Qureos Mentor

Humana

At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. We continuously create innovative solutions and resources that help people live their healthiest lives on their terms, recognizing that healthcare needs evolve for each individual and community. Our commitment to customer-first service is at the heart of our operations, supported by a dynamic workforce dedicated to improving health outcomes.

<div><h1 class="jobSectionHeader">Become a part of our caring community 
</h1>
The Senior Product Manager Conceives of, develops 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 projects that grow enterprise strategy and operational reliability. As a Senior Product Manager, you will plan and manage the enhancement and integration of the business products with a special focus on clinical care management and technology solutions. This role is important to translating 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 be interface between business and technology, driving transformation and new ideas while maintaining operational thoughtfulness. The Senior Product Manager will partner with an Agile delivery team and partners to foster an environment of continuous delivery and improvement.
Key Responsibilities<ul><li>
Strategic Leadership &amp; Transformation:</li><li>
Lead new transformation efforts, aligning technology roadmaps with enterprise goals and clinical, operational, and customer experience goals. Champion improvement and scalability for new markets, services, and population launches.</li><li>
Regarding own work methods, occasionally in, and and receives guidance where needed.</li></ul><ul><li>
Stakeholder Management:</li><li>
Cultivate strong relationships with senior leaders, business leaders, and technical teams. Serve as a trusted advisor, translating complex technical concepts into actionable business recommendations. Facilitate alignment and consensus among diverse stakeholders, ensuring transparency and shared ownership of outcomes.</li><li>
Cross-Platform Delivery:</li><li>
Promote delivery of business capabilities across multiple clinical platforms. Manage dependencies, milestones, and inter-team coordination to ensure timely execution.</li><li>
And experimentation on teams to drive team engagement.</li><li>
Governance &amp; Risk Management:</li><li>
Evaluate and communicate the growth of architectural and integration decisions. Ensure compliance, reliability, and scalability, managing operational risks and issue resolution.</li><li>
Operational Oversight:</li><li>
Anticipate and manage the impact of system changes, outages, and upgrades. Partner with IT and business teams to evaluate issues and escalate risks.</li><li>
Report and Communication:</li><li>
Prepare concise, status reports and summaries. Convert technical updates into clear business terms for leadership visibility.</li><li>
Mentorship &amp; Enablement:</li><li>
Help develop product owners and analysts, encouraging technical fluency and structured delivery approaches.</li></ul>
Use your skills to make an impact<h1 class="jobSectionHeader"> 
Use your skills to make an impact 

</h1>Senior Product Manager is a senior individual contributor who orchestrates complex, cross-platform technology projects that grow enterprise strategy and operational reliability. As a Senior Product Manager, you will plan and manage the enhancement and integration of the business products with a special focus on clinical care management and technology solutions. This role is important to translating 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 be interface between business and technology, driving transformation and new ideas while maintaining operational thoughtfulness. The Senior Product Manager will partner with an Agile delivery team and partners to foster an environment of continuous delivery and improvement.
Key Responsibilities<ul><li>
Strategic Leadership &amp; Transformation:</li><li>
Lead new transformation efforts, aligning technology roadmaps with enterprise goals and clinical, operational, and customer experience goals. Champion improvement and scalability for new markets, services, and population launches.</li><li>
Regarding own work methods, occasionally in, and and receive guidance where needed.</li><li>
Stakeholder Management:</li><li>
Cultivate relationships with senior leaders, business leaders, and technical teams. Be a trusted advisor, translating complex technical concepts into actionable business recommendations. Facilitate alignment and agreement among diverse partners, ensuring transparency and shared ownership of outcomes.</li><li>
Cross-Platform Delivery:</li><li>
Promote delivery of business capabilities across multiple clinical platforms. Manage dependencies, milestones, and inter-team coordination to ensure timely execution.</li><li>
And experimentation on teams to drive team engagement.</li><li>
Governance &amp; Risk Management:</li><li>
Evaluate and communicate the growth of architectural and integration decisions. Ensure compliance, reliability, and scalability, managing operational risks and issue resolution.</li><li>
Operational Oversight:</li><li>
Anticipate and manage the impact of system changes, outages, and upgrades. Partner with IT and business teams to evaluate issues and escalate risks.</li><li>
Report and Communication:</li><li>
Prepare concise, status reports and summaries. Convert technical updates into clear business terms for leadership visibility.</li><li>
Mentorship &amp; Enablement:</li><li>
Help develop product owners and analysts, promoting technical fluency and structured delivery approaches.</li></ul>
Required Qualifications<ul><li>
Bachelor&rsquo;s degree with 1+ year(s) experience in clinical management systems or 5+ years of Product Management or Health Informatics experience</li><li>
Comprehensive knowledge of all, including, Outlook, and Excel (can perform complex functions)</li><li>
Experience communicating complex technical concepts to a variety of audiences in both written and oral forms</li><li>
Communicate product updates, milestones, and progress to internal and external partners</li><li>
Cross-functional initiatives and drive transformation across technology and business domains</li></ul>
Preferred Qualifications<ul><li>
1-2 years experience working with Medicaid and/or Medicaid programs (specifically Special Needs Plans and state Medicaid Care Management) to gather decisions or requirements and document them for system build, configuration or enhancement</li><li>
Master's Degree in Business or Healthcare</li><li>
JIRA Align experience</li><li>
Azure DevOps (ADO) experience</li><li>
Epic experience / certifications</li><li>
Experience excelling in growth-oriented environments, balancing strategic vision with operational execution</li></ul>
Additional Information:<ul><li>
Travel: Willingness to travel up to 25% (annually) for partner engagement and product projects.</li><li>
Typical Workdays/Hours: Monday &ndash; Friday, 8:00 am &ndash; 5:00 pm EST or CST with some weekend hours required</li></ul>
Work-At-Home Requirements<ul><li>
WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. We will provide associates or contractors who live and work from home in the state of California with payment for their internet expense.</li><li>
We require a minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload).</li><li>
Satellite and Wireless Internet service is NOT allowed for this role.</li><li>
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information</li></ul>
Interview Process
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue 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.
Humana value's personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.
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, &ldquo;Humana&rdquo;) 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.
Application Deadline: 06-05-2026<h1 class="jobSectionHeader"> 

