Become a part of our caring community
 

The Manager, Medicare Call Center oversees daily operations of a Medicare-focused contact center supporting members, providers, and brokers. This role is responsible for team leadership, regulatory compliance (CMS), service level performance, quality outcomes, and continuous process improvement to ensure a high-quality member experience across Medicare Advantage, Medicare Supplement, and/or Part D programs.

Key Responsibilities

Call Center Operations & Leadership

• Manage day-to-day operations of the Medicare Call Center, including inbound/outbound member support
• Lead, coach, and develop supervisors and frontline representatives
• Ensure adequate staffing, scheduling, and workload distribution to meet service levels
• Oversee onboarding, training reinforcement, and ongoing performance management

Regulatory & Compliance

• Ensure compliance with CMS regulations, Call Center Monitoring (CCM) requirements, and company policies
• Maintain readiness for CMS audits and corrective action plans (CAPs)
• Monitor scripts, disclosures, and agent behaviors for Medicare compliance
• Enforce HIPAA and data privacy standards

Performance Management & Quality

• Drive key performance indicators (KPIs) including AHT, FCR, CSAT, QA scores, abandonment rate, and compliance metrics
• Partner with Quality, Compliance, and Training teams to address performance gaps
• Analyze call center data and trends to improve efficiency and member satisfaction
• Implement best practices for Medicare customer service excellence

Member Experience & Issue Resolution

• Serve as escalation point for complex member inquiries and complaints
• Ensure timely resolution of grievances, appeals support, and service recoveries
• Promote a member-centric culture aligned with Medicare STAR ratings goals

Collaboration & Reporting

• Collaborate cross-functionally with Operations, Compliance, IT, Enrollment, Claims, and Provider Services
• Prepare and present operational reports and recommendations to senior leadership
• Support annual enrollment period (AEP) and open enrollment period (OEP) readiness

Use your skills to make an impact
 

Required Qualifications

• Bachelor's degree or equivalent experience
• 2+ years of call center operations experience
• 2+ years in a people management role
• Experience managing KPIs, quality programs, and compliance audits
• Proficiency with call center technologies (ACD, CRM, QA platforms)

Preferred Qualifications

• Experience supporting Medicare Advantage, Part D, or Medicare Supplement products
• Prior management of AEP/OEP operations
• AHIP certification or familiarity with Medicare training standards
• Experience in STAR Ratings-driven environments

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 compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$70,000 - $95,500 per year

 

This job is eligible for a commission incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 04-12-2026

About us
 

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.