Remote Health Services Process Improvement Lead

Humana Inc; Columbia (SC); Remote; USD 95,000 - 131,000; Full time

Benefits offered by this job

Health benefits

401(k)

Paid time off

Parental leave

Job summary

Humana, Inc. is seeking a Process Improvement Lead for the MedicaidApply team in Columbia, SC, with a remote work option. You will analyze and measure current processes, identify inefficiencies, and drive reusable, measurable improvements across the organization.

Reporting to the Director of Health Services, you will lead 1–2 direct reports, coordinate cross‑functional initiatives, and ensure alignment with NCQA standards while reducing cost and risk.

Qualifications

• Bachelor's degree required.
• 5+ years of process improvement experience.
• 2+ years of project leadership experience.
• 2+ years of case management or utilization management experience.
• RN or MSW license preferred in state of employment.

Responsibilities

• Analyze and measure the effectiveness of existing processes and develop improvements.
• Lead and execute operational excellence initiatives and drive best practices.
• Review processes for compliance, audits, quality reviews (e.g., NCQA).
• Design and implement new processes and training to improve safety and productivity.

Skills

Process improvement

Project leadership

Case management

Utilization management

Education

Bachelor's degree

Tools

Lean Six Sigma

Job description

Humana, Inc. is seeking a Process Improvement Lead for the MedicaidApply team in Columbia, SC, with a remote work option. You will analyze and measure current processes, identify inefficiencies, and drive reusable, measurable improvements across the organization.

Reporting to the Director of Health Services, you will lead 1–2 direct reports, coordinate cross‑functional initiatives, and ensure alignment with NCQA standards while reducing cost and risk.