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

Sign Up Now - MiamiCrossing.com