Become a part of our caring community and help us put health first

The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors where supervision is minimal.

The Clinical Operations (CO) Team establishes Humana’s enterprise clinical direction, identifying, evaluating and communicating the strategies that will help our members receive superior healthcare access, education and outcomes, while driving down associated costs.

This role, within the Experience and Optimization (E&O) team, will work closely with CO leaders and SMEs in the areas of Utilization Management (inpatient & outpatient), Quality Operations and Market relations as well as key aligned partners in leading and delivering on initiatives and process capabilities that enable improved effectiveness, efficiency and experiences (member, provider and associate).

The Senior Clinical Process Improvement Professional

· Researches best business practices within and outside the organization to establish benchmark data

· Collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on enhanced experience, increased productivity/effectiveness and reduced cost

· Determines how new information technologies can support re-engineering business processes

· 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.

Key Responsibilities Include:

· Execute process initiatives within the framework of a robust process management control system highlighting KPIs that provide observations, insights, and recommendations on actions to be taken

· Further simplify and improve processes in conjunction with business partners that are informed by the ideal member, provider, and associate experience, and are enabled through both technology and non-technology solutions

· Participate and/or facilitate in IT requests, user acceptance testing and interface with various business improvement and technology teams

· Develop policies / procedures associated with resulting process updates

· Lead large scale cross-functional initiatives, with ability to effectively manage competing priorities

· Excellent verbal, written and presentation skills

Use your skills to make an impact

Required Qualifications

• 6 years' experience in clinical operations and/or CGX usage

• Experience leading process improvement initiatives

• Demonstrated ability to manage timelines and priorities and effectively communicate and collaborate across multiple departments

• Advanced proficiency with Microsoft applications (Word, Excel, PowerPoint)

• Demonstrated success with accountability / ownership of responsibilities

• Excellent interpersonal, organizational, communication and presentation skills

• Comfortable working in a fast paced, highly complex organization

• Ability to effectively interact with and influence all levels of the organization

Preferred Qualifications

• Bachelor's Degree

• Clinical process improvement experience

• Market UM operational/process improvement experience

• CGX experience

• Strong clinical or nursing background

• Utilization Management and/or Care Management experience

• Strong with data analysis and telling a story to business customers with data

• Lean / Six Sigma Green / Black Belt certification

• MBA

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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

• 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

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$78,400 - $107,800 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 03-30-2025

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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.