The Process Improvement Principal - Provider Terminations provides data-based strategic direction to identify and address business issues and opportunities. Provides business strategic advice and guidance to functional team(s). The Process Improvement Principal - Provider Terminations requires an in-depth understanding of how organization capabilities interrelate across the function or segment. This is a remote position eligible for hire anywhere within the CST/EST time zones.
The Process Improvement Principal - Provider Terminations will report to the Director, Network Governance and Market Enablement and will be responsible for leading and improving the end-to-end provider terminations process. The Process Improvement Principal 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 member experience, increased productivity 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. Works with senior executives to develop and drive segment or enterprise-wide functional strategies. Advises one or more areas, programs or functions and provides recommendations to senior executives on matters of significance, and as an advanced subject matter expert competent to work at very high levels in multiple knowledge and functional areas across the enterprise.
- Leads the strategy and approach for Humana's termination processes through collaboration with key stakeholders, including but not limited to Member Retention, Stars, Provider and Member Service, Sales, and Provider Network Operations
- Oversight of the process for coordinating and tracking impacts of potential/likely provider terminations across all regions
- Ability to work autonomously across teams to optimize every aspect of the operational processes related to processing a provider termination, with emphasis identifying and mitigating associate, member and provider friction points
- Overseeing governance and progress against opportunity areas
- Ability to influence key partners to simplify and improve business processes, using the provider and member experience as a key tenet
- Identifying additional opportunity areas and prioritizing resources against them
- Understanding provider changes in advance to drive collaboration opportunities resulting in optimized associate, member and provider touchpoints
- Developing key insights around the downstream impacts of provider terminations around Stars, member experience and retention, and provider contracting decisions
- Leveraging data analytics to drive business insights, reporting, and leadership communications around provider terminations
- Advising leadership of functional strategies while exercising independent judgment and decision making on complex issues with minimal supervision
Use your skills to make an impact Required Qualifications- 3+ Years' experience in the payer/provider contracting lifecycle
- Experience leveraging multiple business areas to drive company performance
- 7 or more years of improving or creating business processes
- 3+ years of project or people leadership
- Ability and willingness to travel up to 10% of the time
- Located in the Central or Eastern Time Zone
Preferred Qualifications- Bachelor's degree
- Customer service/account management leadership experience
Additional InformationThis role is "remote/work at home", however, you must be located in the Central or Eastern Time Zone to be considered for this opportunity
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours40
Pay RangeThe 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.
$115,200 - $158,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of BenefitsHumana, 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Application Deadline: 09-01-2026
