Payment Integrity Lead

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $94.9k - $130.5k / year

⏰ Full Time

🟠 Senior

🧐 Strategy

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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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 implementation of senior level strategic initiatives and IT projects • Assess and quantify financial impacts for process changes and new technology needs • Manage and cultivate vendor relationships • Collaborate with internal business and external stakeholders • Update leadership on roadmap initiatives, product progress, milestones, and transition progress • Oversee and develop a team of 6+ Product Owners and Project Managers • Lead requirements gathering, project management oversight, user acceptance testing, production support, training, and education • Create and present project status updates and financial impacts to senior-level executives • Manage and support leaders with multiple high-priority projects • Lead cross-functional initiatives • Use data from internal and external sources to provide insight to decision-makers • Advise executives on functional strategies and significant matters • Exercise independent judgment and decision-making on complex issues under minimal supervision

🎯 Requirements

• 5 or more years work experience reading and interpreting claims • 3 or more years of project leadership experience • Comprehensive knowledge of Microsoft Office Programs Word, PowerPoint, and Excel • Skilled in data and/or situational analysis • Excellent independent judgement and decision making ability for complex issues • Ability to handle multiple priorities • Capacity to maintain confidentiality • Excellent written and verbal communication skills • Passion for contributing to an organization focused on continuously improving consumer experiences • Bachelor's Degree (preferred) • Experience leading people and/or processes (preferred) • Experience in Financial Recovery (preferred) • Experience using CAS, MTV, CISpro and CIS (preferred) • Knowledge of Microsoft Office Programs Access and Project (preferred) • Experience in a fast paced, metric driven operational setting (preferred) • Project Management Professional (PMP) Certification (preferred) • Bilingual in Spanish and English (preferred) • Minimum 25 Mbps download speed and 10 Mbps upload speed for home internet • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

🏖️ Benefits

• Bonus incentive plan based upon company and/or individual performance • Medical, dental and 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 • Internet expense payment for associates working from home in California, Illinois, Montana, or South Dakota • Telephone equipment provided for Home or Hybrid Home/Office associates • Remote work arrangement with occasional travel to Humana offices for training or meetings

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