Associate Director, Process Improvement at Humana in Ohio

Associate Director, Process Improvement Location: Work at Home - Ohio Become a part of our caring community The Associate Director, Process Improvement leads strategic initiatives that enhance clinical and operational workflows across care management and utilization management programs. You will serve as a key liaison between Clinical Health Services, IT, and Operations to design, improve, and resolve technical and process-related solutions that support quality, compliance, and member outcomes. You will establish the strategic direction for process improvement efforts, prioritizes initiatives across a portfolio of work, and guides teams in execution to ensure alignment with organizational goals and regulatory requirements. The Associate Director plays a critical role in translating clinical needs into scalable operational and technical solutions that improve efficiency and effectiveness across teams. Key Responsibilities Establish and lead the strategic roadmap and priorities for process improvement initiatives supporting Clinical Health Services Serve as a liaison between Clinical Health Services, IT, and Operations to translate clinical needs into effective system and workflow solutions Guide and direct teams in prioritizing initiatives, defining next steps, and executing complex, cross-functional work Lead the identification and resolution of complex clinical, operational, and technical challenges Oversee and develop a team of professionals, providing clear direction, accountability, and performance guidance Lead and influence cross-functional stakeholders, including senior leadership, to align priorities and drive outcomes Ensure processes support compliance with regulatory, contractual, and accreditation requirements (e.g., CMS, NCQA) Drive end-to-end process mapping, redesign, and standardization for care management and utilization management workflows Evaluate and implement technology and system enhancements that improve clinical and operational performance Manage competing priorities across the organization, ensuring focus on highest-impact initiatives Support the integration and continuous improvement of onboarding processes and compliance-related training requirements to ensure teams are prepared to meet expectations Build and maintain strong relationships with internal stakeholders, including clinical leaders and market partners Required Qualifications Bachelor's degree required 3+ years of experience in process improvement, operations, or technical program support (healthcare environment preferred) 3+ years of leadership experience, including direct team oversight Experience supporting or partnering with care management, utilization management, or clinical operations teams Demonstrated ability to set strategic direction, prioritize initiatives, and lead teams through execution of complex programs Proven ability to lead and influence cross-functional teams and stakeholders Strong analytical skills with the ability to interpret data and translate insights into actionable improvements Experience developing and operationalizing strategy Strong communication skills with ability to translate between clinical, technical, and business audiences Ability to manage multiple priorities in a fast-paced, matrixed environment Medicaid and/or managed care experience Must reside in Ohio, Kentucky or in bordering state within driving distance of Humana Waterside (Louisville, KY) Preferred Qualifications Clinical background or healthcare experience (e.g., RN, LCSW, or other clinical discipline) strongly preferred Working knowledge of care management and/or utilization management workflows, including assessments, care planning, and authorization processes Understanding of clinical documentation standards and regulatory/accreditation requirements (e.g., CMS, NCQA) Experience supporting clinical systems or platforms used in care management or utilization management Experience in workflow design, process re-engineering, and clinical process optimization Experience with tools such as QuickBase or similar platforms Bilingual Additional Information Travel to the Humana Waterside building (Louisville, KY) for meetings and trainings required. WAH Internet Statement 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 required; 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. Driving Statement This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher. HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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. SSN Alert Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $126,300 - $173,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities. About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. ​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.