Process Improvement Lead, Medicaid

🔥 0 minutes ago

🌴 South Carolina – Remote

🌴 South Carolina – Remote

💵 $94.9k - $130.5k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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

• Analyze and measure the effectiveness of existing business processes • Develop sustainable, repeatable, and quantifiable business process improvements • Develop and execute operational excellence initiatives • Identify inefficiencies, recommend solutions, and drive implementation of best practices • Research business practices to establish team benchmarks • Review and streamline processes and procedures to improve collaboration, efficiency, and compliance • Design and build new processes and practices • Serve as the department point person for compliance, audits, and quality reviews such as NCQA materials • Collect and analyze data, identify gaps, and develop processes and procedures • Review job aids, new-hire onboarding, and training processes • Advise leadership on functional strategies • Report to the Director of Health Services and oversee 1–2 direct reports

🎯 Requirements

• Bachelor's degree • 5 or more years of process improvement experience • 2 or more years of project leadership experience • 2 or more years of case management and/or utilization management experience • Active Registered Nurse (RN) or Master of Social Work (MSW) license in the state of employment (preferred) • Experience with Medicaid compliance (preferred) • At least 2 years of Medicaid experience • Certification in Lean, Six Sigma, or a comparable process improvement methodology (preferred) • Ability to lead multiple initiatives and drive change within a matrixed organization • Familiarity with project management tools and resources

🏖️ Benefits

• 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 • Bonus incentive plan