About us 
</h1>
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 &ndash; 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. 
 
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.</div>

Senior Product Manager

<div><h1 class="jobSectionHeader">Become a part of our caring community 
</h1>
The Senior Grievances &amp; Appeals Analyst/ Professional analyzes and audits complaints received by the plan to ensure the integrity of claims, authorization processes, and business operations. You will report to the Associate Director, Grievances and Appeals, and be a part of the Resolution team.
As a Senior Grievances &amp; Appeals Professional, you will:<ul><li>
Analyze and audit complaints received by the plan to ensure the integrity of claims, authorization processes, and business operations.</li><li>
Utilize established process guidelines and industry knowledge to validate organizational decisions and assess downstream and upstream impacts</li><li>
Perform root cause analysis of audit findings and make recommendations for appropriate change management.</li><li>
Emphasize continuous improvement by identifying opportunities to reduce redeterminations, complaints, and rework of claims.</li><li>
Identify trends and areas of improvement resulting from information obtained through the Resolution team resources and available reporting/data.</li></ul><h1 class="jobSectionHeader"> 
Use your skills to make an impact 

</h1>Required Qualifications:<ul><li>
5 or more years of healthcare services experience in Sales, enrollment, Complaints to Medicare (CTMs)</li><li>
1 or more years auditing experience</li><li>
Experience using data analysis tools (such as Excel, SQL, or Power Bi) to create and analyze reports to identify trends</li><li>
Demonstrated knowledge using advanced features in Microsoft Excel, including data sorting, pivot tables, and complex formulas.</li><li>
Experience managing concurrent projects, maintaining thoroughly documented outcomes and minimal data entry error rates.</li></ul>
Preferred Qualifications:<ul><li>
Bachelor's degree</li><li>
Experience with claims or authorization experience</li></ul>
Additional Information
Work schedule: 8 am to 5pm EST
HireVue
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue 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.
Work at Home
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:<ul><li>
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. Satellite, cellular and microwave connection can be used only if approved by leadership.</li><li>
Employees 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 expense.</li><li>
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.</li><li>
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.</li></ul>
#LI-BB1
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. 

$65,000 - $88,600 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, &ldquo;Humana&rdquo;) 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.
Application Deadline: 06-09-2026<h1 class="jobSectionHeader"> 

About us 
</h1>
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 &ndash; 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. 
 
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.</div>

Senior Grievances & Appeals Analyst

Join Humana and explore 24   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Humana

About Company

Senior Product Manager

Senior Grievances & Appeals Analyst

Senior Grievances & Appeals Analyst

Senior Grievances & Appeals Analyst

Senior Grievances & Appeals Analyst

Senior Grievances & Appeals Analyst

Senior Grievances & Appeals Analyst