Senior Process Improvement Professional Subrogation

Profile

Description

Humana's Claims Cost Management organization is looking for a Senior Process Improvement Professional that is experienced in technical data analysis or project management, to join the Subrogation Team working from home anywhere in the US. This team investigates, identifies and recovers medical claim payments for Humana when an accident insurance carrier is responsible. As the Senior Process Improvement Professional your role is critical to driving creation of and maintaining department dashboards, inventory, performance & financial metrics.

Responsibilities

The Senior Process Improvement Professional researches best business practices within and outside the organization to establish benchmark data. You will collect and analyze process data to initiate, develop and recommend business practices and procedures that focus on increased productivity and reduced cost as well as determine how new information technologies can support re-engineering business processes.

Key Responsibilities

Foster strong working relationships with peers, vendors and internal business process owners to create viable solutions and processes that meet business needs (subrogation, pre-pay, post-pay, financial recovery, FP&A)

Partner with subrogation vendor relationship owners to automate and enhance processes

Drive creation of and maintain vendor and department dashboards, inventory, performance & financial metrics and adhoc reporting

Assist with monitoring and analyzing vendor and business performance and trends

Monitor established data, financial and reporting processes and lead projects with supporting teams to drive strategy

Based on current guidance from the CDC, local and state governments, and Humana leadership related to the coronavirus (COVID-19) outbreak have extended travel restrictions until further notice. The policy will be reassessed as the situation warrants. Once these restrictions are lifted this role may require up to 10% travel depending on business needs.

Required Qualifications

Bachelor's degree or equivalent related work experience

4 years of technical experience in data analysis and/or project management

Comprehensive knowledge of Microsoft Office Applications (Excel, Access and PowerPoint)

Advanced experience working with big and complex data sets within large organizations

Experience analyzing data to solve a wide variety of business problems and create data visualizations that drive strategic direction

Experience with tools such as Power BI, Tableau and/or Qlik for creating data visualizations

Ability to read and interpret SQL reporting logic

Proficiency in understanding Healthcare related data

Proficiency in verbal and written communication to senior leadership

Demonstrated capacity to manage competing priorities

Ability to travel up to 10% (overnight) depending on business needs

Work at Home/Remote Requirements

Must ensure designated work area is free from distractions during work hours and virtual meetings

Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required

Preferred Qualifications

Project Management or a process re-engineering certification

Experienced using the following systems: MOAT, CAS, MTV, CRM, Qlikview, SQL and/or TOAD

Expertise in data mining, forecasting, simulation, and/or predictive modeling

Experience leading people, projects, and/or processes

Sound understanding of Claims Cost Management or Payment Integrity

Healthcare Subrogation background

Experience in a fast paced, metric driven operational setting

Vendor management or oversight experience

Scheduled Weekly Hours

40

Company info

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