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The Innovative Financial Group (IFG) Call Center Manager is responsible for overseeing the daily operations of a Medicare-focused contact center, ensuring high-quality service, regulatory compliance, and achievement of performance goals. This role leads a team supporting Medicare Advantage, Part D, and related healthcare programs while driving operational excellence, member satisfaction, and CMS compliance.
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
Cross‑Functional 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
- Bachelor’s degree or equivalent experience
- 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)
Preferred Qualifications
- Experience supporting STAR Ratings, CAHPS, or HEDIS initiatives
- Managed care or health plan call center background
- Call center workforce management experience
- Lean, Six Sigma, or process improvement experience
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: 05-03-2026
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.
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.