[Hiring] Process Improvement Principal @Humana

Role Description

The Process Improvement Principal – Provider Terminations provides data-based strategic direction to identify and address business issues and opportunities. This is a remote position eligible for hire anywhere within the CST/EST time zones.

• Reports to the Director, Network Governance and Market Enablement.
• Responsible for leading and improving the end-to-end provider terminations process.
• 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 member experience
  • Increased productivity
  • Reduced cost
• Determines how new information technologies can support re-engineering business processes.
• May specialize in areas such as:
  • Benchmarking
  • Business process analysis and re-engineering
  • Change management and measurement
  • Process-driven systems requirements
• Works with senior executives to develop and drive segment or enterprise-wide functional strategies.
• Advises on matters of significance and provides recommendations to senior executives.
• Leads the strategy and approach for Humana’s termination processes through collaboration with key stakeholders, including:
  • Member Retention
  • Stars
  • Provider and Member Service
  • Sales
  • Provider Network Operations
• Oversees the process for coordinating and tracking impacts of potential/likely provider terminations across all regions.
• Works autonomously across teams to optimize operational processes related to provider terminations, focusing on:
  • Identifying and mitigating associate, member, and provider friction points
• Oversees governance and progress against opportunity areas.
• Influences key partners to simplify and improve business processes, emphasizing provider and member experience.
• Identifies additional opportunity areas and prioritizes resources against them.
• Understands provider changes in advance to drive collaboration opportunities.
• Develops key insights around the downstream impacts of provider terminations on:
  • Stars
  • Member experience and retention
  • Provider contracting decisions
• Leverages data analytics to drive business insights, reporting, and leadership communications around provider terminations.
• Advises leadership on functional strategies while exercising independent judgment on complex issues.

Qualifications

• 3+ Years’ experience in the payer/provider contracting lifecycle.
• Experience leveraging multiple business areas to drive company performance.
• 7 or more years of improving or creating business processes.
• 3+ years of project or people leadership.
• Ability and willingness to travel up to 10% of the time.
• Located in the Central or Eastern Time Zone.

Requirements

• Bachelor's degree (preferred).
• Customer service/account management leadership experience (preferred).

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Time off, including paid time off, company and personal holidays, paid parental and caregiver leave.
• Short-term and long-term disability.
• Life insurance.
• Many other opportunities for personal wellness and smart healthcare decisions.