Process Improvement Lead - Provider Payment Integrity

Profile

Description

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Responsibilities

The Process Improvement Lead researches best business practices within and outside the organization to establish benchmark data. This individual collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on enhanced safety, increased productivity and reduced cost. This person will determine how new information technologies can support re-engineering business processes and may specialize in one or more of the following areas: benchmarking, business process analysis and re-engineering, change management and measurement, and/or process-driven systems requirements. This person advises executives to develop functional strategies (often segment specific) on matters of significance. This individual exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision. They will use independent judgment requiring analysis of variable factors and determining the best course of action.

Required Qualifications

Bachelor's degree or 2 years of work experience

Minimum 2 years of project leadership experience

Effective communication both written and verbally

Cross collaboration experience between multiple stakeholders

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Work-At-Home Requirements

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

Associates 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 associates 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

Preferred Qualifications

Previous change management experience

Experience in Financial Recovery

Experience with the CAS and/or MTV systems

Knowledge of Microsoft Office Programs Access and Project

Project Management Professional (PMP) Certification

Bilingual in Spanish and English

Covid-19 Vaccine Policy

According to Humana's COVID-19 policy, vaccination and masking is required regardless of vaccination status (with exception for eating and drinking) for associates working in a clinical setting where patients receive care (e.g., pharmacy retail locations, clinics, home care). The policy only requires the primary series alone (first and second vaccine). Boosters are encouraged, but not required. Associates have the option to request an accommodation for medical, religious or other personal needs.

Additional Information

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. #LI-Remote

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

Humana Inc.
Website : http://www.humana.com