Business Operations Lead - Virtual Health

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We are seeking a strategic, analytically minded business operator with experience in clinical call center operations, workforce management, and member engagement to serve as the Business Operations Lead for our Virtual Clinics organization. This role owns the strategy, design, optimization, and ongoing performance of virtual care access and engagement operationsincluding outbound and inbound call strategies, campaign execution, capacity planning, and call center technology enablement. You will analyze performance, identify root causes, evaluate opportunities, and partner across teams to design solutions that improve access, engagement, and member outcomes. The ideal candidate brings strong analytical and problem solving skills, the ability to influence stakeholders, and working knowledge of member engagement, call center operations, workforce management, dialer strategy, campaign optimization, scheduling systems, clinical outcomes, Stars performance, and CGX call platforms. This leader will build, operate, optimize, and scale virtual care operations while partnering closely with clinical, technology, marketing, and enterprise teams. The scope of this role will evolve as our virtual care model grows and scales.

Key Responsibilities

Operational Design & Continuous Improvement

• Lead day-to-day operational strategy for clinical call center and virtual engagement programs, including inbound/outbound campaigns, care gap outreach, and appointment conversion.
• Design optimal dialer logic, calling strategies, and campaign prioritization to maximize reach, productivity, and member experience.
• Own member engagement strategies across phone, digital, and hybrid channels informed by performance data and clinical priorities.
• Optimize call routing, staffing models, and appointment availability to improve access and reduce friction.

Strategic Problem Solving & Analytics

• Effectively prioritize actions and recommendations based on business need, impact, and resource constraints.
• Conduct ad hoc analyses to diagnose performance issues, uncover insights, and identify opportunities for improvement.
• Analyze trends in engagement, access, scheduling, and call center performance to inform priorities.
• Develop or refine KPIs and dashboards to guide decision making.
• Translate data into clear insights and actionable recommendations for senior leaders.

Workforce Management & Capacity Planning

• Drive capacity modeling, scheduling strategy, and workforce optimization in partnership with WFM and clinical leadership.
• Balance demand, staffing, and productivity across markets, programs, and seasons.
• Identify risks to access, abandonment, and experience metrics and activate mitigation plans proactively.

Technology & Platform Enablement

• Partner with technology teams to enhance or optimize call center and scheduling platforms, including CGX call platforms, dialers, and EMR enabled workflows.
• Work with IT, vendors, and clinical stakeholders to evaluate, implement, and optimize tools that support engagement and access.
• Translate clinical and operational needs into system requirements and workflow enhancements.

Cross Functional Leadership & Stakeholder Management

• Partner with enterprise functions (Stars, Growth, Marketing, Analytics), clinical teams, technology teams, and other stakeholders to align operational execution with business priorities.
• Drive alignment on priorities, timelines, and performance goals.
• Communicate complex issues simply and influence decisions across multiple levels of leadership.

Growth & Business Planning

• Support launch, scaling, and refinement of new virtual care programs and engagement initiatives.
• Contribute to scenario models, business cases, and forecasts.
• Help define the operating model that will support long-term growth in virtual care.

Use Your Skills to Make an Impact

Required

• Bachelor's degree (Master's preferred)
• 7+ years of experience leading clinical call centers, virtual care operations, or healthcare engagement programs
• Strong understanding of how call center operations impact member experience, access, Stars, and quality outcomes
• Demonstrated expertise in: Dialer logic and campaign optimization, Workforce management, capacity planning, and clinical scheduling, CGX call platforms, scheduling platforms, and EMR enabled workflows
• Proven ability to own outcomes in complex, matrixed healthcare environments
• Highly self-directed with the ability to operate independently and lead through influence

Preferred

• Master's degree
• Experience in value-based care, Medicare Advantage, or senior focused healthcare
• Familiarity with HIPAA, CMS, CAHPS, Stars, and healthcare compliance considerations
• Experience scaling virtual or hybrid care models
• Strong executive communication and stakeholder management skills

Additional Information

Remote role

Preferred incumbent locations: Boston, MA; Washington, DC for in person meetings

Anticipate less than 10% annual travel

Standard working hours required; 8:00 am - 5:00 pm; Central or Eastern Time Zones preferred

Work at Home Requirements

To ensure Home or Hybrid Home/Office employees' ability 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 recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• 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 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. $115,200 - $158,400 per year

This job is eligible for a bonus 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: 02-27-2026

About Us

About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.

About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees