Remote LTSS Process Improvement Specialist

Humana Inc; Atlanta (GA); Remote; USD 65,000 - 89,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

401(k) retirement savings plan

Paid time off

Job summary

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation by translating strategy into operational documents and tools. You will draft policies, workflows, and readiness materials, and collaborate with senior team members to ensure compliance and readiness across markets.

The role emphasizes detail-oriented documentation, cross-functional collaboration, and alignment with contract requirements, with remote work options and travel as needed.

Qualifications

• Bachelor's degree or 3 years equivalent experience working in health plan operations.
• 2+ years’ experience supporting LTSS Provider, LTSS Care Management (CM), or LTSS Utilization Management (UM) roles.

Responsibilities

• Support the development and maintenance of implementation documents by drafting, editing, formatting, and preliminary reviews.
• Review member and provider manuals, flag inconsistencies or compliance gaps, align with state requirements.
• Submit internal documentation through review processes with proper version control and file management.
• Review training materials and job aids with the Senior Process Improvement Professional.
• Document process steps and create visual workflows for initial drafts.

Skills

Project management

Medicare/Medicaid knowledge

Education

Bachelor's degree or 3 years equivalent experience

Job description

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation by translating strategy into operational documents and tools. You will draft policies, workflows, and readiness materials, and collaborate with senior team members to ensure compliance and readiness across markets.

The role emphasizes detail-oriented documentation, cross-functional collaboration, and alignment with contract requirements, with remote work options and travel as needed.