Consumer Service Ops Professional

Job Description

Become a part of our caring community

The Consumer Service Operations Professional 2 is responsible for the daily coordination of member support and benefit fulfillment activities across multiple service responsibilities. You will support members by resolving service needs, coordinating benefit delivery, facilitating assistance programs and collaborating with internal and external partners to achieve positive member outcomes.
The Consumer Service Operations Professional 2 works, exercises, manages and contributes to ongoing operational improvements. Work assignments are varied and frequently require interpretation, and independent determination of courses of action.

The Consumer Service Operations Professional 2 may support benefit installation, implementation, and market operations, ensuring the successful administration and oversight of member benefits.

- Investigate and resolve member, provider and customer service issues.

- Coordinate fulfillment of member benefits and resources, including researching products, identifying solutions and arranging delivery.

- Collaborate with internal partners to address member needs and ensure service excellence in benefit administration and fulfillment.

- Coordinate with internal and external partners to facilitate benefit fulfillment, resolve barriers and support member outcomes.

- Use benefit fulfillment systems multiple systems and data sources to process requests, maintain accurate records and support operational workflows.

- Analyze information, research problems and determine appropriate solutions while balancing quality, compliance and member experience.

- Monitor work activity and use operational data, reports and performance metrics to support decision-making and workload prioritization.

- Identify opportunities to improve processes, improve workflows and enhance the member experience.

- Support implementation of new programs, benefits, workflows or operational programs as assigned.

- Operate while exercising and judgment in prioritizing work and adapting established procedures to unique situations.

- Demonstrate for complex issues through resolution.

- Understand department, segment and organizational strategies and how they align with operational goals.

- Contribute to a culture of continuous improvement, teamwork and consumer experience.

Use your skills to make an impact

Required Qualifications

- Bachelor's degree or equivalent work experience

- 3 years experience in a service operations environment

- Must be passionate about contributing to an organization focused on improving consumer experiences

Preferred Qualifications

- Benefit or Program implementation experience

- Experience with healthcare or benefit administration

- Experience analyzing operational data and metrics to identify trends, support decision-making and communicate insights to

- Quality assurance, auditing or continuous improvement experience

- Project Management experience

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.

$58,700 - $68,200 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 at Humana.com and at CenterWell.com.

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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.

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