Remote LTSS Process Improvement Specialist

Humana Inc; Trenton (NJ); A distancia; USD 65.000 - 89.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Bonus incentive plan

Remote work eligibility

Descripción de la vacante

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation activities. The role translates high-level goals into operational documentation and tools, ensuring readiness across new Medicaid markets.

You will draft policies, review procedures, and collaborate with senior professionals to align with contract requirements and Humana’s commitment to excellence and person-centered care. Remote US-based position offering varied, impactful work.

Formación

• 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.
• Preferred: project management experience; Medicare/Medicaid integrated model experience; cross-functional work experience.

Responsabilidades

• Draft and review policies, procedures, and program descriptions to support Medicaid implementation.
• Review member and provider manuals for consistency and compliance with state requirements.
• Prepare documentation for internal approvals and ensure proper version control and file management.
• Collaborate with Senior Process Improvement Professionals to review training materials.
• Document process steps and create visual workflows for initial drafts.
• Develop and maintain clinical auditing tools and other operational tools used across markets.

Conocimientos

Project management

Cross-functional collaboration

Regulatory knowledge

Educación

Bachelor's degree or 3 years' experience

Descripción del empleo

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation activities. The role translates high-level goals into operational documentation and tools, ensuring readiness across new Medicaid markets.

You will draft policies, review procedures, and collaborate with senior professionals to align with contract requirements and Humana’s commitment to excellence and person-centered care. Remote US-based position offering varied, impactful work.