Remote LTSS Process Improvement Specialist

Humana Inc; Honolulu (HI); Remote; USD 65,000 - 89,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings

Paid time off

Company holidays

Parental and caregiver leave

Disability insurance

Life insurance

Job summary

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation activities, translating strategic goals into operational documents and tools.

The role focuses on drafting policies, workflows, and readiness materials for new state launches while ensuring compliance and alignment with contract requirements. The position collaborates with Senior Professionals and Leads, contributes to workflow development, and maintains clinical auditing tools across markets to

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.

Responsibilities

• Drafts and reviews policies, procedures, and program descriptions.
• Prepare and submit internal documentation through review processes.
• Collaborate with Senior Professionals to review training materials and job aids.
• Document process steps and create visual workflows for review.

Skills

Policy drafting

Process documentation

Workflow development

Cross-functional collaboration

Education

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

Tools

Smartsheet

OneNote

SharePoint

Job description

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation activities, translating strategic goals into operational documents and tools.

The role focuses on drafting policies, workflows, and readiness materials for new state launches while ensuring compliance and alignment with contract requirements. The position collaborates with Senior Professionals and Leads, contributes to workflow development, and maintains clinical auditing tools across markets to