Remote Medicare Call Center Leader

Humana Inc; Carson City (NV); Remote; USD 70,000 - 143,000; Full time

Job summary

Humana Inc. is seeking a Manager for the IFG Agnostic Call Center to lead day-to-day operations of the Medicare call center, handling inbound and outbound activities, enrollments, and member inquiries.

You will ensure SLAs, monitor staffing, and drive process improvements in a remote-capable, fast-paced environment. You will oversee CMS and HIPAA compliance, partner with Compliance, coach supervisors, analyze KPIs, and prepare senior leadership reports.

Qualifications

• Active Health Insurance License
• 2+ years call center leadership experience in healthcare
• 2+ years Medicare experience (Medicare Advantage or Part D)
• 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 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 experience

CMS regulations

HIPAA compliance

KPIs & performance

Open Enrollment travel

Job description

Humana Inc. is seeking a Manager for the IFG Agnostic Call Center to lead day-to-day operations of the Medicare call center, handling inbound and outbound activities, enrollments, and member inquiries.

You will ensure SLAs, monitor staffing, and drive process improvements in a remote-capable, fast-paced environment. You will oversee CMS and HIPAA compliance, partner with Compliance, coach supervisors, analyze KPIs, and prepare senior leadership reports.