Medicare Call Center Manager — Remote Leadership & Quality

Humana Inc; Boise (ID); Remote; USD 70,000 - 143,000; Full time

Benefits offered by this job

Medical, dental & vision benefits

401(k) retirement savings plan

Job summary

Humana Inc. seeks a Manager for the IFG Agnostic Call Center to lead Medicare call center operations, ensuring SLAs, KPIs, and quality while maintaining CMS/HIPAA compliance.

The role requires 2+ years in healthcare call center leadership, Medicare experience, and quarterly travel. Open enrollment hours may extend; remote work with periodic travel to Humana offices is possible. 40 hours weekly with a strong focus on member experience.

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

Healthcare leadership

CMS knowledge

KPIs & quality

Open enrollment availability

Travel readiness

Communication skills

Education

Bachelor's degree or equivalent experience

Job description

Humana Inc. seeks a Manager for the IFG Agnostic Call Center to lead Medicare call center operations, ensuring SLAs, KPIs, and quality while maintaining CMS/HIPAA compliance.

The role requires 2+ years in healthcare call center leadership, Medicare experience, and quarterly travel. Open enrollment hours may extend; remote work with periodic travel to Humana offices is possible. 40 hours weekly with a strong focus on member experience.