Permanent Remote Call Monitoring Jobs in Winona, MN

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Join Humana as a Associate Director of Consumer Operations where you will be responsible for ensuring the day to day operation metrics are being met for the WI Medicaid Market. Reporting to the Director of Consumer Service Operations, you will lead customer service, enrollment, and vendor operations that support members, providers, insurance partners. You will oversee call center operations, enrollment and work closely with operational teams that support claims inquiry resolution, configuration activities, provider and member service teams. You will drive operational performance, cost efficiency, process improvement, and implementation of new programs and contribute to overall strategy.

Main Responsibilities

• 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.
• Decision-making related to resolving complex technical and operational problems within department(s) leading multiple managers or specialized professional associates.
• Drive continuous improvement of operational processes to support achievement of daily performance metrics and evolving goals.
• Support coordination with enterprise and market business areas to align priorities, strengthen communication, and ensure collective progress toward shared goals.
• Ensure the team is positioned for success by providing clear direction, appropriate support, and the resources needed.
• Model leadership through accountability, partnership, and a commitment to the Humana Way Principles
• Monitor and recommend improvements to increase operational productivity by providing advice and assistance to other team members.

Use your skills to make an impact

Required Qualifications

• 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 WI
• 2 or more years of experience with project management, process improvement or process design
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, PowerPoint and Visio

Preferred Qualifications

• Prior Experience in healthcare or insurance setting
• Experience with Human Resource principles
• Six Sigma or Lean experience

Additional Information

• Workstyle: remote, work from home
• Typical Workdays/hours: Monday - Friday, between 8:00 am - 5:00 pm CST

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$104,000 - $143,000 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.