Positions locations
San Juan, PR, AL; AK; AZ; AR; CA; CO; CT; DE; DC; FL; GA; HI; ID; IL; IN; IA; KS; LA; ME; MD; MA; MI; MN; MS; MO; MT; NE; NV; NH; NJ; NM; NY; NC; ND; OH; OK; OR; PA; RI; SC; SD; TN; TX; UT; VT; VA; WA; WV; WI; WY; PR;
Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. In 2021, the company ranked 41 on the Fortune 500 list, which made it the highest-ranked company based in Kentucky. It has been the third-largest health insurance in the nation.
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Description
The Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts The Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
Responsibilities
The Inbound Contacts Representative 2 serves as a member advocate, addressing customer needs, which may include acting upon complex benefit needs, resolving grievances, and educating members. The ICR 2 documents member inquiries and resolutions provided per Centers for Medicare and Medicaid compliance criteria. The ICR 2 role intakes.
(Eastern Time Zone)
Description
Humana is continuing to grow! We have several new Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our members and provide excellent service and support. These remote roles are amazing opportunities to join a Fortune 100 company that continues to expand and grow!!
Responsibilities
The Inbound Contacts Representative 2 represents Humana by addressing incoming telephone, digital, or written inquiries from Medicare members. These Inbound Contact Representative 2 strives to provide the member a resolution or path way to resolution on each call while providing a perfect call experience.
What we need your help with:
The Inbound Contact Representative 2 addresses customer needs which may include complex benefit questions, resolving issues, and educating members.
Handle 30-40 inbound calls daily from members in a fast-paced inbound call center environment
Records details of inquiries, comments or complaints, transactions or interactions and takes action in accordance to it.
Escalates unresolved and pending customer grievances. Decisions are typically focused on 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.
COME GROW WITH HUMANA! BENEFITS DAY ONE – STELLAR 401K MATCH – PAID TIME OFF – TUTION ASSISTANCE PROGRAMS – STELLAR WELLNESS/REWARDS PROGRAM
What you need for success! – Required Qualifications
3 years of customer service experience
Must be available to work any shift between the hours of 7:45 am – 8:00 pm EST (M-F) as well as weekends and overtime, especially during our peak season of October-March and as needed by the business.
Training is work at home or virtual. Training will start day one of employment and run the first 10 weeks with a schedule of 8:00 am – 4:30 pm EST. Attendance is vital for success so no time off is allowed during training and 50 days following.
Demonstrated experience with providing strong customer service and attention to details while listening on calls
Prior experience managing multiple or competing priorities, including use of multiple computer applications simultaneously
Prior experience effectively communicating with customers verbally and listening to their needs
Must currently have residency within the Eastern Time Zone
AL; AK; AZ; AR; CA; CO; CT; DE; DC; FL; GA; HI; ID; IL; IN; IA; KS; LA; ME; MD; MA; MI; MN; MS; MO; MT; NE; NV; NH; NJ; NM; NY; NC; ND; OH; OK; OR; PA; RI; SC; SD; TN; TX; UT; VT; VA; WA; WV; WI; WY; PR;
Description
The Inbound Contacts Representative 2 represents Humana by addressing incoming telephone, digital, or written inquiries from Medicare Members. The Inbound Contact Representative 2 strives to provide resolution or path way to resolution on each call while providing a perfect call experience. These roles will be on a Monday-Friday schedule with shifts between 7:45 am – 9:00 pm EST (M-F), some weekends during peak season.
Responsibilities
What we need your help with:
The Inbound Contact Representative 2 addresses customer needs which may include complex benefit questions, resolving issues, and educating members.
Handle 40-50 inbound calls daily from members in a fast-paced inbound call center environment
Records details of inquiries, comments or complaints, transactions or interactions and takes action in accordance to it.
Escalates unresolved and pending customer grievances. Decisions are typically focused on 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.
