Process Excellence Manager
Wipro
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Job summary
Wipro in Kolkata seeks a The Black Belt – Manager to lead end-to-end process excellence, quality transformation, and productivity programs across Healthcare Claims operations (Commercial, Medicare, Medicaid, Specialty).
You will drive Lean Six Sigma projects, RCA-led improvements, automation enablement, and cross-functional governance with Operations, Quality, Training, WFM, and client stakeholders, delivering measurable benefits.
Qualifications
- 10–15+ years total experience, with 5+ years in US Healthcare Claims.
- Proven experience leading Black Belt–level transformation programs.
- Strong hands-on knowledge of Claims adjudication & processing workflows.
- Familiarity with US healthcare regulations & payer guidelines.
- Experience with RCA tools, statistical analysis, and leadership storytelling.
Responsibilities
- Lead Lean Six Sigma Black Belt projects across Claims (Intake, Adjudication, Adjustments, Appeals, EDI, Correspondence).
- Drive defect reduction, rework elimination, and cycle time improvement using DMAIC / Lean methodologies.
- Identify and execute high-impact transformation opportunities aligned to business priorities and client KPIs.
- Own end-to-end project lifecycle from problem definition to benefit realization and sustainment.
- Lead RCA initiatives, Pareto analysis, FMEA, and heatmaps for escalations and audits.
- Partner with Quality teams to improve accuracy, compliance scores, and audit outcomes.
- Apply US Healthcare Claims knowledge across Commercial, Medicare, Medicaid, and Specialty lines.
- Identify opportunities for RPA, AI, analytics, and system-led automation across claims processes.
Skills
Education
Tools
Job description
The Black Belt – Manager will lead end-to-end process excellence, quality transformation, and productivity programs across Healthcare Claims operations (Commercial, Medicare, Medicaid, Specialty). The role is responsible for driving measurable business outcomes through Lean Six Sigma, RCA-driven improvements, automation enablement, and cross-functional governance while partnering closely with Operations, Quality, Training, WFM, and Client stakeholders.
- Lead Lean Six Sigma Black Belt projects across Claims (Intake, Adjudication, Adjustments, Appeals, EDI, Correspondence).
- Drive defect reduction, rework elimination, and cycle time improvement using DMAIC / Lean methodologies.
- Identify and execute high-impact transformation opportunities aligned to business priorities and client KPIs.
- Own end-to-end project lifecycle from problem definition to benefit realization and sustainment.
- Conduct deep-dive RCA using People | Process | System | Technology frameworks.
- Lead Pareto analysis, FMEA, trend analysis, and defect heatmaps for escalations, audits, and quality failures.
- Partner with Quality teams to improve OAR, financial accuracy, compliance scores, and audit outcomes.
- Apply strong US Healthcare Claims knowledge across Commercial, Medicare, Medicaid, and Specialty lines.
- Work closely with UHG stakeholders to align process improvements with payer policies and regulatory requirements.
- Support client governance, business reviews, client visits, and escalations with data-backed insights.
- Translate operational improvements into quantified benefits (QNI, BVM, FTE productivity, cost savings).
- Identify opportunities for RPA, AI, analytics, and system-led automation across claims processes.
- Collaborate with Automation / IT teams on solution design, deployment, and benefit tracking.
- Drive manual exception reduction and touchless processing improvements.
- Bachelor’s degree (Engineering / Healthcare / Business preferred)
- PMP / Agile certification – good to have
- Any programming / Coding would be an advantage
- 10–15+ years total experience, with 5+ years in US Healthcare Claims
- Proven experience leading Black Belt–level transformation programs
- Strong hands-on knowledge of:
- Claims adjudication & processing workflows
- US healthcare regulations & payer guidelines
- RCA tools, statistical analysis, and storytelling for leadership/client forums
- Lean Six Sigma (DMAIC, SPC, Hypothesis Testing)
- RCA / FMEA / Pareto / Control Planning
- Claims domain expertise (Commercial / Medicare / Medicaid)
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