Remote LTSS Process Improvement Specialist

Humana Inc; United States; Remote; USD 65,000 - 89,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) plan

Paid time off

Parental leave

Disability insurance

Life insurance

Job summary

Humana Inc. seeks a Process Improvement Professional II to support Medicaid implementation activities by drafting policies, procedures, program descriptions, workflows, and readiness materials for new state launches.

The role collaborates with Process Improvement Leads and Senior Professionals, reviews member and provider documents, ensures contract alignment, and helps build scalable, compliant processes across markets from a remote US location.

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

• Support the development and maintenance of implementation documents by drafting, editing, formatting, and preliminary reviews.
• Assist in reviewing member and provider manuals, flagging inconsistencies or compliance gaps, and aligning with state requirements.
• Prepare and submit internal documentation through review processes, ensuring proper version control and coordination with SMEs and reviewers.
• Collaborate with senior professionals to review training materials and provide feedback to the training team as needed.
• Document process steps, create visual workflows, and help build initial drafts for final review.

Skills

Project management

Medicare/Medicaid experience

Cross-functional collaboration

Education

Bachelor's degree

Job description

Humana Inc. seeks a Process Improvement Professional II to support Medicaid implementation activities by drafting policies, procedures, program descriptions, workflows, and readiness materials for new state launches.

The role collaborates with Process Improvement Leads and Senior Professionals, reviews member and provider documents, ensures contract alignment, and helps build scalable, compliant processes across markets from a remote US location.