AL; AR; CT; DE; DC; FL; GA; IL; IN; IA; KS; LA; ME; MD; MA; MI; MN; MS; MO; NE; NJ; NY; NC; OH; OK; RI; SC; TN; TX; VT; VA; WI
Fulltime position perks:
Benefits starting day 1 of employment
Competitive 401k match
Generous Paid Time Off accrual
Tuition Reimbursement
Parent Leave
Go365 perks for the well-being
We’re not just a health insurance company. Our diverse lines of business position us to serve millions of people with a wide range of needs, including seniors, military members, and self-employed individuals.
If you're looking for a career that provides opportunities for growth and development in a stable industry, Humana might be the right fit for you. The company offers a variety of perks and benefits including competitive, performance-based wages, retirement plans, medical, dental, vision, and life insurance, on-site health screenings and personal health coaching, paid time off, tuition assistance, leadership development, mentorships, and much more. Read employee reviews here
Phoenix, AZ,FL; OH; TX;
Description The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments. Responsibilities We are looking for an Inbound Contacts Representative 1to represent the company by addressing the following items below, but not limited to:
Incoming telephone, digital, or written inquiries
Addressing customer needs which may include complex benefit questions, resolving issues, and educating members.
Recording details of inquiries, comments or complaints, transactions or interactions and takes action in accordance to it.
Advancing unresolved and pending customer grievances.
Decisions include defined parameters around
Florida, Georgia, Ohio, Wisconsin
Description
The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments.
Responsibilities
The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments. Additional Information – How we Value You Benefits starting day 1 of employment Competitive 401k match Generous Paid Time Off accrual Tuition Reimbursement Parent Leave Go365 perks for the well-being
Responsibilities
The Inbound Contacts Representative 1 addresses customer needs related to dental insurance and coverage. This may include:
complex benefit questions,
resolving issues, and educating members.
Records details of inquiries, comments or complaints, transactions or interactions and take action in accordance to it.
Escalates unresolved and pending customer grievances.
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.
Required Qualifications:
Minimum 1 year within a metric and performance-based call center
Strong customer service orientation
Strong attention to detail
Strong typing and computer navigation skills
Demonstrated ability in using a computer and Windows PC applications, which includes strong keyboard and navigation skills including the ability to learn new computer programs
Effective verbal and listening communication skills
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Additional Requirements Work Style: Remote work at home
Hours: Shifts will be scheduled in 8-hour increments between 7:50 AM-9:00 PM Eastern. Shift schedules are subject to change approximately every 6 months and based on business needs.
Attendance Policy: The department has a strict attendance policy during the first 120 days. Time off is discouraged during this period.
Remote work at home requirements:
Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work
Must have accessibility to hardwired high-speed internet with minimum speeds of 10Mx1M for a home office (Wireless and Satellite are prohibited)
Preferred Qualifications:
Associate's or Bachelor's Degree
Healthcare experience
Fluency in Spanish
Veterans and Military Spouses –
Responsibilities
The Inbound Customer Service/Call Center Representative addresses customer needs which may include complex benefit questions, resolving issues, and educating members.
Records details of inquiries, comments or complaints, transactions or interactions and take action in accordance to it.
Escalates unresolved and pending customer grievances. Decisions are typically focused on the interpretation of area/department policy and methods for completing assignments.
Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing and works under minimal direction.
Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
Required Qualifications
Veterans and Military Spouses
3 or more years of Customer Service experience
Must be available to work any shift between the hours of (8am to 8pm Member Time EST Monday – Friday) Potential weekends during peak months of the year. Overtime may be mandatory based on business needs to include weekends. We strive to provide a minimum of a week advance notice if you need to work OT hours.
Strong customer service orientation
Strong attention to detail
Strong typing and computer navigation skills
Ability to manage multiple or competing priorities, including use of multiple computer applications simultaneously
Effective verbal and listening communication skills
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Work at home (WAH) requirements include a minimum internet connection speed of 10m x 1m and a dedicated secure home workspace for an interview or work purposes
Preferred Qualifications
High School Diploma
Healthcare experience
Previous call center experience
Responsibilities
As a Project Manager 2, you will act as a Product Owner over one of the MRM products. As such, you will work directly with a Scrum Master, Architect, cross-functional teams and have overarching management accountability for the definition and execution of all product initiatives.
Key Role Functions
Apply agile project management methodology during all phases of the project cycle, with responsibilities including project scope, scope management, cost control, and both quality and performance reporting
Partner closely with other members of functional project teams to write detailed stories relating to the business requested initiatives.
Prepare, evaluate, and present cost-benefit analyses
Consult with business areas on issues and work directly with IT to develop long-term solutions
Use problem-solving skills to come up with testing strategies, test cases, and documenting defects.
