Senior Process Improvement Professional

Profile

Description

The Provider Process Team is a process organization residing within the Consumer and Provider Service Organization. Provider Process's mission is to develop, operationalize, and train business processes through thoughtful collaboration with internal/external business partners. These processes support compliance initiatives, new contracting strategies, and product expansion. Provider Process reviews process performance to lower cost, increase accuracy, and identify potential for technology enhancements/automation.

Responsibilities

Provider Process will perform root cause analysis for identified issues, or support and consult with users to identify and resolve issues in process performance, business case realization, or compliance. Provider Process also supports business partners in documenting, training process or policy changes. Finally, Provider Process creates and executes large-scale people change management plans.

The Senior Process Improvement Professional will:

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

Identify changes to optimize turnaround times for work related to provider loading, increase automation of provider processes, and increase accuracy of loading provider data for

Lead collaborative projects with cross-functional departments to develop processes that support provider loading. These departments include, but are not limited to: IT, Credentialing Operations, Provider Contract Load, Data Collection and Verification (DCAV), Provider Pend Group (PPG), Service Fund, Directories, Compliance, Market Contracting teams, and Delegated Credentialing Compliance

Exercise considerable latitude and independent judgement in determining objectives and approaches to assignments; prioritize work based on impacts/timelines, and be adaptable to change in directions/strategy

Perform and implement process improvement initiatives such as using Lean or Six Sigma methodology

Identify and resolve barriers to performance by collecting data to determine root cause of problems, creating process maps, and/or performing cost and benefit analyses

Promote the implementation of best practices; Document process changes (includes process mapping), and assist in communication to/training of impacted operational teams and markets

Possess a solid understanding of operations, technology, communications and processes

Prepare presentations and communication materials

This role is fast paced and needs an individual with excellent communication skills to align on outcomes. The role is autonomous in nature and expected to function within a foundational framework while working to improve the overall provider and member experience. This includes the facilitation of meetings, collecting information, tracking status, identifying gaps, and generating insights to help assist with long term process and/or procedural issues which supports driving continuous improvement within the member and provider experience. There is a heavy emphasis on project management, root cause analysis, and multi-departmental issue resolution; Six Sigma, Lean or PMP Certification highly preferred.

Required Qualifications

2 years' experience in demonstrating ability to analyze information, research problems, and determine and implement solutions

2 years' experience in process development or process improvement

2 years' experience in project management

1 years of provider experience (contracts, contract load, credentialing, or related field)

Prior Professional experience with Microsoft Suite, Word, Excel and PowerPoint

Meet Humana's Work at Home connectivity requirement listed in additional information.

Preferred Qualifications

Knowledge of medical and Behavioral Health contracting and loading

Six Sigma or Lean Certification and/or PMP certification

Bachelor's Degree

Additional Information

Location: Remote, however, if located near a Humana office may ask to travel in for meetings etc.

Hours: Typical business hours

Work at Home Connectivity 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 to support Humana applications, per associate.

Wireless, Wired Cable or DSL connection is suggested.

Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)

Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. 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.

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.

If you have additional questions regarding this role posting, please send them to the Ask A Recruiter by visiting go/Buzz and searching Ask A Recruiter or email askarecruiter@humana.com. Please be sure to provide the requisition number so we may be able to research your request quicker.

#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