Remote Process Improvement Lead – Provider Terminations

Humana Inc; Salem (OR); On-site; USD 115,000 - 158,000; Full time

Job summary

Humana Inc. is seeking a Process Improvement Principal – Provider Terminations to lead end-to-end provider termination processes and drive improvements across regions.

This remote role requires collaboration with senior executives and multiple business areas to optimize member experience, productivity, and cost. Responsibilities include governance, data analysis, and strategic guidance to improve engagement with providers, members, and stakeholders, while aligning with enterprise-wide functional

Qualifications

• 3+ years’ experience in the payer/provider contracting lifecycle.
• 7+ years improving or creating business processes.
• 3+ years of project or people leadership.
• Travel up to 10% of the time.
• Located in the Central or Eastern Time Zone.

Responsibilities

• Lead the strategy and approach for Humana’s termination processes through collaboration with key stakeholders.
• Oversight of the process for coordinating and tracking impacts of potential/likely provider terminations across all regions.
• Ability to work autonomously across teams to optimize every aspect of the operational processes related to processing a provider termination.
• Overseeing governance and progress against opportunity areas.
• Ability to influence key partners to simplify and improve business processes, using the provider and member experience as a key tenet.
• Identifying additional opportunity areas and prioritizing resources against them.
• Understanding provider changes in advance to drive collaboration opportunities resulting in optimized touchpoints.
• Developing key insights around the downstream impacts of provider terminations around Stars, member experience and retention, and provider contracting decisions.
• Leveraging data analytics to drive business insights, reporting, and leadership communications around provider terminations.
• Advising leadership of functional strategies while exercising independent judgment and decision making on complex issues with minimal supervision

Skills

Payer/Provider contracting

Business process improvement

Project leadership

People leadership

Stakeholder collaboration

Education

Bachelor's degree

Job description

Humana Inc. is seeking a Process Improvement Principal – Provider Terminations to lead end-to-end provider termination processes and drive improvements across regions.

This remote role requires collaboration with senior executives and multiple business areas to optimize member experience, productivity, and cost. Responsibilities include governance, data analysis, and strategic guidance to improve engagement with providers, members, and stakeholders, while aligning with enterprise-wide functional