The Manager, IFG Agnostic Call Center conducts selling activities related to inbound calls inquiring about individual health plan products. The Manager, IFG Agnostic Call Center works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.
Key Responsibilities
Call Center Operations
- 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
Medicare & Regulatory Compliance
- Ensure full compliance with CMS guidelines, Medicare regulations, HIPAA, and company policies
- Support CMS audits, internal audits, and compliance reviews
- Maintain documentation and workflows aligned to Medicare Advantage and Part D requirements
- Partner with Compliance and Legal teams to address regulatory updates
Leadership & Staff Development
- 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
Quality & Member Experience
- 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
Reporting & Performance Management
- 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
Cross0Functional Collaboration
- 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
Use your skills to make an impact
Required 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
Preferred Qualifications
- Experience supporting STAR Ratings, CAHPS, or HEDIS initiatives
- Bachelor0s degree or equivalent experience
- Managed care or health plan call center background
- Call center workforce management experience
- Lean, Six Sigma, or process improvement experience
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees0ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The range below reflects a good faith estimate of total compensation for full time (40 hours per week) employment at the time of posting. This compensation package includes both base pay and targeted commission pay. The pay range may be higher or lower based on geographic location. Actual earnings will vary based on individual performance, with the base salary and commission structure aligned with company policies and applicable pay transparency requirements.
$70,000 - $142,500 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, 2Humana2) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 10-01-2026
