Process Improvement Principal

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $115.2k - $158.4k / year

⏰ Full Time

🔴 Lead

⚙️ Operations

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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

• Lead the strategy and approach for Humana’s provider termination processes • Collaborate with Member Retention, Stars, Provider and Member Service, Sales, and Provider Network Operations • Oversee coordination and tracking of potential or likely provider termination impacts across all regions • Optimize operational processes related to provider terminations • Identify and mitigate associate, member, and provider friction points • Oversee governance and progress against opportunity areas • Influence key partners to simplify and improve business processes • Identify additional opportunity areas and prioritize resources • Understand provider changes in advance to drive collaboration opportunities • Develop insights on downstream impacts involving Stars, member experience and retention, and provider contracting decisions • Leverage data analytics for business insights, reporting, and leadership communications • Advise leadership on functional strategies and exercise independent judgment on complex issues • Research business practices and establish benchmark data • Collect and analyze process data to recommend improved business practices and procedures • Determine how information technologies can support business process re-engineering • Report to the Director, Network Governance and Market Enablement

🎯 Requirements

• 3+ years’ experience in the payer/provider contracting lifecycle • Experience leveraging multiple business areas to drive company performance • 7 or more years of improving or creating business processes • 3+ years of project or people leadership • Ability and willingness to travel up to 10% of the time • Located in the Central or Eastern Time Zone • Bachelor's degree preferred • Customer service/account management leadership experience preferred • Minimum download speed of 25 Mbps and upload speed of 10 Mbps • Work from a dedicated space lacking 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 • Occasional travel to Humana offices for training or meetings