Senior Process Improvement Professional

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This position is created specifically to assist with Humana’s efforts to secure and, if awarded, transition into a new business opportunity. Please note that continued employment in this role is expressly contingent upon Humana’s receipt of the business opportunity and a satisfactory transition into the work. In the event Humana does not pursue the opportunity or determines that a timely and satisfactory transition cannot be achieved, employment may be subject to termination.

The Senior Process Improvement Professional serves as the end-to-end process owner and subject matter expert for interoperability and medical documentation chase operations. This role will assess business needs, design new workflows, define operating models, and develop process standards, controls, and performance measures to support successful implementation. The associate will partner closely with business stakeholders, product teams, and IT to document requirements for system functionality, identify dependencies, and ensure technology solutions align to operational needs.

The Senior Process Improvement Professional will map current and future-state processes, identify gaps, risks, and opportunities, and recommend sustainable solutions that improve accuracy, efficiency, and stakeholder experience. This role will help establish business rules, intake requirements, routing logic, exception handling, reporting needs, and governance processes for new work. The associate will also support change management, implementation planning, testing, and operational readiness activities to ensure successful launch and adoption.

The role requires developing deep expertise across the full end-to-end process, including upstream inputs, downstream impacts, stakeholder roles, system touchpoints, and compliance considerations. The Senior Process Improvement Professional makes decisions on moderately complex to complex issues regarding process design, requirements, and implementation approach, and performs work with limited direction while exercising considerable latitude in determining objectives and methods.

Use your skills to make an impact

Required Qualifications

o 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

o Build and maintain end-to-end workflows, including intake, triage, routing, exception handling, escalation paths, and reporting requirements

o Serve as the subject matter expert for the full operational process and associated system interactions, ensuring strong understanding of upstream inputs and downstream impacts

o Partner with business, product, and IT stakeholders to gather, document, and refine business and system requirements for new functionality

o Translate operational needs into functional requirements, business rules, user stories, process maps, and supporting documentation

o Facilitate cross-functional working sessions to define current-state, future-state, and target-state processes; identify gaps, risks, controls, and dependencies across teams and systems

o Recommend and implement sustainable process improvements that improve efficiency, quality, scalability, and operational readiness

o Support solution design, testing, training, SOP/job aid development, and change readiness activities for new process launches and enhancements

Preferred Qualifications

o Bachelor's degree or equivalent professional experience

o Experience standing up new processes, workflows, or operating models from the ground up

o Experience gathering, documenting, and refining business and system requirements

o Experience working cross-functionally with business, product, and IT stakeholders

o Strong written and verbal communication skills, including process documentation and executive-ready materials

o Strong analytical and problem-solving skills, including identifying process gaps, risks, and dependencies

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time…