Identify, analyze, and evaluate system opportunities leveraging data from various sources
This is a remote/work-at-home role working anywhere in the US. The hours are Mon-Fri, 8 hr shifts, with the flexibility to start between 7 am-9 am.
Required Qualifications
Bachelor's degree or equivalent work experience
Previous experience with project management/agile methodologies, process improvement or process design, and implementation
Strong written and verbal communicator – concise, clear, and well thought out with excellent presentation skills
Proficient in working with clients to deliver solutions that meet their needs
Strong consultative and relationship building skills
Excellent planning and organizational skills
Able to excel in a fast-paced, constantly changing environment with tight timelines
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel PowerPoint
Work at Home/Remote Requirements
Must ensure designated work area is free from distractions during work hours and virtual meetings
Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10×1 (10mbs download x 1mbs upload) for optimal performance is required
Preferred Qualifications
SQL and SSRS reporting knowledge
Knowledge of healthcare and experience in working with medical records
PMP or Agile SAFe certified
Scheduled Weekly Hours
40
AL; AR; CT; DE; DC; FL; GA; IL; IN; IA; KS; LA; ME; MD; MA; MI; MN; MS; MO; MT; NE; NH; NJ; NY; NC; OH; OK; PA; SC; TN; TX; VT; VA; WV; WI;
Description
Responsibilities
This position can be in office or work at home in EST or CST and will provide coverage for eastern time zone hours. Weekend work required. Schedules will be from Thursday – Monday. 5% Shift differential for working Saturday and Sunday
The Grievances & Appeals Representative 4 assists members, further/supports quality-related goals. Reviews the level 1 appeals cases and ensures that information is correct and then forwards to CMS entity for further review. Investigates and resolves member and practitioner issues.
Decisions are regarding the daily priorities for an administrative workgroup and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals and is the primary administrative owner of the main process, program, product or technology.
Works within broad guidelines with little oversight.
Required Qualifications
Must be able to work an 8-hour shift from Thursday through Monday.
Strong data entry skills required
1-3 years of customer service experience
Strong proficiency with Microsoft Word and Excel
Must have experience in a production-driven environment
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Associate's or Bachelor's Degree
Experience with electronic inventory management – able to complete assigned cases in a specified time frame.
Previous inbound call center or related customer service experience
2 – 4 years of grievance and appeals experience
CAS, PAHub, and MedHOK experience strongly preferred
Previous experience processing medical claims.
The Inbound Contacts Representative represents Humana by addressing incoming telephone, digital, or written inquiries. You will address our customer needs which may include complex benefit questions, resolving issues, and educating members or providers.
Responsibilities
Where you come in:
Take as many as 30-45 calls per day from Medicaid members or providers who have questions about Humana products.
Assist them with a variety of inquiries including but not limited to: primary care provider changes, locating providers/specialists in our provider network, benefit/coverage, authorizations; provider claims inquiries, grievances and appeals, transportation needs, and pharmacy support.
This position is full-time (40 hours/week) Monday – Friday. Employees are required to have the flexibility to work an 8-hour shift anytime from 7:45 am-8:00 pm EST. It may be necessary, given the business need, to work occasional overtime and weekends. .
COME GROW WITH HUMANA! BENEFITS START ON DAY ONE – STELLAR 401K MATCH – PAID TIME OFF – TUITION ASSISTANCE PROGRAMS – STELLAR WELLNESS/REWARDS PROGRAM
What you need for success! – Required Qualifications
3+ years of experience within a customer service type role preferably within a call center environment
Strong customer service orientation and attention to detail
Prior experience managing multiple or competing priorities, while utilizing multiple computer systems and/or monitors simultaneously with strong typing skills
Ability to effectively communicate verbally and listen to members over the phone
Must live within the state of Ohio
Work at Home Requirements
Must have the ability to provide a high-speed DSL or cable modem for a home office (satellite and wireless internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10×1 (10mbs download x 1mbs upload) is required.
A dedicated workspace without ongoing interruptions to protect member PHI / HIPAA information.
What you need to STAND OUT from the crowd!: Preferred Qualifications
Associate’s or Bachelor’s Degree
1+ years of experience with taking multiple calls within an inbound/outbound call center environment
Prior Medicaid / Medicare / Healthcare experience.
High level of emotional intelligence with a proven ability to influence office culture and engagement in a positive manner
Fluency in multiple languages is a plus, preferably Spanish and English
Additional Information
Additional compensation differential over and above our standard rate is available for bilingual candidates who successfully complete Humana’s Spanish language proficiency test.
Training Hours – Training will start day one of employment and run the first 8-9 weeks with a schedule of 8:00 am – 4:30 pm EST. Perfect attendance is required to avoid gaps in training and is vital for your success in this role. Therefore, no time off is allowed during training.
Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.
