- Enable the re-design of Claims, Enrollment, Provider Data Management and Print & Fulfillment processes
- Facilitate workshops and meetings to map current state processes, gather feedback, and drive consensus to ideal state
- Identify inefficiencies, gaps and work arounds for improvement in current processes
- Facilitate the design and documentation of future-state processes and utilize future state to drive system design and requirements
- Support change management activities, including workstream communication, training, and stakeholder engagement.
- Monitor and report on project performance, including status, risks, opportunities to stakeholders; escalated risks that impact project’s critical path.
Requirements
- Bachelor's Degree or equivalent experience in Healthcare Administration, Business, Public Health, or a related field is required.
- Graduate or Advanced Degree or equivalent experience is preferred.
- PMP certification preferred.
- 7+ years of experience in health plan operations, process improvement, process redesign, or management consulting roles, with demonstrated success in leading cross functional initiatives.
- Microsoft Project skills.
- Proficiency with process mapping tools, change management methods, and data analysis software (e.g., Minitab, Power BI, Visio).
- Microsoft Office - Word, Excel, PowerPoint, Teams, Outlook, Access required at advanced level.
- Deep understanding of continuous improvement frameworks; formal Lean or Six Sigma training or certification (e.g., Green Belt or Black Belt) preferred.
- Experience integrating AI, machine learning, RPA, or other automation platforms into business processes.
Core Competencies
Demonstrates expertise in process improvement and redesign within healthcare operations, utilizing advanced data analysis and change management techniques. Proficient in facilitating stakeholder engagement and driving consensus for future-state process design.
Highest-signal resume keywords
- Process Improvement
- Change Management
- Healthcare Administration
- PMP Certification
- Process Mapping Tools
ATS Optimization Keywords
Hard Skills
- Process Redesign
- Data Analysis
- Continuous Improvement Frameworks
- AI Integration
- Machine Learning
- RPA
- Microsoft Project
- Minitab
- Power BI
- Visio
Soft Skills
- Facilitation
- Stakeholder Engagement
- Communication
- Consensus Building
- Training
Certifications & Qualifications
- PMP Certification
- Lean Certification
- Six Sigma Certification
Industry Keywords
- Health Plan Operations
- Process Improvement
- Management Consulting
- Stakeholder Engagement
- Cross Functional Initiatives
Tools & Technologies
- Microsoft Office
- Microsoft Teams
- Microsoft Outlook
- Microsoft Access