Job Closed
This listing is no longer active.
Louisville, Kentucky-based Humana is a leading healthcare company that offers a variety of health, wellness, and insurance products and services designed to off
Sr. Network Performance Professional
Location
United States
Posted
80 days ago
Salary
$78.4K - $107K / year
Seniority
Senior
No structured requirement data.
Job Description
Sr. Network Performance Professional
Humana
Become a part of our caring community As a Senior Network Performance Professional at Humana, you will play a pivotal role in enhancing provider performance and advancing Humana's mission to deliver high-quality healthcare. You will work with providers to improve their STARs ratings and overall performance through strategic initiatives and strong relationship-building. This role offers a unique opportunity to leverage your expertise in healthcare provider relations to influence operational decisions and support the overall success of the organization. You will operate with a high degree of independence, often determining methods/approach to work and establishing own work priorities and timelines. Your work consists of tasks that are moderately complex, requiring minimal instructions to achieve solutions. You may provide coaching and/or review the work of lower-level associates. You will make decisions on moderately complex issues; exercises discretion and judgment over policies and own approach/priorities. Your work impacts the achievement of results for the department and begins to influence the department's strategy. Key Responsibilities: - Provider Collaboration: Work with providers to define and advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies. Recommend execution strategies and monitor performance toward these goals. - Stars/Quality Program Expertise: Serve as an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experience. Collaborate to develop tailored action plans and communicate actionable insights to improve performance. - Performance Improvement: Actively monitor and analyze provider performance data to identify areas for improvement. Implement strategies to enhance outcomes and provide ongoing support and guidance to providers. - Resource Liaison: Act as a liaison for providers to access Humana resources, educating and encouraging providers on the use of self-serve tools. Facilitate communication between providers and internal teams to ensure seamless access to necessary resources and support. - Reward Programs: Educate provider groups on reward programs and target metrics, collaborating to achieve established goals. Monitor and report on the effectiveness of reward programs, making recommendations for enhancements as needed. - Provider Abrasion Resolution: Resolve provider abrasion issues effectively, ensuring a positive and collaborative relationship between Humana and its providers. Implement strategies to minimize provider abrasion and enhance overall satisfaction. - Internal Collaboration: Partner with internal teams to track and report on market performance, ensuring alignment with organizational goals. Collaborate with cross-functional teams to drive initiatives that support provider performance. Use your skills to make an impact Required Qualifications - Bachelor's degree in business, finance, health care/administration, nursing (BSN), or a related field, or equivalent work experience. - Experience with Medicare Risk Adjustment and/or medical coding. - Experience with Medicare and/or managed care. - Understanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System, and CAHPS/HOS survey system. - Ability to drive interoperability and understanding of Consumer/Patient Experience. - Proven experience building relationships with physician groups and influencing execution of recommended strategies. - Strong communication and presentation skills, both verbal and written, with experience presenting to internal and external customers, including high-level leadership. - Focus on process and quality improvement, with an understanding of metrics, trends, and the ability to identify gaps in care. - Comprehensive knowledge of Microsoft Office Word, Excel, and PowerPoint. - Candidates must live in WA, MT, UT, ID, or OR. - Willingness to travel a minimum of 25% within region. - Must be able to work during 8:00 a.m. – 5:00 p.m. Monday – Friday according to Pacific (PST) or Mountain (MST) time zones. Additional Information This a remote position. Work At Home / 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. SSN Alert Statement: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website. 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. $78,400 - $107,800 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.
Related Guides
Related Categories
Related Job Pages
More Operations Jobs
Sr. Coordinator, Patient Access (Reimbursement Specialist))
Cardinal HealthCardinal Health is an award-winning Fortune 500 healthcare company specializing in the distribution of medical products and pharmaceuticals. The company serves
Cardinal Health Sonexus™ Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions—driving brand and patient markers of success. We’re continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. Together, we can get life-changing therapies to patients who need them—faster. Responsibilities: - Responsible for handling inbound and outbound calls, with ability to determine needs and provide one call resolution - Responsible for reporting adverse events within the required timeframe - Create and complete accurate referrals and applications and keep updated on policy or procedural changes - Investigate and resolve patient/physician inquiries and concerns in a timely manner - Enter detailed information into company proprietary software while conversing via telephone - Place outbound phone calls for patient follow ups or confirmations - Demonstrate superior customer support talents - Interact with the patient referral sources to process new applicants - Steward patient accounts from initial contact through final approval/denial - Prioritize multiple, concurrent assignments and work with a sense of urgency - Maintaining quality and providing an empathetic and supportive experience to the patient by controlling the patient conversation, educating the caller as they provide effective and efficient strategies and processes Qualifications: - High School Diploma, GED or equivalent work experience - 1-3 years in related field preferred - Previous customer service experience, preferred - Knowledge of practices and procedures commonly used in a call center or customer service environment, preferred - Clear knowledge of Medicare, Medicaid & Commercial payer policies and guidelines for coverage, preferred - Knowledge of Diagnostic Medical Expense and Medicare Administrative Contractor practices, preferred - Clear understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred - Excellent written and oral communication, mediation, and problem-solving skills, including the ability to connect with patients, caregivers, and providers - Strong people skills that demonstrate flexibility, persistence, creativity, empathy, and trust - Robust computer literacy skills including data entry and MS Office-based software programs What is expected of you and others at this level: - Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments - In-depth knowledge in technical or specialty area - Applies advanced skills to resolve complex problems independently - May modify process to resolve situations - Works independently within established procedures; may receive general guidance on new assignments - May provide general guidance or technical assistance to less experienced team members TRAINING AND WORK SCHEDULES: Your new hire training will take place 8:00am-5:00pm CST, mandatory on camera attendance is required. This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00 AM to 8:00 PM CST. REMOTE DETAILS: You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following: Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. - Download speed of 15Mbps (megabyte per second) - Upload speed of 5Mbps (megabyte per second) - Ping Rate Maximum of 30ms (milliseconds) - Hardwired to the router - Surge protector with Network Line Protection for CAH issued equipment Anticipated hourly range: $21.40 per hour - $30.60 per hour Bonus eligible: No Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being. - Medical, dental and vision coverage - Paid time off plan - Health savings account (HSA) - 401k savings plan - Access to wages before pay day with myFlexPay - Flexible spending accounts (FSAs) - Short- and long-term disability coverage - Work-Life resources - Paid parental leave - Healthy lifestyle programs Application window anticipated to close: 04/10/2026 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity. Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply. Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law. To read and review this privacy notice click here
Privacy Operations Manager
TennecoTenneco, founded in 1940 and headquartered in Northville, Michigan, is a global leader in automotive technology, operating with approximately 78,000 team member
Job Description – Privacy Operations Manager ABOUT TENNECO At Tenneco, we don’t follow industry standards; we set them, and we don’t settle for being best-in-class because we hustle to be better than best-in-class. Whether it’s our Core Values–radical candor, simplify, organizational velocity, tenacious execution and win–or our Get Stuff Done (GSD) mindset, we’re determined to become the most trusted partner and best manufacturer and distributor to the transportation industry. How do we make it happen? Through the Tenneco Way. Fueled by our Core Values, a winning mindset and a relentless commitment to excellence, the Tenneco Way is how we win. It’s what keeps Team Tenneco bold, driven, and unapologetically focused on pushing past limits and redefining success. Here, you’ll work alongside a team of relentless problem-solvers who are committed to making a tangible impact. If you’re ready to break boundaries, deliver results, and enjoy the ride along the way, you’ll thrive here. Want to learn more about who we are? Check out our website to discover the Tenneco Way. ABOUT THE ROLE Tenneco is seeking a Privacy Operations Manager, to support global privacy operations across multiple jurisdictions. We are seeking a self-starting, hands-on Privacy Operations Manager who will serve as the subject matter expert (SME) for privacy engineering and operations. This role owns the end-to-end lifecycle of privacy assessments and operational processes including DPIAs, PIAs, LIAs, Records of Processing Activities (ROPAs), consent and preference management, data subject request (DSR) operations, and privacy tooling/platforms (built or bought). The ideal candidate brings proven global privacy experience in a multinational environment, thrives in fast-paced environment, operates with speed and high quality, and can represent the function confidently in technical forums and business settings while working closely with Architecture, Security, Legal, and other critical stakeholders. The position may be based in Illinois or Michigan and reports to the Privacy Compliance Director of the company. Remote arrangements may be considered. KEY RESPONSIBILITIES Program Lead & Governance - Serve as the SME and day-to-day lead for privacy engineering and operations, embedding privacy by design and default across products, services, and processes. - Lead and continuously improve the lifecycle of DPIAs, PIAs, LIAs, ROPAs, data mapping, and AI/automated decision-making risk assessments—ensuring completeness, accuracy, and timely closure of risks and actions. - Define and maintain privacy requirements, standards, and technical guardrails in partnership with Enterprise Architecture, Information Security, and Legal. - Represent Privacy on technical design/review boards; influence architectural decisions to ensure compliant, scalable solutions. Privacy Tooling & Automation - Directly administer, configure and plan roadmap for privacy platforms and tools (e.g., assessment workflows, consent and preference management, data mapping/ROPAs, vendor risk, cookie/tracking governance). - Drive automation of privacy controls and workflows (e.g., templates, playbooks, SLAs, integrations, APIs, Power Automate) to reduce cycle time and improve quality. - Establish and maintain data quality checks, dashboards, control matrices (e.g., RACI, requirements-to-controls traceability), and audit-ready evidence repositories. Assessment & Control Execution - Perform technical and data protection reviews of systems, applications, data pipelines, analytics/AI use cases, and vendors to identify privacy risks and required controls. - Design pragmatic remediation plans and partner with control owners to track mitigation to closure. - Address cross-border data transfer requirements, data localization, cookie/tracking technologies, and consent signals across the stack. Data Subject Rights (DSR) Operations - Own the end-to-end DSR process (intake, identity verification, scoping, fulfillment, communications, and retention of evidence) across global jurisdictions. - Engineer repeatable, scalable fulfillment processes leveraging automation, role-based access, and clear SLAs. - Measure and report DSR performance; drive elimination of root causes that generate avoidable requests. Risk, Incident & Compliance Management - Monitor privacy control effectiveness; identify gaps and manage remediation to closure. - Support privacy incident response and breach preparedness activities, including tabletop exercises and after-action reviews. - Ensure vendor/privacy due diligence is performed and aligned with contractual and regulatory requirements. Measurement & Reporting - Define and publish KPIs/KRIs and dashboards (e.g., assessment cycle time, SLA adherence, risk backlog burn-down, DSR throughput, audit findings) for leadership visibility. - Prepare materials for executive updates, audits, and regulatory inquiries; maintain audit-ready documentation. JOB REQUIREMENTS - Bachelor’s degree in Computer Science, Software Engineering, Data Protection/Privacy, Cybersecurity, Regulatory Compliance, or a related field (advanced degree or JD highly desirable). - 8+ years of progressive experience in privacy operations, privacy engineering, or closely related domains within a multinational environment. - Demonstrated expert-level execution of DPIAs, PIAs, LIAs, ROPAs, data mapping, vendor/privacy due diligence, consent and preference management, and cookie/tracking governance. - Hands-on experience operationalizing global privacy regulations (e.g., GDPR, CCPA/CPRA, LGPD, PIPL, PDPA) and aligning with frameworks/standards (e.g., ISO 27001, ISO 27701, ISO 42001, NIST CSF, PCI DSS, SOX, TISAX). - Proficiency collaborating with Enterprise Architecture and Information Security to embed privacy controls into system designs, APIs, data pipelines, analytics, and AI/ML use cases. - Proven ability to lead complex, cross-functional programs with minimal supervision; excels in rapidly changing environment while maintaining quality and compliance. - Good written and verbal communication skills with ability to translate technical concepts for business audiences and present credibly in technical forums. - Experience administering or integrating privacy/GRC platforms. - Advanced Microsoft skills (Excel, PowerPoint, Power BI); ability to build dashboards, operational workflows and executive-ready materials using Microsoft suite of tools. - At least one privacy certification required: CIPP (E/US or other regional), CIPT, CIPM, CDPSE; security certifications (CISM, CISSP) are a plus. We don’t want average. We want exceptional. We want someone who’s hungry to build, unafraid to challenge, and bold enough to lead with empathy, speed, and precision. Sound like you? Let us know
Service Operations Expert, ITSM
Interval GroupHigh quality consulting. On demand. Delivered by top professionals.
• Monitor and manage day-to-day operations for hybrid data platforms • Act as a link between support tiers and technical operations • Identify and manage major incidents • Coordinate root cause analysis • Drive continuous improvement
• Provides leadership and strategic planning for study and regional activities from startup through close • Oversees preferred Contract Research Organization and manages country level plans • Liaises with regulatory colleagues to agree on submission strategy • Implements recruitment strategies and mitigates risks in study execution • Manages vendor relationships and assures follow-up on operational quality events



