Director, Process Improvement

Humana Inc.

Job Overview

Location

Remote Nationwide

Job Type

Full-time

Full Job Description

📋 Description

• As a remote Director, Process Improvement at Humana Inc., you will drive ecosystem strategy, identifying architecture simplifications, provider data quality improvements, operational and quality automations, and deliver end-to-end efficiency, quality, and modernization through automations, operational processes, and product technology strategies.
• You will manage provider data business intelligence, including business case and value for supporting efficiency opportunities and ongoing process improvements across manual and automated provider operations, while partnering across Humana Military products, IT, automation teams, and business partners on data stewardship and data models.
• You will initiate strategies to leverage new technologies to improve provider data quality and reduce manual touch (AI, BOTs), manage UAT processes and automations, ensure quality programs monitor adherence to TRICARE policies, and monitor provider data incident, escalation, and resolution processes to identify key trends and iterative solution strategies.
• You will monitor Claim Deferral inventories to ensure provider-related claim dependencies are resolved timely, report to an Associate VP of Strategy Advancement, and contribute to Humana’s mission of improving health outcomes for military personnel, families, and communities through data-driven process modernization.

🎯 Requirements

• U.S. Citizenship (required by Department of Defense contract)
• 7 years of leadership experience over a large operations area
• 7 years of direct experience in health plan operations: contract management, claims processing, or provider data management
• 7 years of experience in data analysis and/or metrics reporting or auditing for quality
• Bachelor’s degree (preferred)
• Proficiency in SQL data queries and reporting (preferred)

🏖️ Benefits

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave
• Short-term and long-term disability, life insurance
• Bi-weekly internet expense payment for associates in California, Illinois, Montana, or South Dakota
• Telephone equipment provided for home or hybrid work arrangements
• Eligibility for bonus incentive plan based on company and/or individual performance

Skills & Technologies

Remote

$150k-206k

Degree Required

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Humana Inc.

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About Humana Inc.

Humana Inc. is a for-profit health and well-being company headquartered in Louisville, Kentucky. Founded in 1961, it provides health insurance, Medicare Advantage plans, Medicaid services, pharmacy benefit management, and clinical care through primary care centers. Serving millions of members across the United States, Humana focuses on integrated care delivery, home health, and wellness programs aimed at improving health outcomes and reducing costs for individuals, employers, and government partners.

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