Remote Medicaid Implementation Process Specialist

Humana Inc; Salt Lake City (UT); Remote; USD 65,000 - 89,000; Full time

Job summary

Humana Inc. is seeking a Process Improvement Professional II to support Medicaid implementation activities. You will translate high-level goals into operational documentation, develop workflows, and ensure readiness across new markets.

The role involves drafting policies, reviewing provider and member materials, and coordinating with Seniors and Leads to align with contracts and strategic goals. Remote US work with occasional travel may be required, and strong attention to detail is essential.

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.
• Location: Remote US; occasional travel may be required

Responsibilities

• Draft and review policies, procedures, program descriptions, workflows and readiness materials for Medicaid implementations.
• Collaborate with Senior Process Improvement Professionals to review training materials and job aids.
• Document process steps and create initial drafts for review by Senior Professionals or Leads.
• Track document creation and submission tasks using internal project tracking systems.
• Perform quality checks to ensure clarity, formatting and contract alignment

Skills

Project management

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. You will translate high-level goals into operational documentation, develop workflows, and ensure readiness across new markets.

The role involves drafting policies, reviewing provider and member materials, and coordinating with Seniors and Leads to align with contracts and strategic goals. Remote US work with occasional travel may be required, and strong attention to detail is essential.