57 home caregiver jobs found in Columbia

Become a part of our caring community and help us put health first Do you have a passion for architecting robust data ecosystems? Are you energized by advancements in artificial intelligence? Do you see opportunities to transform business strategy by integrating emerging technologies into critical operations? As a Lead Data Engineer at Humana, you will play a pivotal role in designing and implementing next-generation, compliance-focused solutions that drive innovation in data governance and protection. Humana seeks a Lead Data Engineer with a strategic mindset and deep technical expertise to advance our enterprise data governance architecture and processes. This role emphasizes integrating artificial intelligence (AI), machine learning (ML), and modern cloud-native platforms with state, federal, and enterprise policies. The successful candidate will lead initiatives that enable scalable, compliant, and future-ready data solutions across the organization. Key...

Become a part of our caring community and help us put health first The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Program Delivery Professional - IHWA Interoperability plays a key role in driving seamless data integration and collaboration within the In-Home Health and Wellbeing Assessment (IHWA) team and across interoperability initiatives. Serving as a business subject matter expert (SME), this individual partners closely with internal and external stakeholders, as well as the Interoperability team, to advance program objectives. Key responsibilities include collaborating with leaders on...

Become a part of our caring community and help us put health first The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Program Delivery Professional for IHWA is responsible for overseeing and advancing key initiatives that drive organic provider capture following an IHWA visit. This position plays a vital role in enhancing organic performance, supporting improved member care outcomes, and ensuring thorough and accurate documentation. Key responsibilities include monitoring program activities, leading efforts to optimize provider participation, and applying expertise in causal analysis and provider...

Become a part of our caring community and help us put health first The Data and Reporting Professional 2 generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The Data and Reporting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The In-Home Health and Wellbeing assessment team is seeking a Business Analyst who is adept in data analytics and possesses a keen eye for monitoring and troubleshooting KPIs. This role requires someone who can effectively perform ad-hoc analyses to support our business objectives. The ideal candidate will have insatiable curiosity and a strong aptitude for learning. Key Responsibilities: Develop SQL queries for ad hoc data pulls, analysis, and identification of root cause Utilize existing reports and dashboards to monitor and report...

Become a part of our caring community and help us put health first The Director, Home Health Risk Management identifies and analyzes potential sources of risk, proactively ensuring controls and processes are in place to reduce risk. The Director, Home Health Risk Management requires an in-depth understanding of how organization capabilities interrelate across the Home Health segment. The Director of Risk Management for Home Health will be responsible for development and implementation of controls and cost-effective approaches to minimize risks to the organization as well as estimating the potential consequences of risks. Assesses and communicates information regarding business risks with functions across the organization. Their focus will be on CenterWell risk assessments, issue management, auditing and monitoring. Areas of oversight will include CenterWell Home Health, OneHome, as well as new growth initiatives. This role requires an in-depth understanding of Home Health...

Become a part of our caring community and help us put health first The Senior Configuration Professional work focuses on accessing and configuring an application or system that is integrated with business processes/data and IT infrastructure including building modules, developing tables/reports, and creating complex functions. The Senior Configuration Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Configuration Professional responsibilities can include advising the business, evaluating requests, implementing new features and changes, troubleshooting, resolving testing issues, configuring processes and experiences. integrating, developing interfaces, and maintaining documentation. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is...

Become a part of our caring community and help us put health first The Manager, Fraud and Waste conducts investigations of allegations of fraudulent and abusive practices. The Manager, Fraud and Waste works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. Where You Come In The Manager, Fraud and Waste coordinates investigation with law enforcement authorities. Assembles evidence and documentation to support successful adjudication, where appropriate. Conducts on-site audits of provider records ensuring appropriateness of billing practices. Prepares complex investigative and audit reports. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and...

Become a part of our caring community and help us put health first Humana's Marketing organization is seeking an Associate Director, Product Marketing to lead the go-to-market, positioning, and member-focused campaigns for our Medicaid lines of business. You will craft the product value proposition, align messaging to state program objectives, and lead cross-functional teams to deliver integrated, multi-channel experiences that drive measurable outcomes for members and the enterprise. Key Responsibilities Develop and own product marketing strategies and go-to-market plans for Medicaid products across states, including positioning, value propositions, and messaging frameworks. Lead end-to-end campaign delivery (email, direct mail, SMS, app, web, call center/IVR) from creative concept through execution, measurement, and optimization. Translate business goals into data-driven content and personalization strategies; partner with data science to define Next...

