About Humana


Job Category:

Business Services - Business Services


United States

Approximate Salary:

Not Specified

Position Type:

Full Time

Process Improvement Professional 2 - Humana Long-Term Care (Florida)

Humana - Work At Home, Florida

Posted: 10/14/2018


The Process Improvement Professional 2 analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Process Improvement Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.


The Process Improvement Professional 2 researches best business practices within and outside the organization to establish benchmark data.

  • Recognizing and identifying opportunities for improved outcomes and contribute to  development of corporate and market programs.
  • Assist with developing actions to satisfy IOP.s
  • Contribute to the development of Vision Scope and Requirements (VSR) for Market.
  • Review AHCA LRRs , consults with Business Owner , develop action items  and facilitate with implementation.
  • Escalate any issues timely to the Director and Performance Improvement Manager.
  • Research and consults with various business areas to gain knowledge in order to compile reports for projects.
  • Establish RAID  and milestone trackers for business areas.
  • Compile Market data and resources  ITNs
  • Works closely with market leadership.
  • Plan, organize, implement and monitor special projects assigned by Director or Performance Improvement Manager.
  • Review Contract Amendment language for updated, additional, or discontinued plan requirements.
  • Create or update market Policies and Procedures to align with contract amendments.
  • Facilitate discussion/meeting/workshop with stakeholders to develop or update process flows, procedure documents, others.
  • Submit final draft of Policies and Procedures to Contracting Management, Compliance, and Legal.
  • Publish final Policies and Procedures to Mentor and SharePoint sites.
  • Facilitate training of new processes to market.
  • Communicate analysis to all market stakeholders.
  • Present analysis to Quality Improvement Committee quarterly.
  • Requires 25% travel (at least once per month), the rest will be work from home.


Required Qualifications

  • Bachelors Degree.
  • Minimum of 5 years of relevant experiences.
  • Intermediate to advance skills in PowerPoint, Excel, ACCESS, Microsoft Outlook and Visio.
  • Project management and process improvement expertise
  • Strong collaboration and communication skills.
  • Excellent analytical skill and presentation skills.
  • Strong organizational skills.
  • Must have accessibility to high speed DSL or Cable modem for a home office (No Satellite).
  • This role is considered patient facing and is a part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
  • AHCA Fingerprint Required.

Preferred Qualifications

  • LPN licensed in the state of Florida without restrictions in addition to a Bachelors Degree.
  • Previous leadership experience.
  • Experience with Humana Systems: CGX, PAAG, PMDM, CCP2, CDM, CDM,Enterprise
  • Clinical experience.
  • Previous Medicare/Medicaid experience a plus.
  • Prior nursing home diversion or long term care case management experience.

Additional Information

As part of our hiring process, we will be using an exciting interviewing technology provided by Montage, 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 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


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