Process Improvement Lead - Autism Cares Demonstration

Profile

Description

Responsibilities

This role within the Autism Care Demonstration (ACD) Team, will work closely with Care Management leaders and Subject Matter Experts in the areas of Case Management, Utilization Management and Care Management Support as well as other key partners in leading and delivering on initiatives and process capabilities that enable improved effectiveness, efficiency and experiences (beneficiary, provider and associate). The Lead defines improvement projects aligned with business strategies and Medical Management priorities. The successful candidate will identify, advise, lead and facilitate process improvement opportunities.

KEY ACCOUNTABILITIES

Process Improvement and Project Management

Contributes to the identification of projects and business opportunities that foster innovation and meet strategic objectives through proactive process review and researching industry/competitive trends

Leads the design of innovative business processes, creating sustainable competitive advantage and administrative efficiencies.

Interfaces with all areas and levels of leadership within the organization to advise and provide oversight of projects, key insights, and ensure project milestones and deliverables are implemented in a timely manner

Develops and manages detailed project documentation for ACD projects of various scopes and scales

Change Order Management

Facilitate document reviews with subject matter experts

Facilitate discussions to address potential concerns, staffing and process impacts

Respond to designated medical management responder on behalf of ACD clinical department

Work with business informatics to request claims data required for staffing analysis

Work with leaders from impacted ACD teams to formulate staffing impact

Work with finance to finalize response to the Defense Health Agency

Meeting Facilitation/Liaison

Act as liaison to provide support for other areas within Humana Government Business on ACD process and policy related questions

Represent the ACD team in various workgroups and special projects

Required Qualifications

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

Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)

Bachelor's Degree in business administration or healthcare related field

Minimum of three (3) years of Project Management experience

Minimum of three (3) years of managed care experience

Strong business acumen balanced with analytical skills in order to see the big picture and draw out insights and observations

Experience in managing implementations, deadlines, and task assignment

Ability to design highly creative and innovative approaches to problems

Experience with Microsoft Office products including; Word, Excel, PowerPoint, and process mapping software and project management software

Excellent interpersonal, organizational, communication and presentation skills

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Project Management Professional (PMP) Certification

TRICARE Experience

Six Sigma/Lean Certification

Direct or indirect military experience a plus

Scheduled Weekly Hours

40

Company info

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