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 Information
This 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 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 09-01-2026About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
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.
Skills Required
- 3+ years of 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
- Bachelor's degree
- Customer service or account management leadership experience
Humana Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Humana and has not been reviewed or approved by Humana.
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Healthcare Strength — Medical, dental, vision, supplemental health, and long-term care insurance are offered alongside on-site/virtual wellness resources and weekly paid well-being time, indicating a whole-person focus.
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Leave & Time Off Breadth — Paid PTO and holidays, volunteer time, and formal leave options such as parental and caregiver time provide broad time-away support. Adoption assistance and lactation rooms extend coverage for key life events.
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Retirement Support — A 401(k) with company match anchors long-term savings. Employer-matched emergency savings programs complement retirement planning.
Humana Insights
What We Do
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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