Senior LTSS Process Improvement Lead (Remote)

Humana Inc; Michigan; Hybrid; USD 78,000 - 108,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Job summary

Humana Inc. is seeking a Senior Process Improvement Professional to lead LTSS process improvements across HCBS, care management, utilization management, and quality initiatives in Michigan.

You will analyze current workflows, identify improvement opportunities, and develop sustainable solutions that enhance member experience, compliance, and contract performance. You will partner with Care Management, Utilization Management, Quality, Reporting, Provider, and Compliance teams to redesign

Qualifications

• Bachelor's degree required.
• 3+ years in process improvement, healthcare operations, quality improvement, or related field.
• Experience with healthcare, managed care, Medicaid, LTSS, HCBS, or population health.
• Experience interpreting operational and performance data to drive business decisions.
• Advanced proficiency with Microsoft Office (Excel and PowerPoint).
• Excellent verbal and written communication, with experience presenting to leadership teams.

Responsibilities

• Lead process improvement initiatives supporting LTSS, HCBS, care management, utilization management, quality, reporting and operational workflows.
• Analyze LTSS operational workflows and identify opportunities to improve efficiency, quality, compliance and member outcomes.
• Partner with Care Management, Utilization Management, Quality, Reporting, Provider, and Compliance teams to support process redesign and implementation efforts.
• Develop standardized LTSS workflows, policies, procedures, audit tools, and process documentation.
• Monitor Michigan contract requirements and support operational changes necessary to maintain LTSS compliance.
• Conduct root cause analysis of issues, performance gaps, audit findings, grievances, appeals, and quality concerns.

Skills

Process improvement

Healthcare operations

Quality improvement

Project management

Data interpretation

Communication

LTSS

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Humana Inc. is seeking a Senior Process Improvement Professional to lead LTSS process improvements across HCBS, care management, utilization management, and quality initiatives in Michigan.

You will analyze current workflows, identify improvement opportunities, and develop sustainable solutions that enhance member experience, compliance, and contract performance. You will partner with Care Management, Utilization Management, Quality, Reporting, Provider, and Compliance teams to redesign