enterprise applications supporting CenterWell Pharmacy, MyHumana, and Omni-channel platforms. This role will lead strategic initiatives for XIAM deliverables and new team formations, ensuring scalable, secure, and high-performing solutions. The ideal candidate is a hands-on technical leader who thrives in complex environments, influences executive-level decisions, and leads cross-functional teams to deliver impactful business outcomes. Location: Louisville, KY or Dallas, TX (Work At Home with occasional office visits) Key Responsibilities Technical Leadership & Architecture - Define and drive architecture decisions across front-end, back-end, APIs, and data layers - Select and approve frameworks, languages, and platforms (cloud, microservices, integrations) - Lead system modernization, refactoring, and retirement decisions - Ensure solutions are scalable, maintainable, and cost-efficient Delivery Leadership & Execution - Lead strategic initiatives and deliverables across CenterWell Pharmacy, MyHumana, and Omni-channel platforms - Prioritize features, technical debt, and platform investments across teams - Balance business urgency with long-term platform health - Ensure predictable delivery and high-quality outcomes Quality, Security & Risk Management - Define software quality standards, testing practices, and performance benchmarks - Lead debugging, defect resolution, and root-cause analysis - Ensure compliance with security, regulatory, and data protection requirements - Approve production readiness and release decisions Production Support & Incident Response - Lead response to high-severity incidents and system escalations - Drive decisions on rollback, hotfix, or remediation approaches - Ensure rapid resolution while maintaining long-term system stability Strategic Influence & Stakeholder Engagement - Advise senior leadership (Directors, VPs) on engineering strategy and risk mitigation - Translate business requirements into technical execution plans - Partner with Product, UX, QA, and Platform teams to align priorities - Influence investment decisions in tooling, automation, and observability Team Leadership & Talent Development - Lead, mentor, and grow engineering teams and technical leads - Support hiring, onboarding, and succession planning - Identify skill gaps, coach team members, and foster high performance Required Technical Skills - Strong experience with: - Java - .NET - Python - Full-stack development across UI, APIs, and backend services - Experience with distributed systems, cloud architecture, and modern DevOps practices Preferred Technical Skills - Identity & Access Management (IAM) solutions: - ForgeRock - OAuth 2.0 - Ping Identity - Experience in healthcare, pharmacy, or regulated domains Required Qualifications - Bachelor's degree in computer science or related field - 8+ years of progressive experience in software engineering (large-scale enterprise environments) - 2+ years of technical or project leadership experience - Strong analytical, problem-solving, and decision-making skills - Passion for improving consumer experiences through technology Preferred Qualifications - Master's degree - Certifications (preferred): - AZ-900 (Azure Fundamentals) - IAM-related certifications Use your skills to make an impact Interview Format: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Work-At-Home Requirements To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. - Satellite, cellular and microwave connection can be used only if approved by leadership. - Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. #LI-Remote Limited Geography Remote - This is a remote position but located within a specific geography. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $129,300 - $177,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

• Assess members, focusing on health and safety needs, to develop a comprehensive Member Care Plan (MCP) • Conduct regular health assessments • Coordinate with acute and primary care providers • Educate members on disease processes and related risks, nutrition, exercise and lifestyle modifications • Document in member files within required DHS contract timeframes • Participate in member monthly phone contacts and travel to attend in person visits in members setting • Work remotely from your home and travel approximately 40% of the time

• Conduct comprehensive audits of professional evaluation and management services, inpatient, emergency room, minor procedures, consultation services, and annual wellness service encounters • Review and analyze provider documentation for completeness and accuracy to ensure proper code assignment in accordance with CPT, HCPCS, ICD-10-CM, and CMS guidelines • Utilize various encoders and coding tools/resources (e.g., decisionhealth, 3M, AMA, CMS) to validate code selection and support audit findings • Prepare detailed audit reports, summarizing findings, trends, and recommendations for education or process improvement • Remain current with changes in coding guidelines, payer policies, and industry trends impacting Evaluation & Management services • Assist with internal and external audit responses and appeals as needed • Support compliance initiatives and contribute to ongoing process improvement within the coding and auditing team

