Remote Medicare Call Center Leader

Humana Inc; Lincoln (NE); Remote; USD 70,000 - 143,000; Full time

Job summary

Humana Inc. is seeking a Manager, IFG Agnostic Call Center to lead the Medicare call center operations. The role focuses on inbound selling activities, enrollment support, eligibility inquiries, and regulatory compliance with CMS guidelines.

You will coach supervisors and drive performance improvements across metrics such as AHT, CSAT, and CAHPS. Remote position with periodic travel to Humana offices for training.

Qualifications

• 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.

Skills

Call center leadership

Medicare knowledge

CMS/HIPAA compliance

KPI management

Travel readiness

Education

Bachelor's degree or equivalent experience

Job description

Humana Inc. is seeking a Manager, IFG Agnostic Call Center to lead the Medicare call center operations. The role focuses on inbound selling activities, enrollment support, eligibility inquiries, and regulatory compliance with CMS guidelines.

You will coach supervisors and drive performance improvements across metrics such as AHT, CSAT, and CAHPS. Remote position with periodic travel to Humana offices for training.