Senior Process Improvement Professional

Become a part of our caring community and help us put health first
 The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Process Improvement Professional analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

• Responsible for initiating, developing, and recommending best business practices and procedures for physical health clinical and nonclinical team processes

• DRI for overseeing revamp, maintenance and governance of Clinical Operations SharePoint site.

• Ensures operational processes align with governing and NCQA requirements. 

• Executes on process improvement/development and evaluation strategy and analyzes results

• Makes recommendations for improvement based on analysis of results

• Works with process improvement team to create processes and provide direction on implementation of process.  This includes, but is not limited to things such as creating processes and executing on process roll out and communication, tracking implementation of processes

• Evaluates processes to ensure up-to-date and works with trainers to ensure ability of associates to perform needed skills.

• Provides coaching and feedback and develops other process improvement team members to deliver consistent process improvement experiences across all clinical operations processes.

Subject Matter Expertise Coordination

• Develop/leverage subject expertise on systems and processes that support Humana Healthy Horizons National Operations team to lead content direction for learning and development efforts

• Build relationships with other subject matter experts and engage them when appropriate to contribute content for process design and developmental efforts

• Develop cross-functional relationships with other process functions to leverage existing processes to meet clinical needs.  Share information and content developed for clinical curriculum to other areas that support the clinical area.

• When needed, work with learning facilitators to design and develop training materials with support from learning consultants

Use your skills to make an impact
 

Required Qualifications

• Associate's degree or 5 years combination clinical process improvement and quality experience

• Intermediate to Advanced proficiency with the ability to navigate multiple screens and databases with proficiency with Microsoft Office (Excel, Word, Power Point, Lucid) and other virtual platforms i.e. Zoom and Teams

• Experience with creating data presentations in the form or graphs/charts/graphics

• Experience with creating and maintaining SharePoint sites

• Minimum 2 years Medicare/Medicaid or Healthcare experience in Utilization Management

• Great Communication Skills -Written and Verbal

• Emotional Intelligence

Preferred Qualifications

• Knowledge or certificates Project and Process Methodologies, (Lean Six, Project Management)

• Bachelor's Degree

Workstyle: Remote work at Home

Location: Nationwide

Schedule:

• Typically, Monday through Friday 8:30 AM -5:30 PM Eastern time and may fluctuate during high demand business needs.

• Weekends may be required and will be discussed at interview.

Travel:

• Limited

Work at Home Guidance 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 for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

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.

 

$78,400 - $107,800 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: 01-21-2025
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.

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