Scheduled Weekly Hours
40
Spanish/English – Work at Home Puerto Rico
Description
The Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in a selection of methods, techniques, and analytical approach.
Responsibilities
The Supervisor, Inbound Contacts addresses customer needs which may include complex benefit questions, resolving issues, and educating members.
Records details of inquiries, comments or complaints, transactions or interactions and take action in accordance to it.
Escalates unresolved and pending customer grievances.
Decisions are typically are related to schedule, plans and daily operations.
Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates.
Ensures consistency in execution across teams. Holds team members accountable for following established policies.
Additional Job Description
Required Qualifications
High School Diploma or GED
Experience working in an Inbound Call Center
Working experience working in a healthcare environment
1+ years experience leading projects, subject matter expert, team lead or prior leadership experience
Bilingual (English and Spanish); with the ability to pass a language assessment
Experience working in a heavy metric based environment
Intermediate or above Proficiency in Microsoft Office applications, including Outlook, Word and Excel (VLookUp and Pivot tables)
Excellent verbal and written communication skills
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Additional Requirements:
Hours: Must be able work an 8-hour shift Monday through Friday between the hours of 8:00 AM to 8:00 PM and change to Daylight Savings Time 9:00 AM to 9:00 PM – rotating weekends and or holidays. Hours are subject to change based on business needs – Leader will discuss during the interview
Work style/Location: The position will permanently report to a remote/work-at-home office. Position may be required to report to an office environment depending on business need. ***CDC remote work and requirements apply – see below in Additional Information
Travel 15%
Preferred Qualifications
Associate's or Bachelor's Degree
1+ years experience working on escalated call line, providing support to inter-department for Inbound Contact Representatives
Prior work experience in an operational setting
Leadership experience within a call center environment to include hiring, training, coaching, and up to termination.
Previous experience with coordinating and leading projects and tasks
Work at Home/Remote EST and CST
AL; AR; CT; DE; DC; FL; GA; IL; IN; IA; KS; LA; ME; MD; MA; MI; MN; MS; MO; MT; NE; NH; NJ; NY; NC; OH; OK; PA; SC; TN; TX; VT; VA; WV; WI;
Responsibilities
This position can be in the office or work at home in EST or CST and will provide coverage for eastern time-zone hours. Weekend work required. Schedules will be from Thursday – Monday. 5% Shift differential for working Saturday and Sunday
The Grievances & Appeals Representative 4 assists members, further/supports quality-related goals. Reviews the level 1 appeals cases and ensures that information is correct and then forwards to CMS entity for further review. Investigates and resolves member and practitioner issues.
Decisions are regarding the daily priorities for an administrative workgroup and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals and is the primary administrative owner of the main process, program, product or technology.
Works within broad guidelines with little oversight.
Required Qualifications
Must be able to work an 8-hour shift from Thursday through Monday.
Strong data entry skills required
1-3 years of customer service experience
Strong proficiency with Microsoft Word and Excel
Must have experience in a production-driven environment
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Associate's or Bachelor's Degree
Experience with electronic inventory management – able to complete assigned cases in a specified time frame.
Previous inbound call center or related customer service experience
2 – 4 years of grievance and appeals experience
CAS, PAHub, and MedHOK experience strongly preferred
Previous experience processing medical claims
Additional Information
Work at Home/Remote Requirements Must ensure designated work area is free from distractions during work hours and virtual meetings Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10×1 (10mbs download x 1mbs upload) for optimal performance of is required
Scheduled Weekly Hours
40
Description
SeniorBridge Home Care is seeking a Talent Acquisition Representative. The Talent Acquisition Rep coordinates prospective employees for hourly and salaried position interviews and assists with recruiting activities and new employee training.
The Talent Acquisition Representative performs varied activities and moderately complex administrative/operational/customer support assignments.
SeniorBridge is Humana’s wholly-owned home care business acquired in 2012. We’re passionate about helping families and loved ones find solutions that make life better. We provide concierge care management, private duty nursing, and personal care assistance services to seniors.
Responsibilities
The Talent Acquisition Representative 2 refers applicants to particular position openings, administers pre-employment tests, checks references, and conducts new employee training.
This entry-level professional works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing and works under minimal direction. This is a remote, part-time position with a variable schedule.
Required Qualifications
Strong communication skills, both verbally and in writing.
Excellent organizational skills with proven ability to manage multiple tasks and prioritize.
Less than 3 years of technical experience using Microsoft Word, Excel, PowerPoint and Outlook
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
High School Diploma or GED
Additional Information
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire SMS Text Messaging to enhance our hiring and decision-making ability. Modern Hire SMS Text/Voice Messaging 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
Description
The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments.
Responsibilities
We are looking for an Inbound Contacts Representative 1to represent the company by addressing the following items below, but not limited to:
Incoming telephone, digital, or written inquiries
Addressing customer needs which may include complex benefit questions, resolving issues, and educating members.
Recording details of inquiries, comments or complaints, transactions or interactions and takes action in accordance to it.
Advancing unresolved and pending customer grievances.
Decisions include 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.
Required Qualifications
High School Diploma or equivalent
1 year of customer service experience
Phenomenal customer service orientation
Strong attention to detail
Ability to navigate computer programs and tools
Capacity to handle multiple or challenging priorities, including use of multiple computer applications at a time
Effective verbal and listening communication skills
Flexible shifts between the hours for 4:45 am – 9:00 pm Monday – Friday, and 4:45 am – 4:30 pm on Saturday
Must be comfortable working every Saturday
Preferred Qualifications
Associate's or Bachelor's Degree
Previous inbound call center
Healthcare experience
Remote/Virtual in US.
Description
The Senior Consumer Experience Professional ensures optimized interaction between a company and members. The Senior Consumer Experience Professional’s work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Responsibilities
Where you Come In The Senior Consumer Experience Professional – Operational Readiness in Enterprise Shared Services will oversee the development, execution, and continuous improvement of a standardized operational readiness program to ensure Humana is service-ready for every customer contact. This role requires a maniacal focus on experience, ensuring service changes introduced to contact centers land with excellence and achieve expected outcomes. The incumbent will exhibit a depth of understanding and a bias for action related to the recognition and elimination of friction points and opportunities for continuous improvement.
Primary Responsibilities • Develop and implement operational readiness framework to define and measure success o Create processes and tools to evaluate service readiness and define solutions to solve for gaps o Create continuous improvement process and measurement tools to ensure consistent adoption of process and procedure for new service changes o Create process and measurement templates to project value, then determine whether product delivery meets required experience and expected value to the business o Create governance and operating model to implement operational readiness framework • Leverage operational readiness framework and metrics to partner with key stakeholders to ensure operational readiness and value delivery for service changes to the contact center
• Drive improvements on key performance indicators related to member satisfaction (i.e. NPSt, Agent Knowledge, Defects, Issue Resolution) • Develop playbook(s) to create governance and standardized, lean process for implementing command center, rapid response, and service recovery efforts • Partner with key stakeholders to support or quarterback deployment command centers, rapid response, and service recovery efforts, reducing mean time to issue resolution • Operate and improve the enterprise-wide forum to create transparency and inspire collaboration for service changes on the horizon • Create and deliver value reporting and insights for continuous improvement at the initiative, program, and portfolio level
What Humana Offers We are fortunate to offer a remote opportunity for this job. Our Fortune 100 Company values associate engagement & your well-being. We also provide excellent professional development & continued education.
Required Qualifications – What it takes to Succeed • Minimum of 3 years working with contact center-related change management, consumer experience design and operational readiness • Demonstrated process development and metrics-driven continuous improvement experience • Experience with SDLC management, Agile • Proficient in MS Office O365 – Word, Excel, PP and familiar with Visio • Critical thinker who anticipates team needs takes initiative to present ideas, ask questions, and exhibit a commitment to the pursuit of excellence • Exceptional communication skills, both written and verbal (including public speaking) • Must be able to travel 10-15% within the US once travel restrictions are lifted
Preferred Qualifications • High School Diploma or GED or job-related certification • Waterfall knowledge
Additional Information – How we Value You • Benefits starting day 1 of employment • Competitive 401k match • Generous Paid Time Off accrual • Tuition Reimbursement • Parent Leave • Go365 perks for the well-being
• Must have a separate room with a locked door that can be used as a home office to ensure you have absolute and continuous privacy while you work. • Must have accessibility to high-speed DSL or cable modem for a home office (Satellite internet service is NOT allowed for this role), and recommended speed for optimal performance from Humana systems is 10M x 1M
Work At Home- TX, AZ, OH, FL
Description
The Inbound Contacts Representative 1 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments.
Responsibilities
The Pharmacy Inbound Contacts Representative is tasked with assisting/taking inbound calls from members, technicians, and providers.
What does that look like?:
Receiving as many as 40-50 calls a day, mostly from members but also from technicians, pharmacists, and other providers
Processing refills, tracking orders and answering benefits questions
Additional responsibilities may include handling escalated callers.
This is a remote/Work At a Home position in Texas, Ohio, Arizona, or Florida
Required Qualifications
1-2 years of customer service experience
Strong customer service orientation
Strong attention to detail
Strong typing and computer navigation skills
Capacity to multi-task, including use of multiple computer applications simultaneously
Effective verbal and listening communication skills
Must be available to work any shift between the hours of 7:00 am – 10:00 pm Monday-Friday, weekends, and overtime as needed
Preferred Qualifications
High School Diploma or equivalent
Previous inbound call center experience
Healthcare experience
Fluency in Spanish
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