Note: The job is a remote job and is open to candidates in USA. Humana is a healthcare company providing insurance and healthcare services to people with Medicare and Medicaid, families, individuals, military service personnel, and communities. The Process Improvement Lead develops and executes operational excellence initiatives, analyzes business processes and data, and drives sustainable improvements in the Medicaid organization. The role also leads process standardization, compliance support, training reviews, and change initiatives.

Responsibilities

• The Process Improvement Lead analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements
• The Process Improvement Lead is responsible for developing and executing operational excellence initiatives within the organization
• This role uses structured methodologies to identify inefficiencies, recommend solutions, and drive implementation of best practices across business processes
• The Process Improvement Lead will research best business practices within and outside the organization to establish benchmarks for the team
• You will review processes and procedures, work to streamline the department, ensuring better collaboration, efficiency and compliance
• You will design and build out new processes and practices for the team
• Act as the point person for the department regarding resources, policies and procedures such as compliance, audits, quality reviews like NCQA materials
• In this role, you will also collect and analyze data, identifying gaps and building out process and procedures to develop best practices while minimizing risk
• You will review job aids, new hire onboarding and training process to ensure the team is following best in class business practices and procedures that focus on enhanced safety, increased productivity and reduced cost
• You may advise leadership to develop functional strategies (often segment specific) on matters of significance

Skills

• Bachelor's degree
• 5 or more years of process improvement experience
• 2 or more years of project leadership experience
• Must have 2 or more years of experience in case management and/or utilization management experience
• Active Registered Nurse (RN) or Master of Social Work (MSW) license in the state of employment
• Experience with Medicaid compliance preferred
• At least 2 years of Medicaid experience
• Certification in Lean, Six Sigma, or a comparable process improvement methodology preferred
• Ability to lead multiple initiatives and drive change within a matrixed organization
• Familiarity with project management tools and resources

Benefits

• This job is eligible for a bonus incentive plan. This incentive opportunity is 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

Company Overview

Company H1B Sponsorship