Become a part of our caring community and help us put health first
 

The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors where supervision is minimal.

The Clinical Operations (CO) Team establishes Humana’s enterprise clinical direction, identifying, evaluating and communicating the strategies that will help our members receive superior healthcare access, education and outcomes, while driving down associated costs. 

This role, within the Experience and Optimization (E&O) team, will work closely with CO leaders and SMEs in the areas of Utilization Management (inpatient & outpatient), Quality Operations and Market relations as well as key aligned partners in leading and delivering on initiatives and process capabilities that enable improved effectiveness, efficiency and experiences (member, provider and associate).

 

The Senior Clinical Process Improvement Professional

·       Researches best business practices within and outside the organization to establish benchmark data

·       Collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on enhanced experience, increased productivity/effectiveness and reduced cost

·       Determines how new information technologies can support re-engineering business processes

·       May specialize in one or more of the following areas: benchmarking, business process analysis and re-engineering, change management and measurement, and/or process-driven systems requirements.

 

Key Responsibilities Include:

·       Execute process initiatives within the framework of a robust process management control system highlighting KPIs that provide observations, insights, and recommendations on actions to be taken

·       Further simplify and improve processes in conjunction with business partners that are informed by the ideal member, provider, and associate experience, and are enabled through both technology and non-technology solutions

·       Participate and/or facilitate in IT requests, user acceptance testing and interface with various business improvement and technology teams

·       Develop policies / procedures associated with resulting process updates

·       Lead large scale cross-functional initiatives, with ability to effectively manage competing priorities

·       Excellent verbal, written and presentation skills

Use your skills to make an impact
 

Required Qualifications

• 6 years' experience in clinical operations and/or CGX usage
• Experience leading process improvement initiatives
• Demonstrated ability to manage timelines and priorities and effectively communicate and collaborate across multiple departments
• Advanced proficiency with Microsoft applications (Word, Excel, PowerPoint)
• Demonstrated success with accountability / ownership of responsibilities
• Excellent interpersonal, organizational, communication and presentation skills
• Comfortable working in a fast paced, highly complex organization
• Ability to effectively interact with and influence all levels of the organization

Preferred Qualifications

• Bachelor's Degree

• Clinical process improvement experience

• Market UM operational/process improvement experience

• CGX experience

• Strong clinical or nursing background

• Utilization Management and/or Care Management experience

• Strong with data analysis and telling a story to business customers with data

• Lean / Six Sigma Green / Black Belt certification

• MB