Senior Process Improvement Professional

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 will provide business ownership and leadership for strategic Medicaid enrollment and waiver modernization initiatives that support operational efficiency, regulatory compliance, and accurate member administration.

Key Responsibilities

• Lead Enterprise Member Movement Enhancements:
• Serve as a business lead for initiatives that improve the organization's ability to execute large-scale member movement activities accurately and efficiently.
• Partner with Information Technology and business stakeholders to define requirements, conduct testing, validate results, and support implementation activities.
• Identify operational risks and develop solutions that improve responsiveness while minimizing impacts to clinical, claims, finance, and enrollment operations.
• Monitor post-implementation performance to ensure expected business outcomes are achieved.

• Lead Medicaid Waiver Modernization Efforts:
• Provide operational ownership and oversight for enhancements supporting the administration of multiple Medicaid waivers.
• Manage and govern LTSS waiver-related processes, including oversight of waiver updates, validations, and issue resolution activities.
• Assume responsibility for the LTSS mailbox and coordinate timely review, validation, and processing of waiver-related member information.
• Develop and implement scalable processes that reduce manual intervention and improve waiver data accuracy.

• Cross-Functional Leadership:
• Act as a liaison between business operations, technology, finance, claims, clinical, and enrollment teams.
• Facilitate stakeholder alignment on priorities, business requirements, testing strategies, implementation plans, and operational readiness.
• Communicate project progress, risks, dependencies, and recommendations to leadership.
• Support training, change management, and adoption efforts for new processes and capabilities.

• Continuous Improvement and Governance:
• Identify opportunities to automate manual processes and improve operational performance.
• Establish monitoring, reporting, and governance practices to support compliance and operational excellence.
• Analyze business processes and recommend enhancements that improve efficiency, scalability, and member experience.
• Support enterprise transformation initiatives focused on Medicaid operations and enrollment modernization.

Requirements

• Experience leading complex healthcare, Medicaid, process improvement, operational, or technology initiatives.
• Demonstrated success managing cross-functional projects involving multiple business areas.
• Strong analytical, problem-solving, and risk management capabilities.
• Experience developing business requirements, testing strategies, operational processes, and implementation plans.
• Medicaid managed care, enrollment, eligibility, waiver, or member administration experience preferred.

Work Arrangements

• Remote position with occasional travel to Humana's offices for training or meetings.
• Must have a reliable internet connection with a minimum download speed of 25 Mbps and an upload speed of 10 Mbps.

Salary and Benefits

• The compensation range is $78,400 - $107,800 per year.
• Eligible for a bonus incentive plan.
• Humana offers competitive benefits, including medical, dental, and vision benefits, 401(k) retirement savings plan, time off, and short-term and long-term disability.