Senior Process Improvement Professional

Profile

Description

The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

With a focus on Provider Network Operations for Humana Government Business (HGB); The Senior Process Improvement Professional plans, performs, and implements process improvement initiatives such as Lean or Six Sigma to improve output. Diagrams and evaluates existing processes. Develops metrics that provide data for process measurement and identifies indicators for future improvement opportunities. Collects data to determine root cause of problems. Measures performance against process requirements. Aligns improvement to performance shortfalls. Provides consultation on the use of re-engineering techniques to improve process performance and product quality. May deliver presentations and training courses including measurement, analysis, improvement and control. Surveys and analyzes best practices for techniques and processes. Performs cost and benefit analyses. Leads process improvement projects. Acts as liaison and coordinator for Value Based Care contract implementation and operations. Contributes to Associate Engagement plans and strategies.

KEY ACCOUNTABILITIES

45% Evaluates existing processes and makes recommendations for improvement where provider data impacts claims payment accuracy. Develops and implements new processes. Develops, implements and maintains operational policies and procedures. Works with business owners and business partners to implement new processes or improve existing processes

35% Sets and monitors process and productivity thresholds to ensure data accuracy. Reports results, captures and implements best practices. Consults with operational management on associate performance improvement opportunities. Ensure associates fully understand connections between provider information modifications and other business areas including claims, referrals and customer service

10% Acts as departmental liaison for internal and external audit

10% Special projects as assigned

This Role description in no way states or implies that the key accountabilities above are the only ones being performed by the individual(s) with this Role description. The individual(s) may be called upon and required to follow other instructions or perform other duties and tasks requested by his or her supervisor, consistent with the purpose of the position, department and/or company objectives

Required Qualifications

Bachelor Degree in Business or related field

2 or more years of provider relationship management experience

Experience with Accountable Care Organization (ACO) provider contract processes

Advanced skills with Microsoft Access, Excel and the ability to develop and execute SQL Queries

Strong communication skills, both written and verbal

Strong demonstrated strategic, analytical thinking, and consulting skills

Must be self-motivated, detail oriented and able to prioritize workload

Our Department of Defense Contract requires U.S. citizenship for this position

Preferred Qualifications

Lean or Six Sigma Certification

Prior experience or working knowledge of TRICARE/Government policy, contracts and/or regulations

Additional Information

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire Text to enhance our hiring and decision-making ability. Modern Hire Text 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.

If you are selected for a first round interview, you will receive a correspondence inviting you to participate in a Modern Hire Text interview. In this interview, you review a set of interview questions over your phone and you will provide text responses to each question. You should anticipate this interview to take about 15 to 20 minutes. Your text message interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com