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Humana Manager, Process Improvement (Virginia Medicaid) in Richmond, Virginia

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

Humana Healthy Horizons in Virginia is seeking a Manager, Process Improvement who will analyze and measure the effectiveness of existing business processes and develops sustainable, repeatable, and quantifiable business process improvements. The Manager, Process Improvement works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals.

  • Leads a team of process improvement professionals as well as Quality Assurance Learning Design and Facilitation professionals.

  • Research 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 safety, increased productivity, and reduced cost.

  • Determines how new information technologies can support re-engineering business processes and 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.

  • Monitors training personnel records to ensure that employees have met all company training requirements for company, quality, and regulatory compliance.

  • Analyzes course evaluations to judge effectiveness of training sessions and to implement suggestions for improvements.

  • Evaluates the relevance of online resources to complement the facilitated experience in the fields as appropriate.

  • Participates in Virginia Department of Medical Assistance Services (DMAS) virtual and/or in-person trainings.

  • Typically makes decisions related to identifying and resolving complex technical and operational problems within department(s).

Use your skills to make an impact

Required Qualifications

  • Must reside in the Commonwealth of Virginia.

  • Bachelor's Degree.

  • Two (2) or more years process improvement or process design.

  • Three (3) or more years of professional experience working with complex populations or in manage care settings.

  • Two (2) or more years of management or supervisory experience.

  • Intermediate to advance skills in MS Office Programs specifically MS Word, PowerPoint, and Excel.

  • Effective communicator, verbally and written.

  • Must be able to travel throughout the Commonwealth of Virginia.

Preferred Qualifications

  • Experience with training and learning modules or materials to increase performance.

  • Intermediate knowledge or better understanding of curriculum design and adult learning principles.

  • Technical expertise in authoring tools and multiple instructional design platforms (i.e. SharePoint, Camtasia, Articulate, Illustrator, InDesign and Cornerstone).

  • NCQA and CMS audit experience.

  • Medical Management Systems experience.

  • Six Sigma knowledge/Certification, PMP or Green Belt Certification.

Additional Information

  • Workstyle: This is a Remote position that will require you to travel.

  • Travel: Up to 25% of the time to Humana Healthy Horizons office in Glen Allen, VA and within the six Medicaid regions in Virginia for collaboration and face to face meetings as well as possible field interactions with direct reports. Travel will also include participating in DMAS in-person trainings.

  • Typical Workdays and Hours: Monday - Friday; 8:00am - 5:00pm Eastern Standard Time (EST).

  • Direct Reports: Up to 15.

Work at Home Internet Statement

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 recommended; wireless, wired cable or DSL connection is suggested.

  • Satellite, cellular and microwave connection can be used only if approved by leadership.

  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

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 of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$93,000 - $128,000 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

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