Process Improvement Lead - Medicaid

Become a part of our caring community The Process Improvement Lead analyzes, measures, and drives the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable process improvements. The role involves working on problems of diverse scope and complexity, ranging from moderate to substantial. The Process Improvement Lead will report to a Director of Health Services and will have 1–2 direct reports. The incumbent will research best practices within and outside the organization to establish benchmarks for the team. Responsibilities include reviewing and streamlining departmental processes, improving collaboration, efficiency, and compliance, and developing new processes and practices for the team. The Process Improvement Lead will serve as the point person for the department regarding resources and procedures in areas such as compliance, audits, and quality reviews (e.g., NCQA). The role also involves collecting and analyzing data, identifying gaps, building processes to develop best practices, reviewing job aids, and leading onboarding and training processes to ensure the team follows best‑in‑class business practices that focus on safety, productivity, and cost reduction. The incumbent may advise leadership on strategic functional initiatives of significance. Use your skills to make an impact The Process Improvement Lead will play an integral role in shaping efficient and compliant processes that directly impact the quality of care and operational efficiency of the organization. Required Qualifications Bachelor's degree 5 or more years of process improvement experience 2 or more years of project leadership experience 2 or more years of experience in case management and/or utilization management Preferred Qualifications Current RN or MSW license in state of employment 2 or more years of Medicaid experience Certification in Lean, Six Sigma, or similar process improvement methodology Ability to manage multiple initiatives and facilitate change in a matrixed organization Familiarity with project management tools and resources Additional Information Work‑At‑Home Requirements: Minimum 25 Mbps download and 10 Mbps upload (wireless, wired cable or DSL recommended). Satellite, cellular or microwave connections are permitted only with leadership approval. Associates working from home in California, Illinois, Montana or South Dakota will receive a bi‑weekly payment for internet expenses. Humana will provide telephone equipment necessary for the position. Work from a dedicated space free from interruptions to protect PHI/HIPAA information. Scheduled Weekly Hours 40 hours per week Pay Range $94,900 – $130,500 per year This job is eligible for a bonus incentive plan based on company and/or individual performance. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. Humana complies with all applicable federal civil rights laws and provides free language interpreter services. See our accessibility resources at #J-18808-Ljbffr Humana Inc