Become a part of our caring community and help us put health first Encounter Data Management Professional is responsible for ensuring accurate submission and reconciliation of encounter data to Medicaid and Medicare through effective business processes. Ensures claims submissions meet or exceed all compliance standards via analysis of data and develops tools to enhance the encounter acceptance rate by Medicaid/Medicare. Looks for long-term improvements of claims submission processes. Takes ownership by applying professional standards, regulations, and strategies within their work area. Independently sets priorities and makes decisions on work approach while following established direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation. Humana's Encounter Data Management (EDM) team is seeking an Encounter Data Management Professional that has experience with business processing and data...

Become a part of our caring community and help us put health first The Business Systems Analysis Professional 2 will support the Payment Integrity Electronic Medical Record (EMR) Team in the onboarding, implementation, and maintenance of new EMR vendor connections, with a primary focus on Cerner and Integrated Delivery Network (IDN) projects. This position will serve as the main point of contact for Cerner provider integrations scheduled to begin going live in 2026, ensuring successful recruitment, performance monitoring, troubleshooting, and product testing. The Business Systems Analysis Professional 2 performs analysis of business, process and user needs, documentation of requirements, cost/benefit analysis and translation into proper system requirement specifications. The Business Systems Analysis Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Business Systems...

Become a part of our caring community and help us put health first The Business Informatics Shared Services (BISS) Team is focused on optimizing the execution, investments, strategy, application experience, project delivery, and governance between the corporate technology and business teams, primarily in support of enterprise Finance. The BISS team has extensive and broad enterprise data experience that is frequently engaged to support efforts outside of Finance. The Technology Implementation Professional gathers and documents business system and functional requirements. influences system design to optimize support and ensures solutions meet the business objectives and requirements. Completes and/or coordinates implementation of design and requirements. testing, operational readiness, and transition to the appropriate production support team. Advise executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent...

Become a part of our caring community and help us put health first The Associate Director, Technology Solution Implementation delivers new technological solutions to meet business needs within a specified scope while aligned to enterprise objectives. The Associate Director, Technology Solution Implementation requires a solid understanding of how organization capabilities interrelate across department(s). The Associate Director, Technology Solution Implementation gathers and documents business system and functional requirements, influences system design to optimize support and ensures solutions meet the business objectives and requirements. Completes and/or coordinates implementation of design and requirements, testing, operational readiness, and transition to the appropriate production support team. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s) and could lead multiple managers or highly...

Become a part of our caring community and help us put health first Humana is seeking a Prior Authorization RN to join the Wisconsin Medicaid Market (iCare) team. This position reviews the clinical appropriateness of prior authorization (PA) requests and ensures that all benefits authorized meet medical necessity and other Medicare and/or Medicaid criteria if applicable, to promote cost-effective delivery of health care services. Share your talents and develop your skills all while doing your part to improve the lives of others. Essential Duties and Responsibilities: Review PA requests for home health services, durable medical equipment, outpatient therapies, skilled nursing facility therapies, and all outpatient procedures pursuant to applicable Medicare and Medicaid criteria, iCare guidelines, and PA Department policies and procedures. Review PA requests for inpatient medical stays, skilled nursing facility stays, long term acute hospital stays, inpatient...

Become a part of our caring community and help us put health first The Senior Product Manager Conceives of, develops, delivers, and manages products for customer use. The Senior Product Manager work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Senior Product Manager is a senior individual contributor who orchestrates complex, cross-platform technology initiatives that advance enterprise strategy and operational reliability. As a Senior Product Manager, you will plan and manage the enhancement and/or integration of the business products with a special focus on clinical care management and technology solutions. This role is pivotal in translating business vision into scalable technology solutions, ensuring seamless integration across platforms such as clinical care management platforms, telephony, data systems, and enterprise architecture. The Senior Product Manager will...

Become a part of our caring community and help us put health first Care Manager Support Assistants assist in ensuring TRICARE beneficiaries receive the highest quality health care for Autism Spectrum Disorder (ASD) related services in accordance with the Autism Care Demonstration (ACD). This role supports the Autism Service Navigator (ASN) by verifying eligibility for the ACD and monitoring and supporting the family for 180 to assist with any barriers to accessing services; education and initial registration into ECHO registration portal for active duty family members; assistance with regional transfers and ensuring the receiving Managed Care Support Contractor receives the appropriate paperwork; processes faxes for ECHO eligibility or other paperwork pertaining to ACD requirements such as eligibility, referrals, etc.; and identification of ABA providers and researching necessary resources to support the beneficiary. KEY ACCOUNTABILITIES Assist beneficiaries with...

