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.

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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 end-to-end process improvement initiatives across D-SNP operations • Analyze operational workflows, identify root causes, and recommend sustainable solutions • Partner with business stakeholders, IT, compliance, claims, enrollment, customer service, and clinical teams • Develop business requirements, process maps, and future-state operational designs • Monitor and improve KPIs, service levels, quality metrics, and compliance outcomes • Drive automation and modernization efforts to reduce manual work and operational risk • Facilitate cross-functional meetings, decision-making, and change management activities • Support regulatory readiness and adherence to CMS, state Medicaid, and Medicare requirements • Present findings, recommendations, and executive summaries to leadership • Research best business practices and establish benchmark data • Collect and analyze process data to recommend improved business practices and procedures • Determine how new information technologies can support business process re-engineering

🎯 Requirements

• Experience supporting Dual Eligible Special Needs Plans (D-SNP), Medicare Advantage, Medicaid, or government healthcare programs • Knowledge of CMS regulations and state Medicaid requirements • 3-5+ years of process improvement, operations, healthcare, or managed care experience • Strong analytical and problem-solving skills • Strong written and verbal communication skills, including executive presentations • Experience using process mapping and documentation tools (Lucid, Visio) • Familiarity with enrollment, eligibility, claims, care management, provider operations, or member services • Experience with root cause analysis and continuous improvement methodologies • Proven ability to influence stakeholders without direct authority • Experience leading complex, enterprise-wide initiatives and process redesign efforts

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Work-from-home arrangement • Dedicated workspace and internet requirements for home employees

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