COME GROW WITH HUMANA! BENEFITS DAY ONE – STELLAR 401K MATCH – PAID TIME OFF – TUITION ASSISTANCE PROGRAMS – STELLAR WELLNESS/REWARDS PROGRAM.
What you need for success! – Required Qualifications
Minimum 2 years of customer service experience
Must be available to work any shift between the hours of 7:45 am – 9:00 pm EST (M-F), some weekends during peak season
Training is work at home or virtual. Training will start day one of employment and run the first 11 weeks with a schedule of 8:00 am – 4:30 pm EST. Attendance is vital for success so no time off is allowed during training.
Demonstrated experience with providing strong customer service and attention to details while listening on calls
Prior experience managing multiple or competing priorities, including use of multiple computer applications simultaneously
Prior experience effectively communicating with customers verbally and listening to their need.
AL; AZ; AZ; AZ; AR; CA; CO; CO; CT; DE; DC; FL; FL; FL; FL; GA; ID; IL; IL; IN; IA; KS; KY; LA; ME; MD; MA; MI; MN; MS; MO; MT; NE; NV; NH; NJ; NM; NY; NC; ND; OH; OK; OR; PA; RI; SC; SD; TN; TX; TX; TX; TX; TX; UT; VT; VA; WI;
Responsibilities
The Inbound Contacts Representative 2 serves as a member advocate, addressing customer needs, which may include acting upon complex benefit needs, resolving grievances, and educating members. The ICR 2 documents member inquiries and resolutions provided per Centers for Medicare and Medicaid compliance criteria. The ICR 2 role intakes calls, makes outbound calls, resolves grievances and follows the escalation protocol when necessary to address member needs. ICR 2 role must adhere to the member services department protocols that speak to plan benefits as well as align to CMS mandates in the handling of organization/coverage determinations, grievances and appeals. This role is a highly structured role requiring continuous referencing of policies and protocols. Active listening and the intention to work in a proactive manner is key to success in the role. Role does require ongoing receptiveness to training and performance feedback, as compliance mandates are continuously updating and we are audited against our adherence to these.
Additional Details
Work Environment: This is a customer-centric member advocate environment focused on high quality outcomes versus activities. Our department primarily communicates over the phone, but we are not a “call center” environment as we are responsible for the member’s safety and advocacy outcome as part of the continuum of their care. We value quality work as every action taken in the member services department is to facilitate access to the member and avoid adverse outcomes for the member.
Associates can expect to take anywhere from 25 to 35 inbound calls per day with the focus being on high-quality service with a strong emphasis on member advocacy and patient safety.
While this associate receives inbound calls, up to 60% to 70% of these calls may require associates to place outbound calls to physicians, DME vendors, pharmacies or other entities to coordinate benefits and care for the member.
This role calls for strong emotional intelligence focused on proactively providing solutions, ensuring the member's utmost health and safety. De-escalation skills are a must to thrive in this role. We serve a wide variety of members, some of which are experiencing illness and trauma at the time of their call.
Required Qualifications
Education, Experience, Skill set:
High School Diploma or Equivalent
2+ years of customer service experience such as in a Physician Medical Office, Clinical Unit/Office Coordination role, or any experience working with irate member population requiring high degree of organization, structure and focus.
Candidate must be interested in the health insurance industry, Medicare Care Advantage industry, or compliance industry as this opportunity is not a job, but an opportunity to learn the intricacies of a Medicare Advantage Prescription Drug Plan (PDP). This role is a learning opportunity to build a career from. Candidate must understand they will serve the member as a “Universal Agent” which requires knowledge and mastery of multiple disciplines such as but not limited to: pharmacy; plan medical, dental & vision benefits, case management, compliance requirements and more.
Excellent verbal and written communication skills
Must be willing to comprehend complex compliance mandates and inter-dependencies that exist within the operation.
Ability to maintain a professional demeanor, practicing strict confidentiality on all platforms for all sensitive information
Ability to focus on the training and role without significant interruption during the workday.
