Strategic Remote Medicaid Process Improvement Lead

Humana, Inc.; United States; Remote; USD 95,000 - 131,000; Full time

Benefits offered by this job

Bonus plan

Job summary

Humana, Inc. is seeking a strategic partner for Encounter Data Management to translate priorities into decisions and measurable results. This remote role involves organizing complex work, building cross-team relationships, and presenting to C-suite executives.

You will influence governance, data quality, and regulatory readiness for Medicaid encounter submissions. The position reports to the Director, Encounter Data Management.

Qualifications

• Bachelor's degree required with 5+ years of experience in process improvement, business operations, strategy, or program leadership.
• 2+ years of experience leading cross-functional projects or enterprise initiatives.
• 2+ years of experience processing medical claims and/or encounter submissions.
• Demonstrated experience organizing multiple priorities, stakeholders, decisions, and deadlines.
• Demonstrated experience building relationships and influencing across functions without direct authority.

Responsibilities

• Partner with encounter leadership to set priorities, prepare decisions, and drive follow-through on strategic initiatives.
• Organize multiple priorities, meetings, decisions, owners, and timelines to keep complex work moving.
• Build trusted relationships across operations, technology, compliance, markets, vendors, providers, and regulatory partners.
• Prepare and present updates, risks, options, and recommendations to C-suite executives and senior leaders.
• Lead governance forums focused on performance, risks, dependencies, decisions, and regulatory readiness.

Skills

Process improvement

Cross-functional leadership

Stakeholder management

Data-driven decision making

Relationship building

Education

Bachelor's degree

Job description

Humana, Inc. is seeking a strategic partner for Encounter Data Management to translate priorities into decisions and measurable results. This remote role involves organizing complex work, building cross-team relationships, and presenting to C-suite executives.

You will influence governance, data quality, and regulatory readiness for Medicaid encounter submissions. The position reports to the Director, Encounter Data Management.