Risk Program Delivery Professional

🔥 0 minutes ago

🐎 Kentucky, Montana, +3 more states – Remote

🐎 Kentucky – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🌪️ Oklahoma – Remote

💵 $86.3k - $118.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

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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

• Execute Provider Programs and deliver operational performance outcomes • Implement, monitor, and continuously improve program operational processes • Evaluate existing business processes and develop sustainable, repeatable, and measurable improvements • Oversee documentation, design, and implementation of current and new Provider Programs processes • Collect and analyze data to recommend practices and procedures that improve customer experience, support compliance, and increase efficiency • Lead and oversee business process improvement initiatives, including cross-functional, end-to-end lifecycle documentation and improvement • Support, lead, and drive organizational initiatives, retrospective lessons learned, and cross-functional collaboration opportunities • Ensure process and procedure documentation is standardized and accurate across programs • Develop, review, and approve program education and materials • Support operating discipline, including rollout, adoption, and ongoing departmental review of enterprise support frameworks • Support Provider Programs financial management, including program administration, claims management, and departmental administrative expenses

🎯 Requirements

• 5+ years of experience in program delivery, operations, business process improvement, or related operational roles • 2+ years of experience analyzing operational data and using findings to recommend process, compliance, customer experience, or efficiency improvements • 2+ years of experience documenting, standardizing, or improving business processes across cross-functional teams or programs • Experience using Microsoft Office tools, including Excel, PowerPoint, Outlook, and Teams • Experience with departmental finance activities and processes, including budgeting, forecasting, invoicing, reconciliation, and planning • Bachelor’s degree in Business Administration, Health Care Administration, Operations, Finance, or a related field is preferred • Master’s degree preferred • Experience applying Lean, Six Sigma, or other process improvement methodologies • Experience supporting financial management activities, including budgeting, expense tracking, claims management, reporting, or program administration • Experience in operational program management, business operations, or process execution within a matrixed or cross-functional environment • PMP certification or equivalent project/program management credential preferred • Knowledge of health care, managed care, provider programs, risk adjustment, or clinical documentation workflows • Strong analytical skills, including interpreting data, identifying trends, and translating insights into actionable business recommendations

🏖️ 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 • Other personal wellness and healthcare decision support opportunities