Remote LTSS Process Improvement Specialist

Humana Inc; Phoenix (AZ); Remote; USD 65,000 - 89,000; Full time

Job summary

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

You will craft policies, workflows, and readiness materials for new state launches, ensuring contract alignment and compliance across markets. The role involves cross-functional collaboration, document reviews, and coordination with SMEs to ensure quality and accuracy.

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

• Draft and review policies and procedures, program descriptions, workflows, and readiness materials.
• Review member and provider manuals for inconsistencies and compliance gaps.
• Prepare and submit internal documentation through established review and approval processes.
• Collaborate with Senior Process Improvement Professional to review training materials and job aids.

Skills

Project management

Education

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

Job description

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

You will craft policies, workflows, and readiness materials for new state launches, ensuring contract alignment and compliance across markets. The role involves cross-functional collaboration, document reviews, and coordination with SMEs to ensure quality and accuracy.