Description

The Process Improvement Lead identifies best practices within and outside the organization to establish benchmark data for Care Management and Utilization Management procedures.

Responsibilities

Position Responsibilities:

• Collects and analyzes process data to initiate, develop, and recommend business practices and procedures that focus on enhanced safety, increased productivity, and reduced cost.
• Determines how new information technologies can support re-engineering business processes and may specialize in one or more of the following areas: benchmarking, clinical best practices, change management and measurement, and/or process-driven systems requirements.
• Advises leadership to develop functional strategies on matters of significance, exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision.
• Use independent judgment requiring analysis of variable factors and determining the best course of action.

Required Qualifications:

• Active Registered Nurse (RN) license, bachelor’s degree Nursing (BSN)
• Three (3) years of experience in quality management and/or process improvement.
• Three (3) years of experience working with business partners to drive transformation.
• Five (5) or more years of leadership experience guiding teams through change management as a team leader, project leadership, Subject Matter Expert, SME, etc.
• Intermediate to Advanced proficiency in various MS programs specifically, Excel, Word, PowerPoint & Visio.
• Experience in Oklahoma Medicaid care management processes.
• Experience in data collection, data analysis and trending.
• Ability to build and maintain effective working relationships.
• Excellent skills in training and presentations.
• Excellent organizational skills and able to manage multiple priorities; comfortable working in a highly visible, fast-paced environment.

Preferred Qualifications:

• Previous experience working in a managed care field.
• Certification, Case Management
• MSN degree

Additional Information

This position is open to working remote in Oklahoma

Our Benefits

Health benefits effective day 1. Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

• Paid time off, holidays, volunteer time and jury duty pay, Recognition pay.
• 401(k) retirement savings plan with employer match.
• Tuition assistance, Scholarships for eligible dependents.
• Parental and caregiver leave.
• Employee charity matching program.
• Network Resource Groups (NRGs).
• Career development opportunities.

Work at Home Criteria

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• 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.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees 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.

Interview Format

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

Scheduled Weekly Hours

40