Remote Senior Process Improvement Lead

Humana; Annapolis (MD); Remote; USD 78,000 - 108,000; Full time

Benefits offered by this job

Bonus incentive plan

Remote work possible

Job summary

Humana, Inc. is seeking two Senior Process Improvement Professionals to lead enterprise member movement enhancements and Medicaid waiver modernization initiatives.

You will partner across Enrollment, Clinical, Claims, Finance, and Technology to design and sustain enterprise solutions that reduce manual effort, improve data integrity, and mitigate operational risk. The roles require experience in healthcare/Medicaid process improvement, strong analytical and leadership skills, and the ability to

Qualifications

• Experience leading complex healthcare, Medicaid, process improvement, operational, or technology initiatives.
• Demonstrated 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, waiver, or member administration experience preferred.

Responsibilities

• Lead Enterprise Member Movement Enhancements and own initiatives to improve large-scale member movement accuracy and efficiency.
• Partner with IT and business stakeholders to define requirements, test, validate results, and support implementation.
• Identify operational risks and develop solutions to improve responsiveness with minimal adverse impacts across functions.
• Monitor post-implementation performance to ensure expected outcomes are achieved.
• Lead Medicaid Waiver Modernization efforts and oversee LTSS waiver processes and updates.
• Develop scalable processes that reduce manual intervention and improve waiver data accuracy.
• Act as a liaison between business operations, technology, finance, claims, clinical, and enrollment teams.
• Facilitate stakeholder alignment on priorities, requirements, testing strategies, and implementation plans.
• Communicate project progress, risks, dependencies, and recommendations to leadership.
• Support training, change management, and adoption efforts for new processes and capabilities.
• Identify opportunities to automate processes and improve performance.
• Establish governance and monitoring to support compliance and operational excellence.
• Analyze processes and recommend enhancements for efficiency and scalability.

Skills

Healthcare experience

Medicaid experience

Process improvement

Cross-functional leadership

Analytical skills

Risk management

Requirements gathering

Testing strategies

Excel

Power BI

Tools

Power BI

Microsoft Excel

Pivot tables

Macros

Job description

Humana, Inc. is seeking two Senior Process Improvement Professionals to lead enterprise member movement enhancements and Medicaid waiver modernization initiatives.

You will partner across Enrollment, Clinical, Claims, Finance, and Technology to design and sustain enterprise solutions that reduce manual effort, improve data integrity, and mitigate operational risk. The roles require experience in healthcare/Medicaid process improvement, strong analytical and leadership skills, and the ability to