Description
You will serve as a strategic partner to encounter leadership, translating priorities into decisions, action, and measurable results. You will organize complex work, build relationships across teams, and present clear recommendations to C-suite executives. Using data and stakeholder input, you will establish governance, anticipate risks, clarify accountability, and improve Medicaid encounter submission performance.
Key Responsibilities
- Partner with encounter leadership to set priorities, prepare decisions, and drive follow-through on strategic initiatives.
- Organize multiple priorities, meetings, decisions, owners, and timelines to keep complex work moving.
- Build trusted relationships across operations, technology, compliance, markets, vendors, providers, and regulatory partners.
- Prepare and present concise updates, risks, options, and recommendations to C-suite executives and other senior leaders.
- Lead governance forums focused on performance, risks, dependencies, decisions, and regulatory readiness.
- Translate complex encounter processes and business needs into clear workflows, dashboards, insights, and decision points.
- Anticipate regulatory, platform, volume, and data quality risks before they affect encounter submissions.
- Drive cross-functional issues from root cause analysis through solution development, executive communication, and resolution.
- Create and maintain processes and documentation for Medicaid contract compliance and risk oversight.
- Use data to challenge assumptions, recommend priorities, and improve inefficient processes respectfully and constructively.
Required Qualifications
- Bachelor's degree.
- 5+ years of experience in process improvement, business operations, strategy, or program leadership.
- 2+ years of experience leading cross-functional projects or enterprise initiatives.
- 2+ years of experience processing medical claims and/or encounter submissions.
- Demonstrated experience organizing multiple priorities, stakeholders, decisions, and deadlines.
- Demonstrated experience building relationships and influencing across functions without direct authority.
Preferred Qualifications
- Experience with Medicaid or Medicare encounter data.
- Experience with healthcare claims processing.
- Experience with governance, regulatory readiness, dashboards, or corrective action planning.
Work Arrangements
- Remote position.
- Occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
- 40 hours per week.
Pay Range
- $94,900 - $130,500 per year.
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.