Humana KMG Long Term Care Business Consultant in Louisville, Kentucky

Role: KMG Long Term Care Business Consultant Assignment:KMG LTC Location: Green Bay, WI; or Louisville, KY

Role and Responsibilities

Assignment Capsule

The KMG LTC Business Consultant is responsible for operational support of individual long-term care insurance policies. The business consultant will work with complex systems to extract and validate data, prepare reports and analyses, and document processes. This includes accurate customer service support, experience analyses, financial reporting, rate filing support and regulatory reporting. In addition, the business consultant will maintain the existing system structures, in cooperation with product operations and external vendors. The Business Consultant will perform all tasks otherwise expected of a LTC Business Consultant.

Key Accountabilities of Role

  • Analyze claims, expense and premium details, in support of product performance analysis, as directed by department leadership.

  • Develop methodologies and direct analyses and studies to measure the effectiveness of programs

  • Maintain and update existing system tables, following existing processes working with TPA representatives in addition to department leadership.

  • Policy Calculations - provide operations support through determining plan and policy values, benefit values and other needed calculations through the use of existing models, data tables and policy form consultation.

  • Prepare and deliver various regulatory reports and other data to department operations leaders and designated persons.

  • Prepare financial data extracts from internal and vendor systems, utilizing existing models and process documentation.

  • Support any other project requests, including ongoing product migration support in contact with external business partners/TPAs.

    Key Competencies:

  • Accountability. Meets established expectations and takes responsibility for achieving results; encourages others to do the same. Sees opportunities to contribute and takes the initiative to create solutions Organizes and manages multiple priorities and/or projects using appropriate methodologies and tools.

  • Customer Focus. Connects meaningfully with customers to build emotional engagement and customer advocacy. Develops and applies deep customer knowledge and intimacy to develop and deliver products, services, and interactions that provide value beyond expectations. Simplifies complexity and integrates internal efforts to deliver an optimal customer experience

  • Innovates. Introduces or develops new ideas and processes which improve performance and productivity. Generates insights through thought leadership. Leverages business intelligence, data, insights, and other research to drive accuracy and efficiency.

  • Customer Value Chain. Understanding of LTC business processes, systems, tools, regulations and structure and how they interrelate to provide output and services that create value for LTC customer, consumers and key stakeholders. Understanding how the value we create for our customers, consumers and key stakeholders aligns with department's vision, business, culture, brand promise and strategic imperatives.

  • Collaborates. Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Humana's overall success first. Develops and strengthens networks and relationships, both inside and outside the organization, that support company performance.

  • Interpersonal Effectiveness. Understands oneself, effectively manages emotions, and displays awareness of how one's actions affect others. Listens and communicates with respect and empathy toward others. Builds trusting relationships through accountability and integrity in actions

  • Communication. Actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience. Be comfortable with collaboration with external vendors via conference calls, emails and Lync and WebEx sessions. Understands and embodies the principals of cooperation and management by influence—a team player.

  • Builds Trust. Walks the talk; makes choices that are consistent with company's ethical principles; is emotionally intelligent; manages self and relationships effectively, through self-awareness, self-management, awareness of others and skill in dealing with others.

    Role Essentials:

  • Bachelor’s degree in Business/Accounting, Math/Statistics, Computer Science or insurance related field

  • Excellent organizational and communication skills, oral and written

  • Proficient with MS Excel and MS Access

  • Strong data analysis skills with working knowledge of math/statistics, spreadsheets, and relational databases

  • Must have strong attention to detail and ability to work independently under general instructions and with a team.

    Preferred Qualifications:

  • Programming experience using SQL and/or SAS

  • MBA or Master’s degree in Math, Statistics, Actuarial Science, Computer Science, Economics, or health related field

  • 2 years in an actuarial or insurance product environment, individual A&H or life insurance experience is a plus

At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.

After applying, we encourage you to join our Talent Network as well, so you can stay informed and up to date on what’s happening around our organization in the changing world of healthcare.

Title: KMG Long Term Care Business Consultant

Location: WI-Green Bay

Other Locations: US-KY-Louisville

Requisition ID: 188271

Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.