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

　　Humana Healthy Horizons in Oklahoma is seeking a Claims Research & Resolution Lead who manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both for and against the organization. The Claims Research & Resolution Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Claims Research & Resolution Lead will also manage a group of associates.

　　You will be part of a caring community at Humana. When you meet us, you can tell we started as a hometown company. We're proud of our Louisville roots and, as we've grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are-whether you're working from home, from the field, from our offices, or from somewhere in between-you'll feel welcome here. We're a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone's voice is heard and respected. Community is a verb here. It's up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve.

　　Are you Caring, Curious and Committed? If so, apply today!

　　The Claims Research & Resolution Lead:

　　Works with insurance companies, providers, members, and collection services in the settlement of claimsComprised of a group of calls/claims/provider associates researching the resolutionAdvises executives to develop functional strategies (often segment specific) on matters of significanceExercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervisionUses independent judgment requiring analysis of variable factors and determining the best course of action

　　Required Qualifications

　　Must reside in OklahomaBachelor's degree8 or more years of technical experience leading a medical/provider/health plan claims operation2 or more years of project leadership experienceMust be passionate about contributing to an organization focused on continuously improving consumer experiences

　　Preferred Qualifications

　　Master's Degree

　　Additional Information

　　About Humana

　　Your growth is what drives Humana forward.

　　When you get here, the journey is just beginning. Our leaders are committed to understanding what you need to grow. Because we don't grow without youThis is a place where our nurses influence the C-suiteWhere software engineers change livesWhere every associate can build a professional path where they learn and thriveThrough our commitments to wellbeing and work-life balance, we support each associate's personal health, purpose, work style, sense of belonging, and securityBecause finding new ways to put health first-for our members and patients and our associates alike-is what we do

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　　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; wireless, wired cable or DSL connection is suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipAssociates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expenseHumana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/jobWork from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

　　Interview Format

　　As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

　　If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

　　If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

　　Scheduled Weekly Hours

　　40

　　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 because he or she is a protected veteran. 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.