Lead Medicare Call Center Manager (Remote)

Humana Inc; Austin (TX); Remote; USD 70,000 - 143,000; Full time

Job summary

Humana, Inc. is seeking a Manager to lead the IFG Agnostic Call Center, overseeing Medicare inbound/outbound activity, enrollment inquiries, and compliance with CMS rules. This role drives performance, coaching, and process improvements to deliver high-quality member interactions.

The Manager will mentor supervisors, monitor KPIs like CAHPS and STAR, and coordinate with Compliance, Legal, Enrollment, Claims, and IT teams. Occasional travel and remote work are possible.

Qualifications

• Active Health Insurance License is required.
• 2+ years of call center leadership experience in healthcare.
• 2+ years of Medicare (Medicare Advantage, Part D, or CMS-regulated environment) experience.
• Strong knowledge of CMS regulations, HIPAA, and Medicare compliance standards.
• Proven experience managing KPIs, quality programs, and high-volume operations.
• May require extended hours during Open Enrollment Period (OEP/AEP).
• Position will require quarterly travel.

Responsibilities

• Manage day-to-day operations of the Medicare call center, including inbound, outbound, enrollment, eligibility, claims, and benefits inquiries.
• Ensure adherence to service level agreements (SLAs), KPIs, and productivity targets.
• Monitor call volumes, staffing levels, schedules, and escalation processes.
• Implement process improvements to increase efficiency and quality.
• Lead, coach, and mentor supervisors, team leads, and call center agents.
• Conduct performance reviews, goal setting, and corrective action when needed.
• Identify training needs and collaborate with Training teams to enhance Medicare knowledge and customer service skills.
• Foster a culture of accountability, engagement, and continuous improvement.
• Monitor quality assurance results and drive action plans for improvement.
• Address member complaints, grievances, and escalations promptly and professionally.
• Focus on improving CAHPS, STAR Ratings, and overall member satisfaction.
• Ensure consistent delivery of accurate, empathetic, and compliant member interactions.
• Analyze call center metrics including AHT, FCR, CSAT, adherence, and utilization.
• Prepare and present performance reports to senior leadership.
• Use data to identify trends, risks, and opportunities for operational improvement.
• Partner with Enrollment, Claims, Care Management, IT, and Provider Services.
• Support open enrollment and other peak periods with staffing and workflow planning.
• Participate in system enhancements, implementations, and process redesigns.

Skills

Call center leadership

Medicare knowledge

KPIs & quality

Staff development

Regulatory compliance

Open Enrollment

Travel readiness

Education

Bachelor's degree

Job description

Humana, Inc. is seeking a Manager to lead the IFG Agnostic Call Center, overseeing Medicare inbound/outbound activity, enrollment inquiries, and compliance with CMS rules. This role drives performance, coaching, and process improvements to deliver high-quality member interactions.

The Manager will mentor supervisors, monitor KPIs like CAHPS and STAR, and coordinate with Compliance, Legal, Enrollment, Claims, and IT teams. Occasional travel and remote work are possible.