Role Description Become a part of our caring community. The Care Management Support Assistant (CMSA) employs a variety of strategies and techniques to support a member's wellness state by coordinating services and resources. The CMSA may support responsibilities including care and service coordination and redeterminations. Decisions are typically focused 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. - Contribute to administration of care management. - Provide CM support by managing shared mailboxes and entering data into work queues, mailing letters/educational material, researching unable to contact members, and completing other administrative responsibilities as assigned. - Provide non-clinical support to the assessment and evaluation of members' requirements to achieve or maintain a wellness state. - Guide members/families toward resources appropriate for their care and wellbeing, and facilitate interaction with these resources. - Perform varied activities and moderately complex administrative/operational/customer support assignments. - Perform computations. - Typically work on semi-routine assignments. - Indiana Medicaid knowledge preferred. Qualifications - Must reside in the state of Indiana. - Less than 3 years of technical experience with Microsoft Word, Excel (can maintain complex spreadsheets), and Outlook. - Knowledge of Microsoft Word, Excel (can perform complex functions), and Outlook. - Administration support experience in a healthcare industry. - Familiarity with care and well-being resources. - Must be passionate about contributing to an organization focused on improving consumer experiences. Requirements - Associate's Degree (preferred). - Microsoft Access proficiency (preferred). - Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Benefits - Competitive benefits that support whole-person well-being. - Medical, dental, and vision benefits. - 401(k) retirement savings plan. - Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave). - Short-term and long-term disability. - Life insurance. - Many other opportunities. Company Description Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.

Role Description As the Manager, Payment Integrity, you will use technology and data mining, detecting anomalies in data to identify and collect overpayment of claims. You will contribute to the investigations of fraud waste and our financial recovery. You will work within specific guidelines and procedures; apply advanced technical knowledge to solve moderately complex problems; receiving assignments in the form of objectives and determines approach, resources, schedules and goals. Will lead a team of Professionals. - The Manager Payment Integrity Professional contributes to overall cost reduction by influencing department strategy. - Exceptional Certified Professional Coder with advanced knowledge in Medicare/Medicaid guidelines. - Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. - Exercises considerable latitude in determining objectives and approaches to assignments. - Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. - Fosters relationships between Code Edit Management, internal stakeholders such as Medicaid markets and multiple external code editing vendors. - Directly responsible for the code edit maintenance process, which ensures code editing denials remain accurate. - Will manage a team of professional level associates. Qualifications - Certified Professional Coder - 6 or more years of work experience related to claims (claims research and review) - 2 or more years of experience leading people or projects - Demonstrated experience with cross departmental collaboration - Experienced leading meetings and presenting material to broad audiences Requirements - Ability to determine the needed approach, resources, and goals to solve problems - Ability to handle multiple priorities - Capacity to maintain confidentiality - Excellent communication skills both written and verbal Preferred Qualifications - Experience with the following systems: CAS, MTV, CISpro and CIS - Knowledge of Microsoft Office Programs Access and Project - Experience in a fast paced, metric driven operational setting - Project Management Professional (PMP) Certification Benefits - Medical, dental and vision benefits - 401(k) retirement savings plan - Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) - Short-term and long-term disability - Life insurance - Many other opportunities Additional Information - This role is "remote/work at home" and can be based anywhere in the United States. - To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service must meet the following criteria: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. - Satellite, cellular and microwave connection can be used only if approved by leadership. - Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. - While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. - Scheduled Weekly Hours: 40 - Pay Range: $94,900 - $130,500 per year - This job is eligible for a bonus incentive plan based upon company and/or individual performance.

