Remote Process Improvement Lead - Medicaid Data & Strategy

Humana; Oregon; Hybrid; USD 95,000 - 131,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana is seeking a remote Senior Program Manager to serve as a strategic partner to leadership, translating priorities into decisions and measurable results. You will organize complex work, build relationships across teams, and present recommendations to C-suite executives.

Focus areas include governance, risk oversight, and Medicaid encounter submission performance. The role requires at least 5+ years in process improvement or operations, plus 2+ years leading cross-functional projects and

Qualifications

• Bachelor's degree required.
• 5+ years in process improvement or operations.
• 2+ years leading cross-functional projects or enterprise initiatives.
• 2+ years processing medical claims and/or encounter submissions.
• Demonstrated experience organizing multiple priorities, stakeholders, decisions, and deadlines.
• Demonstrated experience building relationships and influencing across functions without direct authority.

Responsibilities

• Partner with encounter leadership to set priorities, prepare decisions, and drive follow-through on strategic initiatives.
• Organize multiple priorities, meetings, decisions, owners, and timelines to keep complex work moving.
• Build trusted relationships across operations, technology, compliance, markets, vendors, providers, and regulatory partners.
• Prepare and present concise updates, risks, options, and recommendations to C-suite executives and other senior leaders.
• Lead governance forums focused on performance, risks, dependencies, decisions, and regulatory readiness.
• Translate complex encounter processes and business needs into clear workflows, dashboards, insights, and decision points.
• Anticipate regulatory, platform, volume, and data quality risks before they affect encounter submissions.
• Drive cross-functional issues from root cause analysis through solution development, executive communication, and resolution.
• Create and maintain processes and documentation for Medicaid contract compliance and risk oversight.
• Use data to challenge assumptions, recommend priorities, and improve inefficient processes respectfully and constructively.
• Demonstrated experience preparing and presenting business risks, results, or recommendations to C-suite executives or equivalent senior leaders.

Skills

Process improvement

Business operations

Strategy

Program leadership

Cross-functional leadership

Stakeholder management

Data-driven decisions

Education

Bachelor's degree

Job description

Humana is seeking a remote Senior Program Manager to serve as a strategic partner to leadership, translating priorities into decisions and measurable results. You will organize complex work, build relationships across teams, and present recommendations to C-suite executives.

Focus areas include governance, risk oversight, and Medicaid encounter submission performance. The role requires at least 5+ years in process improvement or operations, plus 2+ years leading cross-functional projects and