Strong initiative with the ability to adapt to change as the business requires.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Must have the ability and willingness to be selfless and focus on the member as the priority throughout the workday.
Technology, System, and Platform Knowledge Strong computer skills and utilizing multiple systems and applications simultaneously is required as this is a work at home role. Must be comfortable with gaining new systems knowledge at all times as software is constantly updating requiring the ability to learn systems real time. The following is required to ensure success in the role as a remote work at home associate:
Must be proficient in Microsoft Word such as Word, Excel, Outlook/WebEx, Skype and using collaborative platforms for network sharing examples such as SharePoint, and Teams
Must have experience using vendor applications examples such as Salesforce, and department CRM Platforms.
Additional Requirements
Must be able to pass the following pre-hire assessments, (Please review in the below additional information):
Virtual Job Experience Assessment
A writing assignment may be requested during interview
A language assessment may be performed for English and or bilingual Spanish during screen and/or interview.
Anticipated Start Date/Training Date Depending on Interview Schedule: 23 August, and dates anticipated in September and October **Classes are filled as business needs
Hours – Adherence to the following schedule:
Regular Hours and Training Hours: Any 8-hour shift between the hours of 8:00 AM to 8:00 PM Eastern time Monday through Friday
Flexibility to work weekends, holidays and/or mandatory overtime based on business needs
Ability to work any scheduled day and time during the open enrollment, which is between 1 October and 31 March with mandatory overtime as needed.
Schedule changes occur on average 2 times a year to respond to business needs and are generally provided 2 weeks in advance. If there is an immediate business need to adjust schedules, employees are expected to make the accommodation as soon as the business requires it but no later than 48 hours.
Location: Remote/Work at Home ** Please review Work at Home Guidelines below**
English or Bilingual English and Spanish
AL; AZ; AR; CA; CO; CT; DE; DC; FL; GA; ID; IL; IN; IA; KS; KY; LA; ME; MD; MA; MI; MN; MS; MO; MT; NE; NV; NH; NJ; NM; NY; NC; ND; OH; OK; OR; PA; RI; SC; SD; TN; UT; VT; VA; WA; WI;
Responsibilities
Work Environment: This is a customer-centric member advocate environment focused on high quality outcomes versus activities. Our department primarily communicates over the phone, but we are not a “call center” environment as we are responsible for the member’s safety and advocacy outcome as part of the continuum of their care. We value quality work as every action taken in the member services department is to facilitate access to the member and avoid adverse outcomes for the member.
Associates can expect to take anywhere from 30-35 inbound calls per day with the focus being on high-quality service with a strong emphasis on member advocacy and patient safety.
While this associate receives inbound calls, up to 50% of these calls may require associates to place outbound calls to physicians, DME vendors, pharmacies or other entities to coordinate benefits and care for the member.
This role calls for strong emotional intelligence focused on proactively providing solutions, ensuring the member's utmost health and safety. De-escalation skills are a must to thrive in this role. We serve a wide variety of members, some of which are experiencing illness and trauma at the time of their call.
Education, Experience, Skill set:
High School Diploma or Equivalent
2+ year or more customer service experience within any of the following heavy or high volume health care, call quality, retail, and or anything involving working with an irate customer population or requiring high degree of organization, structure and focus.
Ability to communicate general information such as pharmacy; plan medical, dental & vision benefits
Excellent verbal and written communication skills
Ability to maintain a professional demeanor, practicing strict confidentiality on all platforms for all sensitive information
Ability to focus on the training and role without significant interruption during the workday.
Strong initiative with the ability to adapt to change as the business requires.
