Responsible for process improvement projects to increase the quality and performance of a business unit.
Primary duties may include, but are not limited to:
- Work closely with company delegated vendors and internal/external customers to deliver efficient and effective solutions to issues at hand.
- Work closely with internal customers to help triage and resolve provider and member complaints, quality of care issues and/or initiatives that arise.
- Communicate in a professional, consistent and coherent matter (written, verbally and in-person behavior as applicable).
- Work environment is “fast-paced” and requires a high sense of urgency with the ability to adapt accordingly given situations encountered.
- Must collaborate to create “win-win” outcomes with both internal and/or external teams.
- Identifies areas at risk and implements improvements with the appropriate participation of involved parties.
- Develops recommendations for changed/new processes. Documents current work flow.
- Coordinates to obtain consensus and commitment among affected parties.
- Coordinates implementation and monitors post-implementation.
- Makes necessary adjustments as needed.
- May act as lead in providing direction to less experienced associates in the departments.
- Provides process improvement methodology, coaching and training to associates and team members who are participating in process improvement projects.
- Collaborates with cross-functional teams in the identification, research and implementation of process improvements.
- Leads projects of significant scope.
- Manages internal and external process improvement projects with team members who work across regional and enterprise wide organizational structures and with external parties (providers and trade organizations) to formulate consensus on improvements and to implement internal and external systems, policies and procedures.
Requires a BA/BS in a related field, 5- 8 years of process improvement or project management experience; or any combination of education and experience, which would provide an equivalent background. Healthcare experience preferred, especially from the payor side and/or working with delegated vendors. Bachelor degree in Industrial Engineering a plus. Experience with SQL and Microsoft Access highly preferred. Proficiency with MS Excel, MS PowerPoint, SharePoint and its uses for data analytics. Excellent written and verbal communications. Good analytical and problem solving skills. Attention to detail and passion for accuracy. Good interpersonal skills and comfortable presenting, moderating and leading meetings.Six Sigma Black Belt certification or related process improvement certification preferred.