Remote Senior Medicaid Process Improvement Lead

Humana; United States; Remote; USD 78,000 - 108,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement Savings plan

Paid time off & holidays

Parental leave

Disability insurance

Life insurance

Job summary

Humana is seeking a Senior Process Improvement Professional to analyze and measure the effectiveness of Medicaid enrollment and waiver modernization initiatives. You will partner across Enrollment, Clinical, Claims, Finance and Technology to design, implement, and sustain enterprise solutions that reduce manual effort and improve data integrity.

The role focuses on advancing member movement capabilities and waiver administration while establishing governance, monitoring performance, and ensuring

Qualifications

• Experience leading complex healthcare, Medicaid, process improvement initiatives.
• Proven success managing cross-functional projects involving multiple business areas.
• Strong analytical, problem-solving, and risk management capabilities.
• Experience developing business requirements, testing strategies, operational processes, and implementation plans.
• Medicaid managed care, enrollment, eligibility, waiver, or member administration experience preferred.

Responsibilities

• Lead initiatives to improve large-scale member movement activities accurately and efficiently.
• Define requirements, conduct testing, validate results, and support implementation with IT and stakeholders.
• Identify operational risks and develop solutions that minimize impact on clinical, claims, finance, and enrollment operations.
• Monitor post-implementation performance to ensure expected business outcomes are achieved.

Skills

Healthcare process

Medicaid/waiver mgmt

Cross-functional leadership

Requirements gathering

Risk management

Job description

Humana is seeking a Senior Process Improvement Professional to analyze and measure the effectiveness of Medicaid enrollment and waiver modernization initiatives. You will partner across Enrollment, Clinical, Claims, Finance and Technology to design, implement, and sustain enterprise solutions that reduce manual effort and improve data integrity.

The role focuses on advancing member movement capabilities and waiver administration while establishing governance, monitoring performance, and ensuring