LTSS Process Improvement Manager

Become a part of our caring community and help us put health first
 The Medicaid Manager, Long-Term Supports and Services (LTSS) Process Improvement collects and measures the effectiveness of existing business processes using financial, outcome and process data, and develops sustainable, repeatable and quantifiable business process improvements and best practices. The LTSS Process Improvement Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Manager, LTSS Process Improvement works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.

Position Responsibilities:  

• Work with teams to create Power BI dashboards and reports to aid in analyzing trends.

• Partner with cross-functional teams to aggregate data from finance, provider, quality and other teams to inform strategy development and execution.  

• Using cross-functional data, create LTSS Network adequacy and capacity tracking capabilities

• Monitor broader outcomes, including member and provider satisfaction, to ensure partnership value beyond contractual SLAs.

• Identify and segment LTSS providers using developed metrics to identify quantifiable good provider partners, moderate provider partners, and low performing provide partners 

• Analyze utilization trends to optimize LTSS waiver and Community-Based Organization (CBO) service 

• Use data-driven insights to identify nascent LTSS capabilities to enhance innovation and value to stakeholders 

• Oversight CBO partnerships, ensuring compliance and high-quality care is delivered

• Aggregate EVV data to ensure appropriate billing and identify national trends

• Lead team of Process Improvement support roles whose primary responsibility will be to aggregate data and identify trends.

• Support development and operations of National LTSS Strategy Committee 

 

Use your skills to make an impact
 

Required Qualifications: 

• Bachelor’s degree in business or a related field or equivalent experience  

• Minimum five (5) years Healthcare experience

• Minimum two (2) years' experience leading people or project initiatives

• Experience problem solving and consultation within complex environments

• Facilitating cross-functional teams' efforts 

• Strong influencing and process implementation skills 

• Ability to communicate effectively and deliver presentations to senior leaders 

 

Preferred Qualifications: 

• Master’s degree in business, Operations Management, Healthcare Administration, or related field. Eight (8) plus years business experience

• Knowledge of Systems Development Life Cycle, Waterfall, and Agile Development Methodologies

• Possess a solid understanding of operations, technology, communications and processes Six Sigma and / or Project Management Institute certification 

Additional Information

Work At Home Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

• Satellite, cellular and microwave connection can be used only if approved by leadership

• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Interview Format  

As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, a third-party vendor.  This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. 

If you are selected to move forward from your application prescreen, you will receive an email correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. (please be sure to check your spam or junk folders often to ensure communication isn’t missed) If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. 

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided.  Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. 

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$104,000 - $143,000 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 05-01-2025
About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Apply