Become a part of our caring community and help us put health first
 

Humana Healthy Horizons is seeking a Senior Project Manager (PM) who consults with clinical and business partners to help them solve problems through insightful, actionable analytics and helps business partners assess incremental value of existing efforts and identify new levers that generate incremental value for the organization. This role mainly focuses on the "Business" side of State Medicaid clinical processes with very limited scope in the IT field.

The Senior Project Manager designs, communicates, and implements an operational plan for completing projects in clinical applications with a focus on the healthcare claims review process and utilization management. This project manager collaborates with teammates to bring complimentary skillsets to larger projects and works on problems of diverse scope and complexity ranging from moderate to substantial.

The Senior Project Manager key roles and responsibilities:

• Convenes matrixed operational partners to solve for operational gaps/barriers. Solutioning may also include some product development responsibilities, such as developing timelines, process maps, and process flow diagrams in partnership with subject matter experts.
• Describes the clinical tools, technologies, applications, and practices used to collect, integrate, analyze, and present an organization's raw data to create insightful and actionable business information.
• Manages all aspects of a project, from start to finish, so that it is completed on time and within budget.
• Adept at research to determine the structured yet flexible approach to problem solving.
• Gathers business requirements, intelligence, and strategic planning support for business segments.
• Interprets data, analyze results, and provide insights to determine operational impact, trends, and opportunities.
• Identifies and solves problems that impact the management and direction of the business.
• Communicates with other operational areas in the organization to secure specialized resources and contributions for the project.
• Collaborates with cross functional team to resolve data quality and operational issues and ensure timely delivery of products.

Use your skills to make an impact
 

Required Qualifications

• Must work hours within the eastern or central standard time zones from a location within the United States.
• Bachelor's degree, OR 5+ years of equivalent work experience.
• 3+ years of project management experience.
• 2+ years of leadership experience in a matrixed environment.
• Proficient in writing and interpreting SQL queries.
• Proven ability to work with cross-functional teams and translate requirements between business, project management, and clinical projects or programs.
• Experience analyzing data to solve a wide variety of business problems; ability to create data visualizations that drive strategic direction.
• Proficiency in understanding Healthcare related claims data.
• Highly adept at managing processes from concept to completion ensuring on-time, on-budget, and on-target results.
• Demonstrated experience in verbal/written communication to senior and executive leadership, as well as external stakeholders.
• Possess a solid understanding of operations, technology, communications, and processes.
• Proficiency in Microsoft Office programs.

Work at Home Requirements

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Humana will provide Home or Hybrid Home/Office associates 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.

Preferred Qualifications

• Change Management, Six Sigma and/or Project Management Institute certifications.
• Experience in business operations.
• 2+ years of Medicaid health plan experience.
• Intermediate to advanced experience in analytical work with prior authorization and claims data.

Additional Information

• Workstyle: Remote
• Travel: Up to 10% to various states.
• Core Workdays & Hours: Typically, 8-5 pm Monday – Friday, EST or CST with flexible scheduling (i.e. occasional nights and weekends).
• Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.....  

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, a third-party vendor.  This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview.  If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided.  Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

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.

 

$84,600 - $116,300 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
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.