Medicare Call Center Manager - Remote Leadership

Humana Inc; Augusta (ME); On-site; USD 70,000 - 143,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Job summary

Humana Inc. is seeking a Manager for the IFG Agnostic Call Center to lead the Medicare call center operations, drive enrollment and eligibility inquiries, and ensure compliance with CMS and HIPAA requirements.

The role involves managing KPIs, coaching supervisors, and implementing improvements across open enrollment periods. Responsibilities include monitoring call metrics, QA results, and member satisfaction while collaborating with Enrollment, Claims, Care Management, IT, and Provider

Qualifications

• Active Health Insurance License
• 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

CMS regulations

HIPAA compliance

KPI management

Education

Bachelor's degree or equivalent experience

Job description

Humana Inc. is seeking a Manager for the IFG Agnostic Call Center to lead the Medicare call center operations, drive enrollment and eligibility inquiries, and ensure compliance with CMS and HIPAA requirements.

The role involves managing KPIs, coaching supervisors, and implementing improvements across open enrollment periods. Responsibilities include monitoring call metrics, QA results, and member satisfaction while collaborating with Enrollment, Claims, Care Management, IT, and Provider