The Senior Learning Facilitation Professional plans, coordinates, and implements all aspects of training programs for participants throughout the organization, including but not limited to instructor-led and virtual instructor-led training. Selects appropriate materials. Creates an environment that is conducive to learning and exchanging information, engages the learner, and produces the desired outcomes.

The Grievances & Appeals Professional 2 (formerly an Analyst role) assists team to further/support quality and compliance related goals. Analyze member/ provider Grievance and Appeals issues. Coordinating work activities. Often analyze work of others and/or is the primary administrative owner of a main process, program, product or technology. Works within broad guidelines with little oversight. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

The Grievances & Appeals Representative 3 manages client denials and concerns by conducting a comprehensive analytic review of clinical documentation to determine if an a grievance, appeal or further request is warranted and then delivers final determination based on trained skillsets and/or partnerships with clinical and other Humana parties.

Mentored members with completing Medicare Saving Program applications over the Phone and ensure they are prepared for mailings. Streamlined up with members to encourage them to return application, as well as required verifications and notice of actions from the state. Maintained current knowledge of state and federal regulatory requirements.