Senior Specialist, Process Improvement & Operational Excellence

Molina Healthcare · United States

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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.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

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

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