Associate Director, Consumer Service Operations

🔥 0 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $104k - $143k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Ensure day-to-day operation metrics are met for the Wisconsin Medicaid Market • Lead customer service, enrollment, and vendor operations supporting members, providers, and insurance partners • Oversee call center operations and enrollment • Work with operational teams supporting claims inquiry resolution and configuration activities • Support provider and member service teams • Drive operational performance, cost efficiency, process improvement, and implementation of new programs • Contribute to overall strategy • Perform and ensure installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations • Investigate and settle claims and customer service issues • Resolve complex technical and operational problems while leading multiple managers or specialized professional associates • Drive continuous improvement to achieve daily performance metrics and evolving goals • Coordinate with enterprise and market business areas to align priorities and strengthen communication • Provide direction, support, and resources to position the team for success • Model leadership through accountability, partnership, and commitment to Humana Way Principles • Monitor and recommend improvements to increase operational productivity • Report to the Director of Consumer Service Operations

🎯 Requirements

• Bachelor's Degree • 3 or more years of progressive operational or service experience • 2 or more years of formal leadership/people management experience • Reside within the State of Wisconsin • 2 or more years of experience with project management, process improvement or process design • Comprehensive knowledge of Microsoft Office applications, including Word, Excel, PowerPoint and Visio • Prior experience in healthcare or insurance setting preferred • Experience with Human Resource principles preferred • Six Sigma or Lean experience preferred • Minimum 25 Mbps download and 10 Mbps upload internet speed • Dedicated workspace without ongoing interruptions to protect member PHI / HIPAA information

🏖️ Benefits

• Bonus incentive plan based on 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 • Wellness and smart healthcare decision support opportunities