Senior Process Improvement Lead: TRICARE Claims (Remote)

Humana Inc; Northern (KY); Remote; USD 78,000 - 108,000; Full time

Job summary

Humana Inc. is seeking a Senior Process Improvement Professional to analyze TRICARE claims processes and lead measurable improvements. The role collaborates with the East Contract claims processing subcontractor to ensure timely, accurate processing and drives data-driven recommendations to leadership.

The candidate will evaluate policy impacts, gather data, and implement changes with a focus on safety, productivity, and cost reduction, while leveraging A/B testing and KPIs to quantify success.

Qualifications

• 5 or more years of business analysis, testing or process management experience.
• Experience with understanding claims adjudication, systems and reporting.
• Proficient with SQL/PLSQL and large data sets.
• Strong communication and presentation skills for senior leadership.

Responsibilities

• Analyze and measure the effectiveness of existing business processes and develop improvements.
• Provide project and program coordination to guide implementation of new processes and modifications.
• Assist with change management to minimize disruption and maximise impact.
• Oversee the improvement process and benchmark data to drive results.

Skills

Business analysis

SQL/PLSQL

Healthcare knowledge

Communication skills

MS Office

Data analysis

Education

Bachelor's Degree

Tools

SQL/PLSQL

Job description

Humana Inc. is seeking a Senior Process Improvement Professional to analyze TRICARE claims processes and lead measurable improvements. The role collaborates with the East Contract claims processing subcontractor to ensure timely, accurate processing and drives data-driven recommendations to leadership.

The candidate will evaluate policy impacts, gather data, and implement changes with a focus on safety, productivity, and cost reduction, while leveraging A/B testing and KPIs to quantify success.