Remote LTSS Process Improvement Specialist

Humana Inc; Dover (DE); Remote; USD 65,000 - 89,000; Full time

Job summary

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation efforts across new state launches.

The role focuses on translating regulatory requirements into operational documentation, workflows, and readiness materials, with collaboration from senior staff to ensure quality, compliance, and scalable processes. You will help draft policies, procedures, program descriptions, and training content while supporting document submissions and contract alignment.

Qualifications

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

Responsibilities

• Draft, edit, format, and preliminarily review implementation documents.
• Review member and provider manuals for consistency and compliance.
• Submit internal documentation through established approval processes with proper version control.
• Review training materials with Senior Professionals and provide clarifications to the training team.

Job description

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation efforts across new state launches.

The role focuses on translating regulatory requirements into operational documentation, workflows, and readiness materials, with collaboration from senior staff to ensure quality, compliance, and scalable processes. You will help draft policies, procedures, program descriptions, and training content while supporting document submissions and contract alignment.