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For more than 50 years Humana has been a proven leader and innovator in the health and wellness industry. A passionate emphasis on people, choice, well-being and innovation guides our business practices and culture. 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. Read employee reviews here
Work At Home Customer Service Representative MUST be Bilingual
Responsibilities
The Customer Service Representative performs necessarily follow-up with members and/or providers. Ensures responses to member and/or provider inquiries are completed on a timely basis to achieve service and quality standards. Works within defined parameters to identify work expectations and quality standards and works under minimal direction.
This is a Limited-Term, Full-Time position, Monday – Friday, 8:00 to 5:00 through December 2021, with the possibility of extending beyond December.
Required Qualifications
MUST be Bilingual – English and Spanish
Previous Customer Service Experience
Proficiency in Microsoft Office applications, including Outlook, Word, and Excel
Adaptable with the ability to thrive in a fast-paced environment
Strong attention to detail
Strong typing and computer navigation skills
Ability to follow Scripted Content
Ability to create reports, on a daily basis, regarding the progress of work completed
Effective verbal and listening communication skills
Ability to use good judgment and be a quick thinker
Ability to show compassion and empathize with patients and/or situations
Must be comfortable with being on the phone throughout the day making calls to patients to discuss important information about their medication, coverage, and plan
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Description
The Outbound Call Specialist- Dr. Call Phone Department role is a clerking role tasked with making outbound calls to local pharmacies and initiating prescription transfers that are then completed by our internal pharmacists. That looks like making as many as 35-45 outbound calls a day to retail pharmacies, collecting member data, and coordinating with Humana Pharmacy to facilitate a smooth transition of the prescriptions.
Responsibility
The Outbound Call Specialist- Dr. Call Phone Department role is a clerking role tasked with making outbound calls to local pharmacies and initiating prescription transfers that are then completed by our internal pharmacists. That looks like making as many as 35-45 outbound calls a day to retail pharmacies, collecting member data, and coordinating with Humana Pharmacy to facilitate a smooth transition of the prescriptions. Additional responsibilities may include outbound member calls.
Required Qualifications
High school diploma or equivalent
At least 6 months in phone experience
Excellent communication skills are written and verbal
Strong typing and computer navigation skills
Capacity to multi-task, including use of multiple computer applications simultaneously
Required Qualifications
2+ years of customer service.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Mandatory 6 weeks virtual training program Monday – Friday 8:00 am to 4:30 pm.
Must work an 8-hour shift during the hours of 10:30 am – 7:00 pm EST Monday through Friday; overtime based on business need.
Fluency in a professional environment with computer navigation, email, chats, typing skills, and toggling across multiple databases while engaging with the caller.
Must have excellent interpersonal skills and the ability to organize simultaneous tasks; and meet monthly call and performance metrics.
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
Must live within a 50-mile radius of Louisville, KY or San Antonio, TX
Preferred Qualifications
College degree (Associate’s or Bachelor’s) highly preferred
Knowledge of customer service principles and practices – formal training or experience
Additional Information
Benefits package that starts your 1st day of employment
Robust 401k plan through Charles Schwab.
Eligibility for associate wellness and rewards program
Opportunity to learn the industry and build a professional career
Tuition Reimbursement & Student Loan Refinancing
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Responsibilities
The Billing & Enrollment Representative will assist members in a fast-paced inbound call center environment.
You will be responsible for:
Processing enrollments, payments, address changes or other enrollment-related tasks.
All associates must meet established performance metrics including quality, schedule compliance, production standards, and attendance.
Servicing members by telephone to enroll them in the TRICARE program.
Educating members and providing appropriate solutions and alternatives regarding plan benefits.
This is a 100% remote position.
Required Qualifications
2+ years of customer service experience
Required Qualifications
1-3 years of prior grievance and appeals experience
Fully Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. If selected for the position, you will be required to take a Language Proficiency Assessment in English/Spanish. See Additional Information on testing
Strong analytical skills required
Strong data entry skills required
Experience handling multiple projects and assignments as directed by Management
Attentiveness to detail
WAH 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 space lacking ongoing interruptions to protect member PHI / HIPAA information
Preferred Qualifications
Bachelor's Degree
Strong knowledge in Microsoft Access or experience with SQL Server databases
Additional Information
Schedule: Monday to Friday from 8 am to 5 pm, Overtime as needed per business need.
