
10.000+ funcionários
Fundada em 1961
🏥 Saúde
🛡️ Seguros
⚕️ Seguro de Saúde
Healthcare • Insurance • Healthcare Insurance
A Humana é uma empresa de saúde dedicada a gerar um impacto positivo na saúde de indivíduos, comunidades e do sistema de saúde como um todo. Com foco em colocar a saúde em primeiro lugar, a Humana atende a uma ampla e diversa gama de populações, incluindo idosos e militares, oferecendo planos Medicare Advantage (HMO, PPO e PFFS). A Humana está comprometida em promover uma cultura de pertencimento e respeito mútuo, oferecendo benefícios competitivos e flexíveis para garantir a segurança financeira de seus funcionários e de suas famílias. A empresa se orgulha de criar um ambiente de trabalho inclusivo, no qual todos têm a oportunidade de ter sucesso.
🕒 4 dias atrás
🇺🇸 Estados Unidos – Remoto (EUA)
💵 $115.200 - $158.400 / ano
⏰ Tempo Integral
🟠 Sênior
🦅 Patrocina Visto H1B
👻 Score fantasma 0%
🗣️🇺🇸🇬🇧 Inglês obrigatório
Melhore suas chances de conseguir uma entrevista verificando sua pontuação de currículo antes de se candidatar.

10.000+ funcionários
Fundada em 1961
🏥 Saúde
🛡️ Seguros
⚕️ Seguro de Saúde
Healthcare • Insurance • Healthcare Insurance
A Humana é uma empresa de saúde dedicada a gerar um impacto positivo na saúde de indivíduos, comunidades e do sistema de saúde como um todo. Com foco em colocar a saúde em primeiro lugar, a Humana atende a uma ampla e diversa gama de populações, incluindo idosos e militares, oferecendo planos Medicare Advantage (HMO, PPO e PFFS). A Humana está comprometida em promover uma cultura de pertencimento e respeito mútuo, oferecendo benefícios competitivos e flexíveis para garantir a segurança financeira de seus funcionários e de suas famílias. A empresa se orgulha de criar um ambiente de trabalho inclusivo, no qual todos têm a oportunidade de ter sucesso.
• Lead transition from launch into stable operations • Define the sustained operating model, governance cadence, ownership, decision rights, and escalation pathways • Manage day-to-day program delivery, including integrated planning, governance, cross-functional execution, dependency management, risk management, issue resolution, readiness coordination, and executive reporting • Coordinate execution across Product, Digital, Marketing, Sales, Service, Clinical, Compliance, Technology, Analytics, Finance, Operations, and external partners • Own knowledge continuity and core program documentation • Prepare leadership updates on program health, emerging risks, required decisions, and recommended actions • Own the integrated program plan, governance routines, RAID log, decision log, and executive reporting • Serve as primary operational contact for the delivery partner • Own vendor performance scorecards and governance reporting • Monitor SLAs, KPIs, contractual commitments, and operating standards • Lead escalation management, root-cause analysis, and corrective-action planning for vendor issues • Partner with Compliance, Legal, Procurement, Technology, and operations on vendor controls, reporting integrity, audit readiness, and remediation tracking • Own integrated performance and measurement across enrollment, activation, utilization, engagement, service delivery, member experience, quality indicators, and cost • Monitor objectives, identify performance drivers, and coordinate improvement actions • Maintain an end-to-end view of member and associate experience • Partner with Contact Center, Sales, Care Management, Digital, and other teams on frontline processes, tools, and information • Identify systemic issues and drive agreed improvements through implementation • Translate operational, vendor, member-experience, and performance data into leadership insights, trade-offs, and recommendations • Support product strategy, annual planning, bid development, and vendor decisions • Identify capabilities and practices applicable to other emerging supplemental benefits
• 4-5+ years of experience in vendor or partner management, complex program delivery, product operations, or a related field • Demonstrated ownership of cross-functional business outcomes • Ability to lead complex initiatives through implementation, stabilization, and ongoing operations • Experience monitoring SLAs, KPIs, contractual commitments, and/or corrective actions • Track record of driving vendor accountability and operational improvement • Experience defining performance measures and translating operational, member, or vendor data into actionable business recommendations • Strong analytical and structured problem-solving skills • Root-cause analysis and assessment of trade-offs • Exceptional written and verbal communication skills • Experience preparing executive-level materials and recommendations • Ability to influence without direct authority and drive commitments through closure • Strong organizational judgment • Cross-functional teamwork and stakeholder management • Preferred: experience with Medicare Advantage supplemental benefits, D-SNP, SSBCI, or dual-eligible populations • Preferred: familiarity with CMS requirements affecting benefit operations, member communications, data use, reporting, or vendor delegation • Preferred: experience moving a new product, benefit, or program from launch through stabilization and optimization • Preferred: experience developing vendor scorecards, QBRs, performance-governance routines, operating controls, or audit and remediation processes • Self-provided internet service with minimum 25 Mbps download and 10 Mbps upload • Dedicated workspace without ongoing interruptions to protect member PHI / HIPAA information • Ability to work Eastern time • Willingness to travel approximately 5-10%
• Bonus incentive plan based upon company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Work-from-home flexibility • Hybrid work options • Company-provided opportunities supporting personal wellness and smart healthcare decisions
Candidatar-se🕒 4 dias atrás
Remote Florida Performance Monitor Specialist auditing care management calls and clinical documentation for Centene. Ensuring compliance with contractual, clinical, and Model of Care standards.
🗣️🇺🇸🇬🇧 Inglês obrigatório
🕒 4 dias atrás
CVS Health Senior Coordinator reviewing patient complaints, appeals, and grievances. Ensuring compliant resolutions, auditing processes, and improving patient billing and service outcomes remotely in Nevada.
🗣️🇺🇸🇬🇧 Inglês obrigatório
🕒 4 dias atrás
Virtual Clinical Pathologist interpreting veterinary specimens for IDEXX, an animal-health diagnostics company. Providing timely reports, consultations, and customer-focused support for veterinarians worldwide.
🗣️🇺🇸🇬🇧 Inglês obrigatório
🕒 4 dias atrás
Profee audit specialist performing medical-record coding audits for Datavant, a healthcare data collaboration platform. Ensuring accurate, compliant coding and educating coders.
🇺🇸 Estados Unidos – Remoto (EUA)
💰 $40.000.000 Series B em 2020-10
⏰ Tempo Integral
🟡 Pleno
🟠 Sênior
🦅 Patrocina Visto H1B
🗣️🇺🇸🇬🇧 Inglês obrigatório
🕒 4 dias atrás
Service Parts Catalog Specialist managing PIES-compliant parts data and catalog publication for Slate’s customizable electric vehicles. Ensuring accurate attribution, lifecycle control, and customer-ready service solutions.
🇺🇸 Estados Unidos – Remoto (EUA)
💵 $79.386 - $140.840 / ano
⏰ Tempo Integral
🟡 Pleno
🟠 Sênior
🦅 Patrocina Visto H1B
🗣️🇺🇸🇬🇧 Inglês obrigatório