Must have the ability and willingness to be selfless and focus on the member as the priority throughout the workday.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Technology, System, and Platform Knowledge:
Strong computer skills and utilizing multiple systems and applications simultaneously is required. Must be comfortable with gaining new systems knowledge at all times as software is constantly updating requiring the ability to learn systems real time. The following is required to ensure success in the role as a remote work at home associate:
Must be proficient in Microsoft Word such as Word, Excel, Outlook/WebEx, Skype and using collaborative platforms for network sharing examples such as SharePoint, and Teams
Must have experience using vendor applications examples such as Salesforce, and department CRM Platforms.
Additional Requirements
Must be able to pass the following pre-hire assessments, (Please review in the below additional information):
Virtual Job Experience Assessment
A writing assignment may be requested during screening and/or interview
A language assessment may be performed for English and or bilingual Spanish during screen and/or interview.
Anticipated Start Date/Training Date: 26 April, 24 May
Hours – Adherence to the following schedule:
20 Hours per week Monday through Friday between the hours of 8:00 AM to 8:00 PM Eastern Time
Additional hours may be offered up to 5 hours per week are available as business needs and upon leader approval
Shift assignments will be scheduled 4-6 hours daily and must be approved and will be based on business need
Training Hours:
2 to 3 Weeks training
Scheduled 8 hours between 8:00 AM to 8:00 PM Eastern Time, Monday through Friday
Location:
Remote/Work at Home ** Please review Work at Home Guidelines below**
United States, excluding Alaska and Hawaii
Language Fluency Requirement
English fluency
OR
Bilingual English and Spanish fluency
The interagency Language Rating, (ILR), test may be requested as required by the Federal Government under the Federal Care Act, to ensure competency.
Preferred Qualifications
Associates or Bachelor's Degree
Experience in health insurance, Medicare Care Advantage, or compliance industry
experience such as in a Physician Medical Office, Clinical Unit/Office Coordination role,
Experience and/or background with case management processes
Experience with de-escalation of difficult calls
Strong documentation and categorization of call type
Experience working with geriatric population
Member Advocacy Experience
Government Compliance experience
Additional Information – Please Read Full Details Below
Interview and Remote Work at Home Requirements: – In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring/new hire activities. This position provides an opportunity to work at home.
For Interview Purposes:
Access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m,
Dedicated secure home workspace for interview or work purposes.
Upon Hire:
Must have accessibility to hardwired high speed internet with minimum speeds of 10Mx1M for a home office (Wireless and Satellite are prohibited)
Must have a separate room with a locked door that can be used as a home office to ensure you and your members have absolute and continuous privacy during work hours.
The following equipment will be provided: laptop, Two Monitors, mouse, keyboard, Avaya phone system that connects to laptop, and modem cable to hard wire connect laptop
Humana does not cover reimburse costs to set up a home office, or monthly internet service
Additional Information:
Customer Care Assessment / Virtual Job Experience: After submitting your application, if you are selected to move forward you will receive an email to complete the Virtual Job Experience (VJE). This is an online activity where you will learn more about Customer Care jobs at Humana, try out some of the most common job tasks, and tell us more about yourself.
Most people complete the VJE in approximately 30 minutes. To complete it, you will need a smart phone, computer or tablet with internet access, and speakers/headphones.
Candidates will not be reviewed for consideration if the VJE, is incomplete.
The email will come from vjtadmin@mg.jobtryout.net please add to your contacts or safe senders list to avoid this going to your spam folder.
Interview Format As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
You will be able to respond to the recruiters preferred response method via text, video or voice technologies
If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate.
You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Continuous New Hire Testing/Assessments: The CarePlus team provides a thorough training program consisting of at least 2 to 3 weeks.
Ability to retain and pass multiple exams during new hire training and throughout employment.
Time off Requests:
Humana is regulated by the Center for Medicare and Medicaid Services and maintain a high level of commitment to our members. For this reason, time off and scheduling are heavily based on business need so we can provide the best service to our membership.
The training and onboarding for this position is critical for your development as an associate. Time off and scheduled obligations during the first 90 days will be evaluated as part of the selection process.
