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

　　Humana Healthy Horizons in Indiana is seeking Process Improvement Professionals who analyzes and measures the effectiveness of existing business processes and develops sustainable, repeatable, and quantifiable business process improvements. The Process Improvement Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. In this role, the professional must understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas.

　　The Process Improvement Professional roles and responsibilities:

　　Research best business practices within and outside the organization to establish benchmark data.

　　Collect and analyze process data to initiate, develop, and recommend business practices and procedures that focus on enhanced safety, increased productivity, and reduced cost.

　　Determine 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.

　　Performs audits focused on improving compliance and quality.

　　Focus audits - including annual and initial HRA compliance, post discharge and transition of care contacts.

　　Review of internal quality metrics.

　　Support process improvement initiatives.

　　Assist in reviewing new Job Aids to support Training & Operations.

　　Review current Job Aids and Policies and Procedures as requested.

　　Create and present education as requested by the Process Improvement Lead.

　　Supports Operations Managers in quality improvement initiatives.

　　Assist Managers in communicating audit findings to individuals and teams.

　　Communicate and manage remediation efforts with individuals.

　　Participates in Interrater Reliability (IRR) meetings and assists in the development of Interpretation Standards to guide audit scoring and increase consistency across the Process Improvement Team.

　　Participates in root cause analysis research for audits.

　　Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.

　　Use your skills to make an impact

　　Required Qualifications

　　Must reside in the state of Indiana.

　　Bachelor's degree, 4+ years of equivalent experience, or Licensed Practical Nurse (LPN).

　　2+ years of experience related to process improvement, compliance measures, or auditing practices.

　　Clinical background or physician office practice / hospital experience.

　　Proven oral / written communication and presentation skills.

　　Excellent analytical skills, able to manipulate and interpret data.

　　Exceptional organizational and prioritization skills.

　　Comprehensive knowledge of Microsoft Office Word, Excel, and PowerPoint.

　　Ability to work within highly structured contractual time compliance requirements with occasional short turnaround time.

　　Work at Home Requirements

　　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 associates 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.

　　Preferred Qualifications

　　Registered Nurse or Master's/bachelor's in social work.

　　Knowledge of HEDIS/Stars/CMS/Quality.

　　Experience in Medicaid or Medicare Guidelines.

　　2+ years of previous quality or process improvement experience in a hospital or physician office practice.

　　Strong business skills, including sales and marketing objectives.

　　Detail orientated and comfortable working with tight deadlines in a fast-paced environment.

　　Additional Information:

　　Workstyle: Remote

　　Travel: Travel may be required to support state and federal audits.

　　Core Workdays & Hours: Monday - Friday; typically, 8:00am - 5:00pm Eastern or Central Standard Time.

　　Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.....

　　Interview Format

　　As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

　　If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

　　If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

　　Scheduled Weekly Hours

　　40

　　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 because he or she is a protected veteran. 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.