Authorization and Referral Claims Process Improvement Lead

Humana

Process Improvement Lead analyzing and improving business processes for Humana's healthcare initiatives. Collaborating with teams to ensure scalable and compliant operations.

Posted 7/1/2026full-timeRemote • 🇺🇸 United StatesSenior💰 $94,900 - $130,500 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in process analysis, improvement initiatives, and data analysis to drive operational efficiency. Proficient in facilitating workshops and communicating effectively with cross-functional teams to support decision-making and ensure compliance.

Highest-signal resume keywords

Process Improvement InitiativesData AnalysisMicrosoft Office ApplicationsProject ManagementChange Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Process AnalysisRoot Cause AnalysisOperational Data AnalysisKPI DefinitionReport BuildingClaims ProcessingBusiness Process EvaluationTrend IdentificationBottleneck AnalysisRisk Assessment

Soft Skills

FacilitationCommunicationCollaborationProblem-SolvingMotivation

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft AccessMicrosoft PowerPointMicrosoft Visio

Industry Keywords

Claims ProcessingBusiness ProcessesOperational EfficiencyComplianceStakeholder Engagement

About the role

Key responsibilities & impact

Analyze and measure the effectiveness of existing business processes
Work closely with the Authorization and Referral Process team on large scale initiatives
Partner with business leaders to lead process analysis and root cause
Facilitate workshops, working sessions, and improvement events
Communicate progress, risks, and outcomes to leadership
Analyze operational data to identify trends and improvement opportunities
Build reports/dashboards to monitor improvements and define KPIs and metrics
Ensure processes are scalable, repeatable, and compliant
Evaluate current business processes to identify inefficiencies, bottlenecks, and risks
Collaborate with stakeholders to support decision-making

Requirements

What you’ll need

Minimum 2 years of experience processing and/or researching claims using CAS
Minimum 2 years of experience leading and implementing process improvement initiatives
Demonstrated experience using Microsoft Office applications including Word, Excel, Access, PowerPoint, and Visio
Demonstrated ability to analyze data and draw actionable conclusions
Experience facilitating and communicating among claims and cross-functional teams
Strong motivation to expand process improvement knowledge and expertise
Experience applying analytical and problem-solving skills
Experience with project and change management
Bachelor's degree preferred

Benefits

Comp & perks

medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
short-term and long-term disability
life insurance
many other opportunities