Senior Process Improvement Professional
About The Position
The Senior Process Improvement Professional serves as the end-to-end process owner and subject matter expert for interoperability and medical documentation chase operations. The role assesses business needs, designs workflows, defines operating models, and develops process standards, controls, and performance measures to support successful implementation. The associate partners with business stakeholders, product teams, and IT to document system requirements, identify dependencies, and align technology solutions with operational needs. The position maps current- and future-state processes, identifies gaps, risks, and opportunities, and recommends sustainable solutions that improve accuracy, efficiency, and stakeholder experience. It establishes business rules, intake requirements, routing logic, exception handling, reporting needs, and governance processes for new work. The role also supports change management, implementation planning, testing, and operational readiness to enable successful launch and adoption. The role requires deep expertise across the end-to-end process, including upstream inputs, downstream impacts, stakeholder roles, system touchpoints, and compliance considerations. It makes decisions on moderately complex to complex process design, requirements, and implementation issues, and performs work with limited direction and considerable latitude in determining objectives and methods.
Requirements
- Lead process design and implementation for interoperability and medical documentation chase operations.
- Build and maintain end-to-end workflows, including intake, triage, routing, exception handling, escalation, and reporting.
- Develop subject matter expertise in operational processes and associated system interactions, including upstream inputs and downstream impacts.
- Gather, document, and refine business and system requirements with business, product, and IT stakeholders.
- Translate operational needs into functional requirements, business rules, user stories, process maps, and supporting documentation.
- Identify process gaps, risks, controls, and dependencies across teams and systems.
- Support process improvements, solution design, testing, training, documentation, and change readiness.
- Bachelor's degree or equivalent professional experience (preferred).
- Experience standing up new processes, workflows, or operating models from the ground up (preferred).
- Experience gathering, documenting, and refining business and system requirements (preferred).
- Experience working cross-functionally with business, product, and IT stakeholders (preferred).
- Strong written and verbal communication skills, including process documentation and executive-ready materials (preferred).
- Strong analytical and problem-solving skills, including identifying process gaps, risks, and dependencies (preferred).
- For home or hybrid home/office work, self-provided internet must have at least 25 Mbps download and 10 Mbps upload; a dedicated workspace without ongoing interruptions is required to protect member PHI/HIPAA information.
Nice To Haves
- Bachelor's degree or equivalent professional experience.
- Experience standing up new processes, workflows, or operating models from the ground up.
- Experience gathering, documenting, and refining business and system requirements.
- Experience working cross-functionally with business, product, and IT stakeholders.
- Strong written and verbal communication skills, including process documentation and executive-ready materials.
- Strong analytical and problem-solving skills, including identifying process gaps, risks, and dependencies.
Responsibilities
- Lead the design and stand-up of new processes supporting interoperability and medical documentation chase operations, including defining the end-to-end operating model and implementation approach.
- Build and maintain end-to-end workflows, including intake, triage, routing, exception handling, escalation paths, and reporting requirements.
- Serve as the subject matter expert for the full operational process and associated system interactions, including upstream inputs and downstream impacts.
- Partner with business, product, and IT stakeholders to gather, document, and refine business and system requirements for new functionality.
- Translate operational needs into functional requirements, business rules, user stories, process maps, and supporting documentation.
- Facilitate cross-functional working sessions to define current-state, future-state, and target-state processes and identify gaps, risks, controls, and dependencies across teams and systems.
- Recommend and implement sustainable process improvements that improve efficiency, quality, scalability, and operational readiness.
- Support solution design, testing, training, SOP and job aid development, and change readiness activities for new process launches and enhancements.
- Support change management, implementation planning, and operational readiness activities to facilitate launch and adoption.
Benefits
- Medical, dental, and vision benefits.
- 401(k) retirement savings plan.
- Paid time off, company and personal holidays.
- Paid parental and caregiver leave.
- Short-term and long-term disability.
- Life insurance.
- Bonus incentive plan based on company and/or individual performance.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
