Senior Process Improvement Professional

Humana Inc. · Remote Nationwide · $78,400 - $107,800 per year · remote The Senior Process Improvement Professional analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable, and quantifiable business process improvements. Key Responsibilities: Lead end-to-end process improvement initiatives across D-SNP operations. Analyze operational workflows, identify root causes, and recommend sustainable solutions. Partner with business stakeholders, IT, compliance, claims, enrollment, customer service, and clinical teams. Develop business requirements, process maps, and future-state operational designs. Monitor and improve key performance indicators (KPIs), service levels, quality metrics, and compliance outcomes. Drive automation and modernization efforts to reduce manual work and operational risk. Facilitate cross-functional meetings, decision-making, and change management activities. Support regulatory readiness and adherence to CMS, state Medicaid, and Medicare requirements. Present findings, recommendations, and executive summaries to leadership. Required Qualifications: Experience supporting Dual Eligible Special Needs Plans (D-SNP), Medicare Advantage, Medicaid, or government healthcare programs. Knowledge of CMS regulations and state Medicaid requirements. 3-5+ years of process improvement, operations, healthcare, or managed care experience. Strong analytical and problem-solving skills. Strong written and verbal communication skills, including executive presentations. Experience using process mapping and documentation tools (e.g., Lucid, Visio). Preferred Qualifications: Bachelor’s degree in business, Healthcare Administration, Industrial Engineering, or related field. Familiarity with enrollment, eligibility, claims, care management, provider operations, or member services. Experience with root cause analysis and continuous improvement methodologies. Proven ability to influence stakeholders without direct authority. Experience leading complex, enterprise-wide initiatives, and process redesign efforts. Additional Information: Work from home requirements: minimum download speed of 25 Mbps and upload speed of 10 Mbps, dedicated workspace. Occasional travel to Humana's offices for training or meetings may be required. Scheduled weekly hours: 40. Pay range: $78,400 - $107,800 per year. Eligible for a bonus incentive plan. Benefits: Medical, dental, and vision benefits. 401(k) retirement savings plan. Time off (including paid time off, company and personal holidays, paid parental and caregiver leave). Short-term and long-term disability. Life insurance.