Senior Remote Interoperability Process Lead

CenterWell; New York (NY); Remote; USD 78,000 - 108,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana is seeking a Senior Process Improvement Professional to own end-to-end interoperability and medical documentation chase processes. You will design new workflows, define operating models, and establish governance while partnering with business stakeholders and IT to ensure effective solutions.

The role emphasizes change readiness, testing, and training across the enterprise. The successful candidate will map current and future state processes, identify gaps and risks, and implement

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
• 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

Skills

Process design

Workflow development

Stakeholder engagement

Requirements gathering

Documentation

Cross-functional collaboration

Strong communication

Analytical thinking

Problem solving

Education

Bachelor's degree

Job description

Humana is seeking a Senior Process Improvement Professional to own end-to-end interoperability and medical documentation chase processes. You will design new workflows, define operating models, and establish governance while partnering with business stakeholders and IT to ensure effective solutions.

The role emphasizes change readiness, testing, and training across the enterprise. The successful candidate will map current and future state processes, identify gaps and risks, and implement