Remote LTSS Process Improvement Specialist

Humana Inc; Little Rock (AR); Remote; USD 65,000 - 89,000; Full time

Benefits offered by this job

Bonus incentive

Job summary

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation activities by partnering with Process Improvement Leads and Senior Professionals.

You translate high-level goals into operational documents and tools that enable scalable, repeatable state launches, while ensuring compliance and readiness. Remote US opportunity; responsibilities include drafting policies, reviewing manuals for state requirements, coordinating with SMEs, and maintaining documentation

Qualifications

• Bachelor's degree or 3 years’ equivalent experience in health plan operations.
• 2+ years’ LTSS Provider, LTSS CM, or LTSS UM experience preferred.
• Project management and cross-functional collaboration beneficial.

Responsibilities

• Draft and edit policies, procedures, program descriptions and readiness materials.
• Review member/provider manuals for compliance gaps and state requirements.
• Submit documentation through internal review processes with proper version control.
• Collaborate with Senior Process Improvement Professionals to review training materials.
• Document process steps and create visual workflows for reviews.
• Develop and maintain clinical auditing tools and operational tools for multiple markets.
• Coordinate setup of shared mailboxes and other communication tools for new state implementations.
• Research contracts/regulatory documents to support material development.
• Track progress using project management tools and meet deadlines.
• Take notes in meetings and summarize discussions for action items.
• Provide general project support to the cohort team and contribute to process improvements.

Skills

Documentation

PM coordination

Cross-functional collaboration

Regulatory awareness

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 by partnering with Process Improvement Leads and Senior Professionals.

You translate high-level goals into operational documents and tools that enable scalable, repeatable state launches, while ensuring compliance and readiness. Remote US opportunity; responsibilities include drafting policies, reviewing manuals for state requirements, coordinating with SMEs, and maintaining documentation