Senior Specialist, Process Improvement & Operational Excellence

Molina Healthcare; United States; On-site; USD 85,000 - 125,000; Full time

Benefits offered by this job

Competitive benefits package

Equal Opportunity Employer

Job summary

Molina Healthcare seeks a senior professional to lead operational process redesign, change management, and optimization initiatives that boost efficiency and customer satisfaction. You will back-end operationalize policies, standardize system setup, and support resourcing across departments and health plans, collaborating with stakeholders to implement enterprise improvement methodologies.

Experience in analytics and project leadership is preferred, with strong communication and ability to

Qualifications

• 3+ years of process improvement or analytics experience.
• Knowledge of managed care enrollment processes, encounter processes, provider/configuration and claims processing.
• Strong organizational and time-management skills and ability to manage multiple projects to deadlines.

Responsibilities

• Partners with various business functions and units to identify, document, and baseline all relevant processes.
• Utilizes industry techniques to improve effectiveness and efficiency of business processes.
• Conducts interviews with staff and leadership to assess internal processes and review SOPs and other guidelines.
• Reviews and researches information to evaluate compliance of a process or function and related documentation.
• Develops metrics for process measurement to identify future improvement opportunities.
• Summarizes and documents outcomes and communicates recommendations to process owners and leadership.

Skills

Data analysis

Cross-functional collaboration

Time management

Verbal and written communication

Process improvement

MS Office proficiency

Tools

Microsoft Office Suite

Job description

Job Summary

Provides senior level support for operational business process redesign, communications and change management initiatives that result in operational efficiencies and/or an increase customer satisfaction. Responsible for back-end operationalization of policies, standardization of system set-up and resourcing support for all departments and health plans. Assists in development of enterprise business process improvement methodologies and implementation of business process improvement capabilities company-wide.

Essential Job Duties

• Partners with various business functions and units to identify, document, and baseline all relevant processes.
• Utilizes industry techniques to improve the effectiveness and efficiency of business processes.
• Conducts interviews with staff and leadership to assess internal business processes within a department or function, and review/ensure compliance with existing organizational policies and procedures/standard operating procedures (SOPs) and other internal, external and regulatory guidelines.
• Reviews and researches information to evaluate compliance of a process or function and corresponding written documentation.
• Researches and analyzes fundamental issues in business process development.
• Uses analytical skills and data insights to identify process/informational variances.
• Diagrams and evaluates existing processes.
• Develops metrics that provide data for process measurement - identifying indicators for future improvement opportunities.
• Recommends, implements, and documents continuous improvement process best practices to support the business.
• Summarizes and documents assessment outcomes and recommendations, and ensures that they are appropriately communicated (written and verbal) to process owners and leadership.
• Collaborates with process owners to maintain and/or create business process documentation and workflows related to core operations functions.
• Conducts ongoing reviews and updates complex business processes in collaboration with functional subject matter experts and other stakeholders.
• Serves as liaison between core operations and internal and external auditors for all formal core operations audits that are not compliance related.
• Coordinates, facilitates and documents audit walkthroughs.
• Researches, collects or generates requested documentation; provides timely and accurate responses, both written and verbal.
• Researches and responds to questions submitted by internal and external auditors.
• Researches requested documentation and collaborates in partnership with teams and other functional areas as needed.
• Provides training and support to new and existing process improvement team members.

Required Qualifications

• At least 3 years of process improvement/analytics experience, or equivalent combination of relevant education and experience.
• Data analysis skills.
• Knowledge of managed care enrollment processes, encounter processes, provider and contract configuration, provider information management, claims processing and other related functions.
• Strong organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
• Ability to work cross-collaboratively across a highly matrixed organization and establish and maintain effective relationships with internal and external stakeholders.
• Effective verbal and written communication skills.
• Microsoft Office suite (including Excel) and applicable software programs proficiency.

Preferred Qualifications

• Proven analytical experience within an operations or process-focused environment.
• Health care experience.
• Lean Six Sigma certification.
• Previous audit and/or oversight experience.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V