Program & Process Design Advisor

Become a part of our caring community and help us put health first
 Humana Healthy Horizons is seeking a Program & Process Design Advisor who provides data-based strategic direction to identify and address business issues and opportunities. The Program & Process Design Advisor will support the New Medicaid State Implementations and lead teams to analyze complex business problems to meet State obligations.

The Program & Process Design Advisor leads initiatives to analyze complex business problems, performs risk mitigation steps, and practices change management principles to counter unpredictability in implementation strategies. The Advisor uses data from internal and external sources and brings expertise or identifies subject matter experts in support of multi-functional efforts to identify, interpret, and produce recommendations and plans based on company and external data analysis. The Program & Process Design Advisor ensures that policies and procedures align with corporate vision and uses independent judgment requiring analysis of variable factors and determining the best course of action.

 

Key Role Objectives/Responsibilities:

•  Utilizes change management skills to assist an organization to navigate through a difficult transitional process or task.
• Defines and documents the design for the new contract components to meet the contractual requirements and provide strategic direction. 
• Works cross-functionally across the enterprise to define requirements, gain consensus, and help support process decision making that support the operations.
• Selects, develops, and evaluates personnel ensuring efficient operation of the function.
• Advises executives to develop functional strategies (often segment specific) on matters of significance.
• Provides business intelligence and strategic planning support for business segments or the company at large.
• Exercises independent judgment and decision making on complex issues regarding job duties and related tasks.

Use your skills to make an impact
 

Required Qualifications

• Must reside in the eastern or central standard time zones in the United States.
• Bachelor's degree, or 4 years of relevant work experience.
• 2+ years of formal change management experience in prior positions.
• 3+ years of business project management experience with large size initiatives.
• 3+ years working in a managed care healthcare system.
• 2+ years in process design and workflow documentation experience.

Preferred Qualifications

• Change Management certifications (Prosci) or Six Sigma Black Belt.
• PMP or PMI-ACP certifications, Certified Scrum Master (CSM) or Professional Scrum Master (PSM).
• Experience with Medicaid implementation initiatives.

Work at Home Requirements

• 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.
• Humana will provide Home or Hybrid Home/Office associates 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.

Additional Information

• Travel: Role may include limited travel to a Humana office location.
• Workstyle: Remote
• Core Workdays & Hours: Typically, 8-5 pm Monday – Friday; Eastern Standard Time (EST) with flexible scheduling (i.e. occasional nights and weekends)
• Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.....  

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 correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.  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 or computer 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.

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.

 

$112,400 - $154,900 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.
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.

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