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.

Key Responsibilities:

• Lead end-to-end process improvement initiatives across D-SNP operations.
• Analyze operational workflows, identify root causes, and recommend sustainable solutions.
• Partner with business stakeholders, IT, compliance, claims, enrollment, customer service, and clinical teams.
• Develop business requirements, process maps, and future-state operational designs.
• Monitor and improve key performance indicators (KPIs), service levels, quality metrics, and compliance outcomes.
• Drive automation and modernization efforts to reduce manual work and operational risk.
• Facilitate cross-functional meetings, decision-making, and change management activities.
• Support regulatory readiness and adherence to CMS, state Medicaid, and Medicare requirements.
• Present findings, recommendations, and executive summaries to leadership.

Required Qualifications:

• Experience supporting Dual Eligible Special Needs Plans (D-SNP), Medicare Advantage, Medicaid, or government healthcare programs.
• Knowledge of CMS regulations and state Medicaid requirements.
• 3-5+ years of process improvement, operations, healthcare, or managed care experience.
• Strong analytical and problem-solving skills.
• Strong written and verbal communication skills, including executive presentations.
• Experience using process mapping and documentation tools (e.g., Lucid, Visio).

Preferred Qualifications:

• Bachelor’s degree in business, Healthcare Administration, Industrial Engineering, or related field.
• Familiarity with enrollment, eligibility, claims, care management, provider operations, or member services.
• Experience with root cause analysis and continuous improvement methodologies.
• Proven ability to influence stakeholders without direct authority.
• Experience leading complex, enterprise-wide initiatives, and process redesign efforts.

Additional Information:

• Work from home requirements: minimum download speed of 25 Mbps and upload speed of 10 Mbps, dedicated workspace.
• Occasional travel to Humana's offices for training or meetings may be required.
• Scheduled weekly hours: 40.
• Pay range: $78,400 - $107,800 per year.
• Eligible for a bonus incentive plan.

Benefits:

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance.