Medicaid Implementation & Process Improvement Specialist

Humana Inc; Austin (TX); Remote; USD 65,000 - 89,000; Full time

Job summary

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation efforts, translating regulatory requirements into actionable documentation and tools.

You will draft policies, program descriptions, and workflows while ensuring compliance and readiness across markets. Remote role with occasional travel; responsibilities include coordinating with senior staff, reviewing member and provider materials, and maintaining project documentation to meet deadlines and

Qualifications

• Bachelor's degree or 3 years’ equivalent experience in health plan operations.
• 2+ years’ experience supporting LTSS Provider, LTSS Care Management (CM), or LTSS Utilization Management (UM) roles.
• Project management experience and cross-functional collaboration preferred.

Responsibilities

• Draft, edit, format, and preliminarily review implementation documents (policies, procedures, program descriptions, letters, assessments).
• Review member and provider manuals for inconsistencies or compliance gaps; align with state requirements.
• Submit internal documentation through established review processes with proper version control and coordination with SMEs.
• Review training materials and job aids with the Senior Process Improvement Professional; provide clarifications to the training team.

Education

Bachelor's degree or 3 years’ equivalent experience in health plan operations

Job description

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation efforts, translating regulatory requirements into actionable documentation and tools.

You will draft policies, program descriptions, and workflows while ensuring compliance and readiness across markets. Remote role with occasional travel; responsibilities include coordinating with senior staff, reviewing member and provider materials, and maintaining project documentation to meet deadlines and