Role Description The Senior Fraud and Waste Investigator conducts investigations of allegations of fraudulent and abusive practices. Work assigned to the Senior Fraud and Waste Investigator involves moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Fraud and Waste Investigator conducts comprehensive investigations into allegations of fraud, misconduct, and other unethical or unlawful activity impacting the organization and its stakeholders. This role focuses on complex, non-traditional investigations, including: - Agent misconduct - Internal matters - High-risk issues affecting brand integrity and compliance The Senior Investigator manages end-to-end investigations by: - Gathering and analyzing information - Conducting interviews - Synthesizing findings into clear, well-supported conclusions All investigative activities are thoroughly documented in alignment with organizational and regulatory standards. This role identifies patterns and emerging risks, providing insights to support mitigation strategies and business decisions. The investigator collaborates with internal partners such as: - Legal - Human Resources - Compliance They may also coordinate with external regulatory or law enforcement agencies as needed. The Senior Investigator exercises independent judgment in handling complex assignments, influencing investigative strategy, and recommending actions, while working with minimal direction and demonstrating leadership capability. WORK STYLE: Work at home, remote. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS: Typical business hours are Monday-Friday, 8 hours/day, 5 days/week. All associates will align their work hours to EST, regardless of their home time zone. Qualifications - Bachelor's degree - At least 3 years of health insurance fraud investigations and other investigative/auditing experience - Knowledge of healthcare payment methodologies - Inquisitive nature with ability to analyze data to metrics - High level of computer literacy (MS, Word, Excel, Access) - Exceptional organizational, interpersonal, and communication skills - Strong personal and professional ethics - Must be passionate about contributing to an organization focused on continuously improving consumer experiences Requirements - Graduate degree and/or certifications (MBA, J.D., MSN, Clinical Certifications, CPC, CCS, CFE, AHFI) - Understanding of healthcare industry, claims processing and investigative process development - Experience in a corporate environment and understanding of business operations Benefits - Medical, dental and vision benefits - 401(k) retirement savings plan - Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave) - Short-term and long-term disability - Life insurance - Many other opportunities Additional Information Work at Home Requirements: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Interview Format: As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to the next round of interviews. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours: 40 Pay Range: The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Role Description Become a part of our caring community. The Inpatient Medical Coding Auditor - PPI Coding Disputes reporting to the Manager reviews the appropriate DRG and ICD-10-CM/PCS coding assignments for accuracy within the coding disputes team from a variety of medical records. - The Disputes Auditor - MSDRG Inpatient Coding on the Disputes Team consults and collaborates with coding professionals within and across departments to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. - Will be an experienced medical coding auditor with in-depth experience in inpatient coding audits (MSDRG/APDRG). - Ensures overall accuracy and compliance of coding disputes reviews by adhering to all appropriate coding guidelines and communicates disputes outcomes to providers in a professional and concise manner. - Leverages advanced auditing expertise to make coding decisions based on standard industry guidelines and best practices. - Manages multiple priorities, collaborates with peers, and ensures timely completion of inpatient coding disputes. Qualifications - RHIA, RHIT or CCS Certification (have held at least one of these qualifications for 4 years). - MS-DRG coding/auditing experience. - 3+ years' experience performing inpatient coding reviews/audits in health insurance and/or hospital settings. - Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel. - Can work independently and determine appropriate course of action. - Excellent communication skills both written and verbal. Requirements - Associate's Degree or higher in Health Information Management (HIM) (preferred). - Experience in APR DRG coding/auditing (preferred). - Experience in Financial Recovery (preferred). - Experience in a fast-paced, metric-driven operational setting (preferred). Benefits - Health benefits effective day 1. - Paid time off, holidays, volunteer time, and jury duty pay. - Recognition pay. - 401(k) retirement savings plan with employer match. - Tuition assistance. - Scholarships for eligible dependents. - Parental and caregiver leave. - Employee charity matching program. - Network Resource Groups (NRGs). - Career development opportunities. Company Description Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. - Medical, dental, and vision benefits. - 401(k) retirement savings plan. - Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave). - Short-term and long-term disability. - Life insurance and many other opportunities.

