Sr. Program Delivery Professional, G&A in Swindon

Become a part of our caring community and help us put health first

Join Humana\’s In Home Well-being Assessment (IHWA) team and play a critical role in ensuring exceptional member experience and compliance with CMS standards. As a Senior Program Delivery Professional, you will manage complex grievance and complaint processes, oversee vendor relationships, and support quality initiatives that directly impact Medicare members.

Key Responsibilities:

• Lead daily management of grievance and complaint queues in PPCM, ensuring timely resolution per CMS SLAs.
• Coordinate with internal teams and external vendors to uphold best practices and contractual obligations.
• Manage additional feedback from Stars vendors (~150 pieces weekly) as IHWA expands responsibilities in 2025–2026.
• Support highly regulated processes, including Privacy concerns, Quality of Care issues, and MRA delete management.
• Analyze feedback trends, communicate findings, and influence strategy for continuous improvement.

Environment: Remote role. Operating heavily in the Patient/Provider Compliant and Management System (PPCM), managing Grievance & Appeals (G&A). Candidates must be comfortable with queue based work.

Use your skills to make an impact

Required Qualifications

• Bachelor\’s degree or equivalent years of experience
• 5+ years in member/provider grievance management
• Strong knowledge of Microsoft Office (Word, Excel, Access)
• Excellent communication, both oral and written
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Master\’s Degree in Business Administration or a related field
• PMP certification a plus
• Knowledge and experience in health care environment/managed care
• Strong analytical skills

Additional Information

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

• Health benefits effective day 1

• Paid time off, holidays, volunteer time and jury duty pay

• Recognition pay

• 401(k) retirement savings plan with employer match

• Tuition assistance

• Scholarships for eligible dependents

• Parental and caregiver leave

• Employee charity matching program

• Network Resource Groups (NRGs)

• Career development opportunities

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.

• Satellite, cellular and microwave connection can be used only if approved by leadership.

• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly