Humana · 3 hours ago
Lead, LTSS Process Improvement
United States
Full-time
Remote
Mid, Senior Level
$95K/yr - $130K/yr
5+ years expHumana Inc. is committed to putting health first, and they are seeking a Lead for their LTSS Process Improvement team. The role involves analyzing and improving Medicaid long-term support and services processes, collaborating with stakeholders, and developing policies to enhance efficiency and compliance.
Health CareHealth InsuranceInsuranceVenture Capital
Responsibilities
Analyze current Medicaid long-term support and services programs to identify areas for improvement
Research, analyze, and interpret state contracts and responses
Develop and implement strategies to enhance program efficiency, ensuring optimal utilization of resources
Oversee the creation, review, and update of program descriptions to align with evolving Medicaid requirements
Collaborate with relevant stakeholders to ensure accuracy and completeness of program descriptions
Interpret complex regulations and process to translate them into easily understandable policies and procedures
Establish and maintain policies and procedures governing Medicaid long-term supports and services
Lead the development, writing, editing, and updating of Medicaid policies and procedures, ensuring clarity, accuracy, and alignment with regulatory requirements
Lead initiatives to streamline processes related to Medicaid services, reducing administrative burden, and enhancing service delivery
Collaborate with internal teams, external partners, and Medicaid agencies to ensure alignment with program goals and objectives
Act as a liaison between the organization and regulatory bodies, fostering positive relationships
Lead by influence, both internal and external team members, to create policy and procedures, including training and mentoring
Qualification
Required
Bachelor's degree in Business or a related field AND a minimum five (5) years business experience
Experience in Managed care health plan operations
Strong influencing and process implementation skills
Facilitating and driving cross-functional teams' efforts
Successfully demonstrated delivering presentations to senior leaders
Must be available to work normal business hours in the Eastern Standard Time Zone
Available for 10% travel to the Virginia office for meetings and or trainings on a quarterly basis
Preferred
Master's degree in Business, Operations Management, Healthcare Administration
2+ years in project leadership
Knowledge of Systems Development Life Cycle, Waterfall, and Agile Development Methodologies
Possess a solid understanding of operations, technology, communications and processes Six Sigma and / or Project Management Institute certification
Benefits
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
Company
Humana
Humana is a health insurance provider for individuals, families, and businesses.
10001+ employees
H1B Sponsorship
Humana has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (282)
2024 (246)
2023 (284)
2022 (274)
2021 (212)
2020 (84)
Funding
Current Stage
Public CompanyTotal Funding
$13.07B2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B
Leadership Team
Jim Rechtin
CEO and President
Caleb Gallifant
Chief Operating Officer, CenterWell Home Health
Recent News
2026-01-16
2026-01-16
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