Title: Care Coach, Family Care Partnership Location: Milwaukee United States Job Description: Remote Job: Yes widget:Full time Category:Social Worker Humana Job ID:R-416584 Description Become a part of our caring community Humana/iCare is looking for a Care Coach to join the growing Milwaukee County team in the Family Care Partnership (FCP) program. The FCP Care Coach provides care management services through the FCP program including assessment, service plan development, ongoing care coordination, quality assurance and ongoing monitoring of services to adults with disabilities and the frail elderly. Share and develop your skills all while doing your part to improve the lives of others. You will report to Manager of Care Management Support. The FCP Care Coach works collaboratively with the Interdisciplinary Team (IDT) and other Partnership staff to assist members and their families with identifying service needs and gaining access to medical, social, rehabilitation, vocational, educational, and other services to achieve members' desired outcomes. Essential Duties & Responsibilities: - Conduct psychosocial assessments as part of the comprehensive assessment process. - Utilize the Resource Allocation Decision making methodology (RAD), help member identify their preferred outcomes and potential strategies to achieve those outcomes, including through the identification of community resources and cost-effective services or equipment. - Coordinate and monitor services and resources implemented to meet member's identified outcomes and member's progress toward meeting those outcomes. - Conduct periodic reassessment and updates of the member's care plan and monitor member's health and safety. - Assist member or member's representative in filing complaints, grievances and obtaining advocacy services. - Document member information and contacts made regarding member's care and services provided. - Create documentation according to policy and procedure, workflows, audit requirements and time frames. - Build constructive working relationships with the member, their family members, and appropriate outside agency staff. - Facilitate collaboration with the member's physician or appropriate medical professionals to coordinate member's care. - Assist in problem resolution between member and providers. - Educate member and providers regarding benefits, service providers and protocols to access resources and the appropriate use of medical services. Provide referrals for community resources and social services as necessary. - Actively monitor member's ability and willingness to engage in treatment regimes, and problem solve with staff, member and providers to find alternatives or solutions to their needs. Applicants should reside within the Milwaukee County or surrounding areas. All candidates must be willing and able to travel up to 75% in the field as part of their regular responsibilities. Use your skills to make an impact Required Qualifications The Family Care target group population is defined as: Frail Elders, Physically Disabled, or Intellectually, Developmentally Disabled*** The Care Coach must meet one of the following qualifications: - 4-year bachelor's degree or more advanced degree in the Human Service or Social Work area and one (1) or more years' experience working with at least one of the Family Care target populations. - 4-year bachelor's degree or more advanced degree in any area other than human services with three (3) or more years' experience working with at least one of the Family Care populations. The Care Coach must meet all of the following qualifications: - Must reside in the state of Wisconsin - Ability to travel up to 75% to any location within Milwaukee County to conduct assessments within members' residences. - Knowledge of the community resources available to meet the needs of the members and a deep understanding of the range and type of long-term care options available in the community. - Previous experience working with Microsoft Outlook, Word, Teams, and Excel. - Must have a dedicated office space to protect member PHI/HIPPA information. Preferred Qualifications - Certification or Licensure in Social Work in the State of Wisconsin or be eligible for Certification and Licensure. - Previous managed care or Medicaid experience. Additional Information - Workstyle: Field. Field workstyle is defined as associates performing their core duties at one or more non-Humana/iCare locations. - Travel: up to 75% of the time throughout Milwaukee County. - Typical Work Days/Hours: Monday through Friday; 8:30am – 5:00 pm Central Standard Time (CST). Work-At-Home Requirements: To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. - Satellite, cellular and microwave connection can be used only if approved by leadership. - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. TB Statement: This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Driving Statement: This role is part of our company's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher. Medicaid Mileage Reimbursement We provide mileage reimbursement for work-related travel. Eligible mileage includes: - Travel from your home to your first work location of the day. - Travel between client or assignment locations during the workday. - Travel from your final work location back to your home. Interview Format: As part of our hiring process for this opportunity, we will be using exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first-round interview, you will receive an email correspondence inviting you to participate in a HireVue interview. In this interview, you will receive a set of interview questions you may answer via by phone or computer, and you will provide recorded or text message responses to each question. Some of the questions may require longer responses and using a computer vs phone to type responses may work best. You should anticipate this interview to take about 15-20 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. Why Humana? Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc $53,700 - $72,600 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.