Senior Process Improvement Professional

Become a part of our caring community The Senior Process Improvement Professional will lead the design and implementation of new operational processes to support interoperability and medical documentation chase work. This role is responsible for building processes from the ground up, defining future-state workflows, and translating business needs into clear operational and system requirements. The Senior Process Improvement Professional will work across business, product, and IT teams to stand up new capabilities, improve end-to-end process performance, and ensure processes are scalable, compliant, and operationally sustainable.

Work assignments involve moderately complex to complex issues where independent judgment, cross-functional collaboration, and deep process analysis are required.

*** This position is created specifically to assist with Humana's efforts to secure and, if awarded, transition into a new business opportunity. Please note that continued employment in this role is expressly contingent upon Humana's receipt of the business opportunity and a satisfactory transition into the work. In the event Humana does not pursue the opportunity or determines that a timely and satisfactory transition cannot be achieved, employment may be subject to termination.

***

In this remote position you will report to the VP, VA CCN Program Leader. As the Deputy VA CCN Program Leader, you will serve as a key member of the VA leadership team, directly supporting the VA CCN Program Leader (VPL) in providing overall management, execution, and operational performance of the Department of Veteran Affairs (VA) Community Care Network program. You will support the VP, VPL in providing strategic and operational leadership to ensure contract compliance, service delivery, and support for Veteran's, providers, and VA stakeholders.

The Deputy VPL serves as a liaison across cross-functional teams and helps drive improvement, operational excellence, and achievement of program objectives.

The Senior Process Improvement Professional serves as the end-to-end process owner and subject matter expert for interoperability and medical documentation chase operations. This role will assess business needs, design new workflows, define operating models, and develop process standards, controls, and performance measures to support successful implementation. The associate will partner closely with business stakeholders, product teams, and IT to document requirements for system functionality, identify dependencies, and ensure technology solutions align to operational needs.

The Senior Process Improvement Professional will map current and future-state processes, identify gaps, risks, and opportunities, and recommend sustainable solutions that improve accuracy, efficiency, and stakeholder experience. This role will help establish business rules, intake requirements, routing logic, exception handling, reporting needs, and governance processes for new work. The associate will also support change management, implementation planning, testing, and operational readiness activities to ensure successful launch and adoption.

The role requires developing deep expertise across the full end-to-end process, including upstream inputs, downstream impacts, stakeholder roles, system touchpoints, and compliance considerations. The Senior Process Improvement Professional makes decisions on moderately complex to complex issues regarding process design, requirements, and implementation approach, and performs work with limited direction while exercising considerable latitude in determining objectives and methods. Use your skills to make an impact

• Lead the design and stand-up of new processes supporting interoperability and medical documentation chase operations, including defining the end-to-end operating model and implementation approach
• Build and maintain end-to-end workflows, including intake, triage, routing, exception handling, escalation paths, and reporting requirements
• Serve as the subject matter expert for the full operational process and associated system interactions, ensuring strong understanding of upstream inputs and downstream impacts
• Partner with business, product, and IT stakeholders to gather, document, and refine business and system requirements for new functionality
• Translate operational needs into functional requirements, business rules, user stories, process maps, and supporting documentation
• Facilitate cross-functional…