Humana

Senior Process Improvement Professional

Kentucky, United States

Not SpecifiedCompensation
Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Health Insurance, MedicareIndustries

Requirements

Candidates must have at least 3 years of experience in the healthcare solutions industry and 3 years of experience in a process improvement environment. Experience working on cross-functional projects, analyzing and interpreting data, and proficiency in Microsoft Office are required. A Bachelor's degree and experience with Medicare, Medicaid, Medicare Reconciliation, coordination of benefits, BPM software, and the SDLC are preferred. Advanced Microsoft Excel skills and experience with Power BI and Lucid are also preferred. The role requires the ability to be self-organizing, a systems thinker, possess strong critical thinking and decision-making skills, and have excellent written and verbal communication abilities. Candidates must be comfortable with change and ambiguity and be located within reasonable driving distance of Humana's Louisville, KY offices.

Responsibilities

The Senior Process Improvement Professional will analyze internal and external data to recommend and implement organizational changes, technologies, processes, and procedures to enhance safety, increase productivity, revenue, and reduce costs. Responsibilities include demonstrating strategic management, business process leadership, and data analytics skills to define, measure, and deliver value. This role involves optimizing business organization, structure, systems, and processes, aligning them with strategy and objectives. The professional will perform portfolio, program, and/or project management, develop business cases, assign value to changes, and prioritize them. They will work with teams to define business opportunities, design and implement business systems, formulate automation plans, and implement quality controls. Analyzing, interpreting, and displaying financial, health, competitive, and performance measurement data to optimize projects is key. Utilizing Business Process Management (BPM) software, mapping supplier inputs, business process, customer journey, and customer output, and applying change management and communication planning are also part of the role. The professional will represent Medicare Billing, Coordination of Benefits and Reconciliation to leadership and stakeholders.

Skills

Process Improvement
Data Analysis
Business Process Management (BPM)
Project Management
Change Management
Automation
Quality Control
Financial Analysis
Strategic Planning
Stakeholder Management

Humana

Health insurance provider for seniors and military

About Humana

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.

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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