Training: 4 weeks remotely
% Travel: 5
Role Essentials
Bachelor’s Degree highly preferred and/or equivalent experience required
Insurance or health services industry experience preferred
5+ years in Product Management or Product Operations roles required
The ability to communicate and influence senior executives to individual contributors
Product management discipline with proven project management skills necessary to meet deadlines
Advanced Microsoft Office applications, including Word, Excel, PowerPoint, Teams, and other process mapping and product management software. Power-bi skills preferred
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Excellent time management skills, bringing the ability to quickly put structure in place to manage work in a dynamic complex environment
Understand iterative development frameworks and experience collaborating with cross-disciplinary agile teams
The ability to build/maintain & communicate Product Development dashboards & product portfolio analytics to Group Product Management teams, key stakeholders, and leadership
Works under minimal supervision and be able to use independent judgment to analyze variable factors and determining the best course of action to deliver on the Group Product Development Cycle launches and in the advancement of the Group Product roadmap & strategic priorities.
Expert facilitator with the ability to design and deliver multiple types of custom content for stakeholders
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.
Description
The Mail Operations Pharmacy Technician 2 accurately fills and counts medications. The Mail Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
Responsibilities
The Mail Operations Pharmacy Technician 2 ensures inventory levels are adequate for dispensing by working with the inventory supply team. Decisions typically focus 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
Must have an active license with the Board of Pharmacy in the appropriate state.
Less than 3 years of related experience
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
High School Diploma or GED
National Certification, PTCB Cph
Required Qualifications
Active Health & Life Insurance Licenses
Ability to establish relationships with community partners
Strong organizational, interpersonal, communication, and presentation skills
Comprehensive knowledge of Microsoft Office
Ability to successfully navigate mobile applications.
High level of self-motivation; ability to accomplish goals independently
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
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Associate's or Bachelor's Degree
Bilingual with the ability to speak, read and write in both languages without limitations or assistance
Sales experience in a managed health care setting
Additional Information
Upon offer acceptance, you must be able to complete and pass the AHIP certification (paid for by Humana)
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.
Required Qualifications
Active Health & Life Insurance Licenses
Ability to establish relationships with community partners
Strong organizational, interpersonal, communication, and presentation skills
Comprehensive knowledge of Microsoft Office
Ability to successfully navigate mobile applications.
High level of self-motivation; ability to accomplish goals independently
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
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Associate's or Bachelor's Degree
Bilingual with the ability to speak, read and write in both languages without limitations or assistance
Sales experience in a managed health care setting
Additional Information
Upon offer acceptance, you must be able to complete and pass the AHIP certification (paid for by Humana)
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.
Required Qualifications
2 or more years experience as a Desktop/End User Support Engineer
Experienced in researching and resolves technical problems of moderate complexity, typically escalated from first-line support teams.
Experienced responding to escalated telephone, email, and online requests for technical support
Experienced documenting, tracking, and monitoring the problem using applicable systems and tools. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
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Responsibilities
The Associate Director will focus on Medicaid consumer Experience: maintaining and building Medicaid with the following responsibilities:
Responsible for working across all Medicaid markets to align member and associate experiences for a consistent and differentiated member and associate experience
Accountable for expansion outcomes; hitting project delivery timing for states in-flight to ensure readiness
Oversight of run the business state audits and accountable to speak to various state entities during an audit or new state expansion representing contact center process
Partners with Directors and above to align strategy to solve insights and recommendations for senior leaders on strategic steps and actions needed to be taken to overcome obstacles and risks
Partners across the enterprise to align on shared outcomes and responsibilities to accomplish the goal
A representative for contract shred enroll services who will help identify contract needs and partner to bring needs to realization
Oversight of the Medicaid insight into action program which identifies new and existing state insights which bring efficiencies, cost savings, and best member and associate outcomes
Responsible to prep for audit and re-contracting to ensure adherence to contract and represent the contact center process during the audit
Ongoing strategy and growth planning for new business
Partners with various Medicaid segment leaders to collaborate and make decisions that impact outcomes of our members and associate
Development of run the business program to performance manage multiple states and new states
Creation and oversights of new programs such as ART which are state requirements
Accountable for the strategy of the expansion team which needs to align to the overall vision of Medicaid and Medicaid growth
Required Qualifications
1+ years of experience analyzing and solving customer problems, OR 1+ years of work experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
1+ years experience in the Healthcare industry or Medical field (Production Goal oriented environment)
Strong Data entry and Writing skills
Excellent interpersonal skills with the ability to sensitively and compassionately interact with the geriatric population
Fully Bilingual in English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance.
WAH 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 space lacking ongoing interruptions to protect member PHI / HIPAA information
Preferred Qualifications
Associate's or Bachelor's Degree highly preferred
1 or more years of Call Center or High Volume/Metric driven environment.
Prior job experience working with assigned cases with specific time-frames to resolve
Grievance and Appeals or Utilization Review experience.
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