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

Humana Healthy Horizons in Florida is seeking a Manager, Process Improvement who will analyze and measure the effectiveness of existing business processes and develop sustainable, repeatable and quantifiable business process improvements for the Long Term Care Services and Supports (LTSS) program. The Manager, Process Improvement works within specific guidelines and procedures, applies advanced technical knowledge to solve moderately complex problems, and receives assignments in the form of objectives and determines approach, resources, schedules and goals.

The Manager, Process Improvement researches best business practices within and outside the organization to establish benchmark data.

Role Overview:

• Oversees the development of policies and processes for the LTSS market, ensuring that clear and documented market policies, procedures, and support tools are established and adhered to.
• Manages a team of process professionals.
• Ensures compliance with processes and contracts.
• Leverages strategic thinking in the management of projects.
• Develops and implements strategies to address contract changes and mitigate any instances of contractual non-compliance.
• Stays informed on industry trends and changes in contractual agreements and amendments.
• Collaborates with corporate partners to monitor and enhance the efficiency of the system, as well as assists in the development of new system tools.
• Serves as a point of escalation and resolution for system issues affecting associates' ability to utilize electronic member files.
• Manages the completion of various state reports.
• Provides assistance in achieving annual HEDIS compliance.
• Supports the organization in obtaining NCQA accreditation.

Use your skills to make an impact
 

Required Qualifications

• Bachelor's Degree.
• 5 years of experience in a health care, health insurance, or case management setting.
• 2 or more years of management experience as a people leader.
• Experience in process improvement.

Preferred Qualifications

• Managed care experience.
• Six Sigma Lean or project management certification.

Additional Information

• Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
• Work Location: must reside in the state of Florida.
• Travel: potential for travel once/year.
• Typical Work Days/Hours: Monday – Friday, 8:30 am – 5:00 pm Eastern Standard Time (EST).
• Direct Reports: up to 6 associates.

WAH Internet Statement

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 required; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• 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.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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.

 

$104,000 - $143,000 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.

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.

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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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.