Louisville, Kentucky-based Humana is a leading healthcare company that offers a variety of health, wellness, and insurance products and services designed to offer an integrated app
Director, Process Improvement
Location
United States
Posted
9 hours ago
Salary
$150K - $206.3K / year
Seniority
Lead
No structured requirement data.
Job Description
Director, Process Improvement
Humana
Role Description As a remote Director, Process Improvement, you will report to an Associate VP of Strategy Advancement. - Drive ecosystem strategy, identifying architecture simplifications, provider data quality improvements, operational and quality automations. - Deliver end-to-end efficiency, quality, and modernization through automations, operational processes, and product technology strategies. - Manage provider data business intelligence, including business case and value for supporting efficiency opportunities and ongoing processes improvements across manual and automated provider operations. - Partner across Humana Military products, IT, automation teams, and business partners on data stewardship and data models. - Initiate strategies to leverage new technologies to improve provider data quality and reduce manual touch (AI, BOTs). - Manage UAT processes and automations, including pre and post-deployment testing across product and operations teams. - Ensure quality programs monitor adherence to TRICARE policies. - Monitor provider data incident, escalation, and resolution processes identifying key trends and iterative solution strategies. - Monitor Claim Deferral inventories ensuring provider-related claim dependencies are resolved timely. Qualifications - U.S. Citizenship required due to Department of Defense contract. - Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services). - 7 years in leadership experience over a large operations area. - 7 years direct experience in health plan operations: contract management, claims processing, or provider data management. - 7 years experience in data analysis and/or metrics reporting or auditing for quality. Requirements - Bachelor's degree preferred. - Experience and proficiency with TRICARE operations policy preferred. - Proficiency in SQL data queries and reporting preferred. - Work at Home Requirements: Minimum download speed of 25 Mbps and upload speed of 10 Mbps recommended; wireless, wired cable, or DSL connection suggested. - Associates in California, Illinois, Montana, or South Dakota will receive bi-weekly payment for internet expenses. - Humana will provide telephone equipment appropriate for the position. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. - Occasional travel to Humana's offices for training or meetings may be required. Benefits - Competitive benefits that support whole-person well-being. - 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. 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. $150,000 - $206,300 per year This job is eligible for a bonus incentive plan based on company and/or individual performance. Application Deadline 05-28-2026
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