Process Improvement Lead

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $94.9k - $130.5k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

🦅 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

• Partner with encounter leadership to set priorities, prepare decisions, and drive follow-through on strategic initiatives • Organize priorities, meetings, decisions, owners, and timelines for complex work • Build relationships across operations, technology, compliance, markets, vendors, providers, and regulatory partners • Prepare and present updates, risks, options, and recommendations to C-suite executives and senior leaders • Lead governance forums focused on performance, risks, dependencies, decisions, and regulatory readiness • Translate encounter processes and business needs into workflows, dashboards, insights, and decision points • Anticipate regulatory, platform, volume, and data quality risks affecting encounter submissions • Drive cross-functional issues from root cause analysis through solution development, executive communication, and resolution • Create and maintain Medicaid contract compliance and risk oversight processes and documentation • Use data to challenge assumptions, recommend priorities, and improve inefficient processes • Report to the Director, Encounter Data Management • Occasional travel to Humana offices for training or meetings may be required

🎯 Requirements

• Bachelor's degree • 5+ years of experience in process improvement, business operations, strategy, or program leadership • 2+ years of experience leading cross-functional projects or enterprise initiatives • 2+ years of experience processing medical claims and/or encounter submissions • Experience organizing multiple priorities, stakeholders, decisions, and deadlines • Experience building relationships and influencing across functions without direct authority • Experience preparing and presenting business risks, results, or recommendations to C-suite executives or equivalent senior leaders • Must meet home internet requirements of at least 25 Mbps download and 10 Mbps upload • Must work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information • Not eligible for work visa sponsorship

🏖️ Benefits

• Bonus incentive plan based upon 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 • Dedicated home workspace • Internet service requirements/support for home work

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