LTSS Process Improvement Professional

Job not on LinkedIn

🔥 39 minutes ago

🇺🇸 United States – Remote

💵 $65k - $88.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

⚙️ Operations

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👻 Ghost score 0%

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Support development and maintenance of implementation documents, including policies, procedures, program descriptions, letters, and assessments • Review member and provider manuals for inconsistencies and compliance gaps • Prepare and submit internal documentation through review and approval processes • Maintain version control, file management, and coordination with SMEs and reviewers • Review training materials and job aids and provide feedback to training teams • Document process steps and create visual workflows • Support creation and maintenance of clinical auditing tools and operational tools • Set up and document shared mailboxes, fax numbers, and other communication tools • Research contracts, regulatory documents, and internal stakeholder information • Track document creation and submission tasks using Smartsheet, OneNote, SharePoint, and internal project tracking systems • Participate in meetings, take notes, summarize discussions, and follow up on tasks • Provide project support to the cohort team and broader process improvement efforts • Interpret contract requirements and convert them into summaries or draft documentation • Perform quality checks on documentation • Complete stretch assignments and special projects supporting Medicaid implementation and process improvement

🎯 Requirements

• Bachelor's degree or 3 years’ equivalent experience working in health plan operations • 2 plus years’ experience supporting LTSS Provider, LTSS Care Management (CM), or LTSS Utilization Management (UM) roles • Project management experience preferred • Medicare/Medicaid integrated model experience preferred • Experience/knowledge working in a cross-functional setting preferred • Minimum download speed of 25 Mbps for home internet • Minimum upload speed of 10 Mbps for home internet • Dedicated workspace without ongoing interruptions to protect member PHI / HIPAA information

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Remote work • Occasional travel to Humana offices for training or meetings • Home office work requirements supported by internet service criteria