Senior Remote Interoperability & Process Improvement Lead

CenterWell; Lexington (KY); Remote; USD 78,000 - 108,000; Full time

Job summary

Humana is seeking a Senior Process Improvement Professional to own end-to-end interoperability and medical documentation chase operations. You will map current and future-state processes, define operating models, and partner with business, product, and IT teams to document requirements and ensure systems support operational needs.

This remote role offers 40 hours weekly, a pay range of $78,400 to $107,800 per year, and eligibility for a bonus incentive plan.

Qualifications

• Lead the design and stand-up of new processes supporting interoperability and medical documentation chase operations, including defining the end-to-end operating model and implementation approach
• Build and maintain end-to-end workflows, including intake, triage, routing, exception handling, escalation paths, and reporting requirements
• Serve as the subject matter expert for the full operational process and associated system interactions, ensuring strong understanding of upstream inputs and downstream impact
• Partner with business, product and IT stakeholders to gather, document, and refine business and system requirements for new functionality
• Translate operational needs into functional requirements, business rules, user stories, process maps and supporting documentation
• Facilitate cross-functional working sessions to define current-state, future-state, and target-state processes; identify gaps, risks, controls, and dependencies across teams and system
• Recommend and implement sustainable process improvements that improve efficiency, quality, scalability, and operational readiness
• Support solution design, testing, training, SOP/job aid development and change readiness activities for new process launches and enhancements

Responsibilities

• Lead the design and stand-up of new processes supporting interoperability and medical documentation chase operations, including defining the end-to-end operating model and implementation approach
• Build and maintain end-to-end workflows, including intake, triage, routing, exception handling, escalation paths, and reporting requirements
• Serve as the subject matter expert for the full operational process and associated system interactions, ensuring strong understanding of upstream inputs and downstream impact
• Partner with business, product and IT stakeholders to gather, document, and refine business and system requirements for new functionality

Skills

End-to-end process ownership

Interoperability operations

Requirements gathering & documentation

Cross-functional collaboration

Process design & modeling

Change management support

SOP development & training

Education

Bachelor's degree or equivalent

Job description

Humana is seeking a Senior Process Improvement Professional to own end-to-end interoperability and medical documentation chase operations. You will map current and future-state processes, define operating models, and partner with business, product, and IT teams to document requirements and ensure systems support operational needs.

This remote role offers 40 hours weekly, a pay range of $78,400 to $107,800 per year, and eligibility for a bonus incentive plan.