Transfer Timeline within Humana:
Interested associates will be eligible to move into a full-time role after successful completion of training, attendance, 6 month’s work performance and business availability.
Once in a full-time role, must complete a minimum of 2 years within this department before transferring to another department or reverting to part-time role.
Scheduled Weekly Hours 40
AL; AK; AZ; AR; CA; CO; CT; DE; DC; FL; GA; HI; ID; IL; IN; IA; KS; KY; LA; ME; MD; MA; MI; MN; MS; MO; MT; NE; NV; NH; NJ; NM; NY; NC; ND; OK; OR; PA; RI; SC; SD; TN; TX; UT; VT; VA; WA; WV; WI; WY; PR;
Responsibilities
The Inbound Contacts Representative 2 represents Humana by addressing incoming telephone, digital, or written inquiries from Medicare Members. The Inbound Contact Representative 2 strives to provide resolution or path way to resolution on each call while providing a perfect call experience. These roles will be on a Monday-Friday schedule with shifts between 7:45 am – 9:00 pm EST (M-F), some weekends during peak season.
What we need your help with:
The Inbound Contact Representative 2 addresses customer needs which may include complex benefit questions, resolving issues, and educating members.
Handle 40-50 inbound calls daily from members in a fast-paced inbound call center environment
Records details of inquiries, comments or complaints, transactions or interactions and takes action in accordance to it.
Escalates unresolved and pending customer grievances. Decisions are typically focused on 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.
COME GROW WITH HUMANA! BENEFITS DAY ONE – STELLAR 401K MATCH – PAID TIME OFF – TUTION ASSISTANCE PROGRAMS – STELLAR WELLNESS/REWARDS PROGRAM
What you need for success! – Required Qualifications
Minimum 2 years of customer service experience
Must be available to work any shift between the hours of 7:45 am – 9:00 pm EST (M-F), some weekends during peak season
Training is work at home or virtual. Training will start day one of employment and run the first 11 weeks with a schedule of 8:00 am – 4:30 pm EST. Attendance is vital for success so no time off is allowed during training and 50 days following.
Demonstrated experience with providing strong customer service and attention to details while listening on calls
Prior experience managing multiple or competing priorities, including use of multiple computer applications simultaneously
Prior experience effectively communicating with customers verbally and listening to their needs
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 space lacking ongoing interruptions to protect member PHI / HIPAA information.
What you need to be STAND OUT among the crowd! : Preferred Qualifications
Associate's or Bachelor's Degree
Prior inbound call center or related customer service experience
Prior Healthcare experience
Bilingual in English and Spanish
Additional Information
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
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 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 takes 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 computer and Windows PC applications, which includes strong keyboard and navigation skills including 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
Locations: Florida, Georgia, Ohio, Wisconsin
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
Additional Information:
Resumes need to be formatted, free of spelling and grammar errors, and complete with full work history within 7-10 years. Please notate any positions that may be considered seasonal, short term and any reasons for gaps in work history, (pursuing education, relocated, taking care of family).
After submitting your application, if you are selected to move forward you will receive an email to complete the Virtual Job Experience (VJE). This is an online activity where you will learn more about Customer Care jobs at Humana, try out some of the most common job tasks, and tell us more about yourself. Most people complete the VJE in 30 minutes. To complete it, you will need a smart phone, computer or tablet with internet access, and speakers/headphones. We do not make job offers to candidates that do not complete the VJE. The email will come from vjtadmin@mg.jobtryout.net, please add to your contacts or safe senders list to avoid this going to your spam folder.
As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire Text/Voice Messaging to enhance our hiring and decision-making ability. This 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, you will receive a text correspondence inviting you to participate in a Text Message screen. You should anticipate this interview to take about 5 to 10 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to the next round of interviews.
In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time.
These requirements include:
Access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m
Dedicated secure home workspace for interview or work purposes.
Humana continues to monitor the situation and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and well-being during the hiring process.
If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
Scheduled Weekly Hour- 40
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