Become a part of our caring community and help us put health first

Do you have a desire to work from home? Do you love assisting others when they are in need? Are you looking for valuable experience working for a Fortunate 100 company that focuses on the well-being of their customers? Come be a part of Humana’s Member Calls Organization! Our Call Center Representatives have a passion for assisting people with their healthcare needs; in particular, our Medicaid members, to provide the best solutions and outcomes working in a best-in-class contact center.

As a Call Center Representative 2, you will provide coverage for Eastern Time Zone hours, taking 40 to 50 calls per day from Kentucky Medicaid customers who have questions about their health benefits. This is a fast-paced, high-volume call center setting which can be stressful at times. In addition, you would also support our Medicaid Outbound Call Campaign efforts by conducting outreach calls to our members. As their advocate, you will assist them with PCP changes, locating Providers / Specialists, benefit coverages, authorizations, Provider claims inquiries, grievances and appeals, transportation needs, and pharmacy support.

• Handle 40-50 inbound calls daily from members in a fast-paced inbound call center environment and, at times, back-to-back phone calls.
• Documents accurate details of inquiries, comments or complaints, transactions or interactions and records all actions taken in accordance with the requests or questions being asked.
• Escalates unresolved and pending member grievances and appeals. Decisions are typically focused on detailed processes and area/department policies 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.
• Participates in daily team chats, accesses a knowledge-based database (Mentor) on every call, and reads emails daily to stay on top of alerts, trainings, and all Medicaid updates/changes.

Use your skills to make an impact

Required Qualifications

• MUST reside in Kentucky or Indiana within a 50-mile radius of Humana’s Louisville offices, located at 101 E. Main Street, Louisville, KY 40202.
• Minimum two (2) years customer service experience is required.
• Proficiency with Microsoft Office applications, particularly Outlook and Teams.
• Strong technical skills with the ability to work across multiple software systems including email, chats, efficient typing skills, and toggling across multiple databases while engaging with callers.
• Must have excellent interpersonal skills and the ability to organize simultaneous tasks.
• Must meet monthly call, attendance, and performance metrics.

Training

• This position is scheduled to start on January 13, 2025. Virtual training starts on day one of employment and will run for the first 6 to 7 weeks with a schedule of 8:00 AM to 4:30 PM Eastern, Monday – Friday. 
• You must be on time, dressed appropriately / camera ready, with your camera on during training and for other meetings required by leadership.
• Attendance is vital for your success; no time off will be allowed during training or within your first one hundred twenty (120) days.
• The initial 120 days of employment as a Medicaid Inbound Call Center Representative constitute an appraisal period.  This Appraisal Period is essential to your learning and development, which is why we ask for perfect attendance during both the classroom training and nesting periods.
• This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role. You must be willing to remain in this position for a period of twelve (12) months before applying to other Humana opportunities.

Work Hours Following 6 – 7 Week Training Period

• Following training, associates are required to have flexibility to work any 8-hour shift between the hours of 6:45 AM – 9:00 PM Eastern time, Monday – Friday. Early shifts are not a guarantee, so it is important to have availability any time during this timeframe.
• Some overtime may be required, based on business needs.

Preferred Qualifications

• Bilingual in Spanish / English (See Language Proficiency Testing below)
• Associate or Bachelor’s Degree
• Previous Inbound and / or Outbound call center or related customer service experience
• Prior healthcare experience

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended.
• You will be required to be hard-wired to your modem.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Language Proficiency Testing

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. 

Additional Information 

• PLEASE MAKE SURE YOU ATTACH YOUR RESUME TO YOUR APPLICATION (PDF OR WORD FORMAT) ** 

Interview Process

As part of our hiring process for this opportunity, we will be using technology called HireVuee to enhance our hiring and decision-making ability. HireVue 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. 

• Text Prescreen: Shortly after submitting your application, you may receive both a text message and email requesting you to complete 10 to 15 prescreen questions with either yes or no answers. The text message may arrive prior to the email. If you prefer to answer via computer or tablet, wait for the email.
• Assessment: 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. We do not make job offers to candidates that do not complete the VJE.
• Video Prescreen: If you are successful with the VJE, you will receive another communication to record a Video Prescreen. This is an online video activity using your phone, tablet, or computer; however, most candidates prefer using a computer or tablet. 
• Interviews: Some candidates will be invited to interview. If so, the recruiter will reach out to schedule.
• Offers: Finalists from the interview will be contacted by a recruiter to discuss an offer for the job
• Note: Depending on the number of openings, the number of candidates who apply, and the schedules of interviewers and recruiters, this process may take several weeks or less; however, know that we are working hard to proceed as quickly as possible and to keep you informed.

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.

$34,500 – $47,400 per year

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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

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