[Remote] Manager, UM Administration at Humana

Wisconsin, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor's Degree
Two years of supervisory or people leadership experience
Prior demonstrated experience with process improvement or process design and implementation roles
Availability to work the hours of 8am to 4:30pm CST, Monday through Friday
Comprehensive knowledge of all Microsoft Office applications
Progressive experience in the health service industry, healthcare finance or healthcare related consulting
Deep understanding of strategic planning, customer loyalty and retention programs, and primary and secondary research processes
Strategic thinking and business planning capabilities; organized and detail-oriented
Excellent written and verbal communication skills
Demonstrated presentation skills

Responsibilities

Provide non-clinical support for policies and procedures, including creating service authorizations
Offer customer support for authorization inquiries and claim-related issues
Make decisions related to resources, approaches, and tactical operations for projects and initiatives within your department
Collaborate across departments and maintain frequent contact with other managers
Conduct briefings and area meetings to ensure alignment and communication across teams
Supervise and lead 3 units within your area, providing people management and support
Identify inefficiencies and opportunities, develop business process improvement plans, and leading the implementation
Conduct strategic planning efforts
Use your skills to make an impact

Skills

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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