Process Improvement Specialist

UNITE HERE HEALTH•Oak Brook, IL

3d•$64,100 - $80,100•Hybrid

About The Position

The purpose of the Process Improvement Specialist is to lead and drive process improvement initiatives across Operations, with primary focus on Claims and Contributions & Enrollment, while working in an integrated manner with Member Services and Claims Cost Management to support as needed. This role identifies process gaps, performs root cause analysis, standardizes workflows, and implements sustainable solutions to improve efficiency, reduce errors, and enhance the member experience. Primary responsibilities include developing and optimizing procedures, establishing performance metrics, driving cross-functional improvements, and ensuring processes are consistent, effective, and aligned with Fund goals.

Requirements

Minimum 3–5 years of relevant experience in healthcare operations, including claims, enrollment, eligibility, or related administrative functions
Experience managing or supporting projects involving process improvement, workflow redesign, system enhancements, or operational change
Strong understanding of healthcare business processes and how claims, enrollment, eligibility, and member services work together
Proven ability to gather business requirements, document workflows, coordinate testing, and support implementation of operational and system changes
Strong analytical, organizational, and problem-solving skills
Strong communication skills with the ability to provide clear, concise updates to leadership
Ability to manage multiple projects and priorities in a fast-paced environment
Strong attention to detail with a focus on accuracy and quality
Ability to analyze data, identify trends, and make actionable recommendations
Effective collaboration skills with the ability to work across departments and build strong relationships
Ability to lead change, influence stakeholders, and drive adoption of new processes
Extensive experience in data analysis and reporting, with strong working knowledge of Microsoft Office (Excel, Word, PowerPoint)
Bachelor’s degree in Healthcare Administration, Business Administration, or related field, or equivalent work experience required
20% travel as needed

Nice To Haves

Working knowledge of project management tools (e.g., MS Project) preferred
Preferred: Six Sigma Green Belt, Project Management Professional, or other process improvement / project management certification

Responsibilities

Acts as the primary point of contact for process improvement initiatives across Operations, with primary focus on Claims and Contributions & Enrollment, and is integrated with Member Services and Claims Cost Management to provide support as needed.
Leads end-to-end process improvement and cross-functional projects from identification and requirements gathering through testing, implementation, and post-production support
Identifies process gaps, inefficiencies, and recurring issues through root cause analysis (including complaints and audit findings) and implements corrective actions to prevent recurrence
Evaluates current-state processes, maps future-state workflows, and develops standardized procedures, job aids, and operational guides to improve consistency, accuracy, and turnaround times
Partners with Operations leadership, business stakeholders, and system teams to define priorities, scope, timelines, dependencies, and deliverables for process and system improvement initiatives
Coordinates project resources, facilitates meetings, tracks action items, and monitors milestones to ensure initiatives stay on schedule and aligned with business and regulatory requirements
Establishes, tracks, and reports on key performance metrics (KPIs) to measure process effectiveness, outcomes, and continuous improvement
Leads change management efforts, including communication, training, and adoption of new processes and workflows across departments
Monitors implemented solutions to ensure sustained results, identifies additional improvement opportunities, and drives continuous improvement
Identifies system and workflow gaps and partners with IT and system teams to implement enhancements, automation, and data integrity improvements
Coordinates and supports testing activities (regression and validation) for system changes, ensuring accuracy and successful deployment
Supports audit readiness by gathering documentation, validating controls, and incorporating audit findings into process improvements to reduce risk and ensure compliance
Maintains project tracking tools and provides clear, concise status reporting to Operations leadership, including progress, risks, issues, and outcomes
Builds and maintains strong relationships with stakeholders to drive collaboration, accountability, and successful delivery of initiatives
Supports and collaborates with other Operations Administrative roles to ensure alignment, coverage, and execution of departmental priorities and initiatives
Assists with operational reporting, data review, and ad hoc analysis to support leadership decision-making and performance monitoring
Drives process improvements by setting clear goals and delivering measurable results tied to operational performance and departmental objectives
Contributes ideas and recommendations for workflow redesign, system optimization, and best practices to support departmental and Fund goals
Exemplifies the Fund’s BETTER Values and Professional Effectiveness Dimensions in contributing to a respectful, trusting, and engaged culture of diversity and inclusion
Performs other duties as assigned within the scope of responsibilities and requirements of the job
Performs Essential Job Functions and Duties with or without reasonable accommodation