Senior Payment Integrity Manager
Devoted Health- Full Time
- Senior (5 to 8 years)
Candidates should possess a Bachelor’s degree in Business Administration, Management, or a related field, and have at least 10 years of progressive experience in process improvement, operations management, or a related field, along with 5 plus years in a senior leadership role. They must demonstrate a proven track record of successfully leading and implementing significant process improvement initiatives with measurable results, and possess strong analytical and problem-solving skills with the ability to interpret data and draw meaningful conclusions. Exceptional communication, presentation, and interpersonal skills are also required, along with the ability to influence and collaborate effectively at all levels of the organization, and a demonstrated ability to lead and motivate teams and foster a culture of continuous improvement.
The AVP of Process Improvement will develop and execute a long-term process improvement strategy aligned with Medicaid’s strategic objectives, identify key operational areas for improvement, lead comprehensive assessments of existing business processes, utilize methodologies such as Lean, Six Sigma, and BPR to analyze current state and recommend future state improvements, partner effectively with senior leadership across the organization, establish and maintain a standardized framework for process improvement methodologies, ensure consistent application of best practices, develop and implement training programs to build process improvement capabilities within the department, mentor and coach team members, use technology to intake, inventory and track progress on initiatives, identify and evaluate opportunities to leverage technology and automation, manage subcontractor and vendor performance, and champion a culture of continuous improvement throughout the organization.
Health insurance provider for seniors and military
Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.