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The In-Office Provider Programs organization within Risk Adjustment delivers a portfolio of products to support physicians in providing optimal patient care and improving the accuracy of their clinical documentation. The products are a mix of in-house and vended solutions, with an eye toward growth of analytics-driven and interoperable solutions.

The Program Delivery Lead strategically identifies, develops, and implements programs that influence providers, including ownership of the execution and operational performance outcomes for Provider Programs. The Program Delivery Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

The Program Delivery Lead implements, monitors and seeks to continually improve program operational programs.  Partners with leaders regarding implementation planning. Reviews and communicates results of programs. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. 

• In-Office Provider Vended Programs; Issue Research and Resolution, operational routines (file generation, distribution, reconciliation, quality control), program consultation, program implementations, change management and operational readiness, program budget management, and performance monitoring and controls. 
• Leads and oversees business process improvement initiatives, including cross-functional, end-to-end lifecycle documentation and improvement, such as product and performance lifecycles.
• Collects and analyzes data to develop and recommend business practices and procedures that improve the customer experience, support compliance, and increase efficiency.
• Supports, leads, and drives key organizational initiatives, including retrospective lessons learned and cross-functional collaboration opportunities.
• Ensures process and procedure documentation is standardized and accurate across programs.
• Develops, reviews, and approves program education/materials

Use your skills to make an impact
 

Required Qualifications

• 8+ years of experience in program delivery, operations, business process improvement, or related operational roles.
• 2+ years of experience analyzing operational data and using findings to recommend process, compliance, customer experience, or efficiency improvements.
• 2+ years of experience documenting, standardizing, or improving business processes across cross-functional teams or programs.
• Experience using Microsoft Office tools, including Excel, PowerPoint, Outlook, and Teams, to manage reporting, documentation, communication, and stakeholder updates.
• Experience supporting program administration, operational reporting, financial tracking, claims management, or departmental expense processes.

Preferred Qualifications

• Bachelor’s degree in Business Administration, Health Care Administration, Operations, Finance, or a related field; master’s degree preferred.
• Experience applying Lean, Six Sigma, or other process improvement methodologies to improve operational efficiency, quality, or performance outcomes.
• Experience in vended operations and / or vendor management
• Experience supporting financial management activities, including budgeting, expense tracking, claims management, reporting, or program administration.
• Experience in operational program management, business operations, or process execution within a matrixed or cross-functional environment.
• Knowledge of health care, managed care, provider programs, risk adjustment, or clinical documentation workflows.
• Strong analytical skills, including the ability to interpret data, identify trends, and translate insights into actionable business recommendations.

*Local Louisville candidates are encoluraged to apply

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

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.

 

$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 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: 08-29-2026

About 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.

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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.