Senior Process Improvement Professional

About the Role

Become a part of our caring community and help us put health first. Humana Healthy Horizons is seeking a Senior Process Improvement Professional who analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable, and quantifiable business process improvements. The Senior Process Improvement Professional will manage projects, identify trends and emerging issues, recommend solutions, and ensure timely, complete responses to business partners and senior leaders.

The Senior Provider Process Improvement Professional supports the member and provider experience occurring under the Medicaid Operating Model.

Key Roles and Responsibilities

• Focus on process improvement and standardization - ensuring the coordination of the components of the provider and member experience.
• Deploys a proactive and consultative approach to providing strategic thought leadership to identify and address complex issues.
• Analyze and measure the effectiveness of existing business processes and develop sustainable, repeatable, and quantifiable business process improvements.
• Identify trends, conduct risk assessments, and identify areas of improvement resulting from information obtained through business partners.
• Research best practices and determine how technology can support re-engineering business processes.
• Work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
• Advises business partner and related stakeholders on contractual risk and mitigating factors.
• Describes the tools, technologies, applications, and practices used to collect, integrate, analyze, and present an organization's raw data to create insightful and actionable business information.

Required Qualifications

• Bachelor’s degree
• 3+ years’ experience in a corporate setting.
• Ability to work independently with an agile mindset.
• Demonstrated stellar communication skills and ability to positively influence others.
• Solid experience of interpretation and independent determination of the appropriate courses of action during projects.
• Possesses a solid understanding of how organization capabilities interrelate across department(s).

Preferred Qualifications

• Previous experience working with Medicaid/Medicare/Managed Health Care programs and regulations.
• PMP or Six Sigma Certification.
• Prior digital/website experience a plus.

Additional Information

• Employment Type: Full time
• Location: This position is open to work remote.
• Core Workdays & Hours: Typically, Monday to Friday from 8 am to 5 pm (alternative schedule possible).
• Training: Virtual foundational trainings will take place within the first few weeks of employment.

Work at Home Criteria

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain