As a remote Director, Process Improvement, you will report to an Associate VP of Strategy Advancement.
You will drive ecosystem strategy, identifying architecture simplifications, provider data quality improvements, operational and quality automations
You will deliver end to end efficiency, quality and modernization through automations, operational processes and product technology strategies
You will manage provider data business intelligence, including business case and value for supporting efficiency opportunities and ongoing processes improvements across manual and automated provider operations
You will partner across Humana Military products, IT, automation teams and business partners on data stewardship and data models
You will initiate strategies to leverage new technologies to improve provider data quality and reduced manual touch (AI, BOTs)
You will manage UAT processes and automations, including pre and post deployment testing across product and operations teams
You will ensure quality programs monitor adherence to TRICARE policies
You will monitor provider data incident, escalation and resolution processes identifying key trends and iterative solution strategies
You will monitor Claim Deferral inventories ensuring provider related claim dependencies are resolved timely
Required Qualifications
Our Department of Defense contract requires U.S. Citizenship
Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services)
HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.
7 years in leadership experience over a large operations area
7 years direct experience in health plan operations: contract management, claims processing or provider data management
7 years experience in data analysis and/or metrics reporting or auditing for quality
Preferred Qualifications
Bachelor's degree
Experience and proficiency with TRICARE operations policy
Proficiency in SQL data queries and reporting
Work at Home Requirements
Scheduled Weekly Hours
40Pay 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.
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.Application Deadline: 05-28-2026
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.