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Humana Senior Clinical Process Improvement Professional in Newport, Rhode Island


The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.


Location: work at home anywhere

The Humana Clinical Operations (HCO) Team establishes Humana's enterprise clinical direction (cultural clinical conscience), identifying, evaluating and communicating the strategies that will help our members get superior healthcare access, education and outcomes, while driving down associated costs.

This role, within the Experience and Optimization (E&O) team of HCO, will work closely with HCO leaders and SMEs in the areas of Utilization Management (inpatient & outpatient), Care Management, Quality Operations and Market relations as well as key partners in leading and delivering on initiatives and process capabilities that enable improved effectiveness, efficiency and experiences (member, provider and associate).

The Senior Clinical Process Improvement Professional researches best business practices within and outside the organization to establish benchmark data. Collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on enhanced experience, increased productivity/effectiveness and reduced cost. Determines how new information technologies can support re-engineering business processes. May specialize in one or more of the following areas: benchmarking, business process analysis and re-engineering, change management and measurement, and/or process-driven systems requirements.

Key Responsibilities Include:

  • Execute process initiatives within the framework of a robust process management control system highlighting KPIs that provide team observations, insights and recommendations on actions to be taken

  • Further simplify and improve processes in conjunction with partners (ie. Clinical Business Improvement Team) that are informed by the ideal member, provider and associate experience, and are enabled through both technology and non-technology solutions

  • Participate and/or facilitate in IT requests, user acceptance testing and interface with various business improvement and technology teams

  • Develop policies / procedures associated with resulting process updates

  • Lead large scale initiatives, with ability to effectively manage competing priorities

Role Essentials

  • Bachelor's degree in business, engineering or any field

  • 5 or more years of consulting and/or process improvement experience

  • Experience in leading process improvement initiatives with proven results

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

  • Excellent verbal, written and presentation skills

  • High emotional intelligence

  • Excellent interpersonal, organizational, communication and presentation skills

  • Problem solver with a proven ability to lead in a fast paced, highly complex organization

  • Ability to effectively interact with and influence all levels of the organization, including front line associates and senior leadership

Role Desirables

  • Clinical process improvement experience

  • Lean / Six Sigma Green / Black Belt certification

  • MBA

Additional Information

Humana is an organization with careers that change lives-including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.

Scheduled Weekly Hours