Senior Process Improvement Professional

🔥 2 minutes ago

🇺🇸 United States – Remote

💵 $78.4k - $107.8k / year

⏰ Full Time

🟠 Senior

⚙️ Operations

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.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

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 • Provide business ownership and leadership for strategic Medicaid enrollment and waiver modernization initiatives • Lead enterprise member movement enhancements • Define requirements, conduct testing, validate results, and support implementation with IT and business stakeholders • Identify operational risks and develop solutions minimizing impacts to clinical, claims, finance, and enrollment operations • Monitor post-implementation performance and business outcomes • Provide operational ownership and oversight for multiple Medicaid waiver enhancements • Govern LTSS waiver-related processes, updates, validations, and issue resolution • Manage the LTSS mailbox and coordinate review, validation, and processing of waiver-related member information • Develop scalable processes that reduce manual intervention and improve waiver data accuracy • Liaise across business operations, technology, finance, claims, clinical, and enrollment teams • Facilitate stakeholder alignment on priorities, requirements, testing, implementation, and operational readiness • Communicate project progress, risks, dependencies, and recommendations to leadership • Support training, change management, and adoption efforts • Identify automation opportunities and establish monitoring, reporting, and governance practices • Support enterprise Medicaid operations and enrollment modernization initiatives

🎯 Requirements

• Experience leading complex healthcare, Medicaid, process improvement, operational, or technology initiatives • Demonstrated success managing cross-functional projects involving multiple business areas • Strong analytical, problem-solving, and risk management capabilities • Experience developing business requirements, testing strategies, operational processes, and implementation plans • Medicaid managed care, enrollment, eligibility, waiver, or member administration experience preferred • Experience with Medicare and/or Medicaid preferred • Experience with Medicare Reconciliation preferred • Experience analyzing, interpreting, and displaying financial, health, competitive, and performance measurement data preferred • Experience leading strategy and/or operational planning preferred • Experience consulting to, and/or influencing, executive leadership preferred • Experience influencing change in a matrix organization preferred • Experience with Microsoft Excel chart creation, macros, and pivot tables preferred • Experience with Power BI preferred • Minimum home internet speed of 25 Mbps download and 10 Mbps upload for home or hybrid home/office employees • Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information

🏖️ 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 • Personal wellness support and smart healthcare decision resources

📊 Check your resume score for this job

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

Upload Resume