Lead, LTSS Process Improvement

at  Humana

BECOME A PART OF OUR CARING COMMUNITY AND HELP US PUT HEALTH FIRST

The Medicaid Long-Term Supports and Services (LTSS) Process Improvement Lead analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements and best practices. The LTSS Process Improvement Lead works on problems of diverse scope and complexity ranging from moderate to substantial.
The LTSS Medicaid Process Improvement Lead 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 safety, increased productivity, 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. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.

REQUIRED QUALIFICATIONS:

• Bachelor’s degree in Business or a related field or a minimum five (5) years business experience; two (2) or more years in project leadership Experience problem solving and consultation within complex environments
• Facilitating and driving cross-functional teams’ efforts
• Strong influencing and process implementation skills
• Successfully demonstrated delivering presentations to senior leaders
• Must be available to work normal business hours in the Eastern Standard Time Zone
• Available for 15% travel to the Office for meetings and or trainings

PREFERRED QUALIFICATIONS:

• Master’s degree in Business, Operations Management, Healthcare Administration, or related field. Eight (8) plus years business experience
• Knowledge of Systems Development Life Cycle, Waterfall, and Agile Development Methodologies
• Possess a solid understanding of operations, technology, communications and processes Six Sigma and / or Project Management Institute certification

WORK AT HOME REQUIREMENTS

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

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.

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.

• Program Enhancement:
• Analyze current Medicaid long-term support and services programs to identify areas for improvement.
• Research, analyze, and interpret state contracts and responses.
• Develop and implement strategies to enhance program efficiency, ensuring optimal utilization of resources.
• Description Management:
• Oversee the creation, review, and update of program descriptions to align with evolving Medicaid requirements.
• Collaborate with relevant stakeholders to ensure accuracy and completeness of program descriptions.
• Policy and Procedure Oversight:
• Interpret complex regulations and process to translate them into easily understandable policies and procedures.
• Establish and maintain policies and procedures governing Medicaid long-term supports and services.
• Lead the development, writing, editing, and updating of Medicaid policies and procedures, ensuring clarity, accuracy, and alignment with regulatory requirements.

Process Optimization:

• Lead initiatives to streamline processes related to Medicaid services, reducing administrative burden, and enhancing service delivery.
• Stakeholder Collaboration:
• Collaborate with internal teams, external partners, and Medicaid agencies to ensure alignment with program goals and objectives.
• Act as a liaison between the organization and regulatory bodies, fostering positive relationships.
• Lead by influence, both internal and external team members, to create policy and procedures, including training and mentoring.