Become a part of our caring community and help us put health first The Lead Systems Engineer is responsible for design, analysis, configuration and maintenance of complex systems software solutions in a virtual environment, based on a thorough knowledge of systems engineering and programming concepts and techniques. Systems software engineering/programming is a specialized area of software engineering/programming focused on software that operates/controls computer hardware and provides a platform for running end user applications. Includes operating systems, device drivers, utilities, and software; development tools (e.g., assemblers, compilers, etc.). The Lead Systems Engineer works on problems of diverse scope and complexity ranging from moderate to substantial. The Lead Virtualization Engineer is responsible for architecting, implementing, and maintaining enterprise-grade virtual environments that support the organization's critical applications and services. This...

Become a part of our caring community and help us put health first The Software Engineer 2 codes software applications based on business requirements. The Software Engineer 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Software Engineer 2 standardizes the quality assurance procedure for software. Oversees testing and debugging and develops fixes. Researches complaints and makes necessary adjustments and/or recommendations to resolve complex software related issues. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Bachelor's Degree in Computer...

Become a part of our caring community and help us put health first The Care Manager, Telephonic Nurse utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration. The work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Associate will be expected to participate in weekend rotation a minimum of one hour each on Saturday and Sunday once every 17 weeks. Work schedule can be between 8am-6:30pm EST. The Care Manager Telephonic Nurse uses clinical knowledge, communication skills, and independent critical thinking skills to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their...

Become a part of our caring community and help us put health first The Software Engineer 2 codes software applications based on business requirements. The Software Engineer 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Software Engineer 2 standardizes the quality assurance procedure for software. Oversees testing and debugging and develops fixes. Researches complaints and makes necessary adjustments and/or recommendations to resolve complex software related issues. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications Bachelor's Degree in Computer...

Become a part of our caring community and help us put health first The Senior Clinical Recruiter plays a critical role in driving talent acquisition efforts across multiple business units. As a strategic partner, the Senior Recruiter leads full-cycle recruitment, from the initial strategy sessions with business leaders to the final offer stage. This role involves deep collaboration with key stakeholders, ensuring alignment on sourcing strategies, talent pipelines, and long-term hiring plans. With a consultative approach, the Senior Recruiter delivers tailored solutions, utilizing advanced recruitment technologies to enhance the candidate experience and meet the organization's evolving talent needs. The Senior Clinical Recruiter places advertisements, attends career days, job fairs and student and RN conventions. Coordinates in-house recruitment efforts. Interviews candidates and refers them to appropriate clinical service. Begins to influence department's strategy. Makes...

Become a part of our caring community and help us put health first The Financial Planning & Analysis Lead analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. The Financial Planning & Analysis Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Financial Planning & Analysis Lead collects, compiles, verifies, and analyzes financial information and economic indicators so that senior management has accurate and timely information for making strategic and operational decisions on, for example, acquisitions, investments, capital expenditure, divestitures, mergers, or the sale of assets. Analyzes the financial implications of proposed investments or other transactions so that senior managers can evaluate alternatives against the organization's business objectives. Evaluates industry, economic, financial, and market trends to forecast...

Become a part of our caring community and help us put health first The Senior Pharmacy Contracting Professional conducts all aspects of pharmaceutical contracting and pricing including development, implementation, and maintenance. The Senior Pharmacy Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Pharmacy Contracting Professional ensures contract compliance and performs analysis regarding pharmacy claims and purchasing data to identify future contracting opportunities. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Use your skills to make an impact Required Qualifications Bachelor's...

Become a part of our caring community and help us put health first Humana's Health Quality and Stars organization is seeking a Senior Data Quality/Integrity Engineer to deliver quality and value in a fast-paced, dynamic environment. The successful candidate will be self-directed, highly-engaged, and will demonstrate expertise and business intelligence in supporting execution of the HEDIS program and related activities, all within tightly regulated requirements and timelines. This will require building and maintaining strong relationships with corporate and market teams, including IT, Quality Operations and Compliance, and Risk Adjustment, as well as vended partners. The Senior HEDIS Operations & Quality Professional supports all aspects of the non-standard supplemental (NSS) program; including: systems readiness, process improvements, resource deployment, technology implementation, and data management/reporting. The Senior HEDIS Operations & Quality Professional...

Become a part of our caring community and help us put health first The Workforce Management Professional 1 applies and integrates advanced and predictive analysis, people metrics and reporting to develop strategic and operational insights for workforce decision-making (e.g., staffing, learning and development, talent management, diversity and human resource compliance). The Workforce Management Professional 1 work assignments are often straightforward and of moderate complexity. The Workforce Management Professional 1 assesses organizational staffing and identifies requirements and solutions to meet workforce objectives. Provides analysis of talent and staffing needs based on strategic planning at the enterprise level. Understands own work area professional concepts/standards, regulations, strategies and operating standards. Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented...