Sr. Director, Process Improvement

LucyRx•Bethesda, OH

2d•$180,000 - $202,000

About The Position

The Senior Director, Process Improvement, will work within our operations team and lead our Process Improvement initiatives within our organization. This is a highly visible, hands-on leadership role responsible for establishing a Process improvement strategy, designing scalable processes, and driving measurable operational outcomes that directly impact our clients, members, and internal teams. This role requires a proven builder of enterprise-wide Process Improvement programs, not solely an operator within existing frameworks. The Sr. Director must have demonstrated success designing, implementing, and scaling formal PI systems that drive measurable improvements across complex PBM operations.

Requirements

5+ years of experience in PBM, health plan, or healthcare benefits administration, with at least 3 years in an operations, Process improvement, operational excellence, or quality-focused leadership role.
Understanding of pharmacy benefit operations, including claims adjudication, formulary structures, utilization management, benefit configuration, and member/client services.
Proven experience building or enhancing Process improvement programs, frameworks, or processes from the ground up.
Expertise in process improvement methodologies (Lean, Six Sigma, or equivalent); certification preferred.
Exceptional analytical skills with the ability to translate complex data into clear insights and actionable recommendations.
Experience working cross-functionally in a fast-paced, deadline-driven environment.
Strong communication and influencing skills with the ability to engage and align stakeholders at all levels.
Familiarity with PBM platforms, claims systems, or adjudication engines.
Demonstrated ability to lead high-performing teams through change and drive sustainable operational results.

Responsibilities

Program Development & Leadership Design, launch, and continuously refine a comprehensive Process Improvement program, including frameworks, workflows, documentation standards, and performance metrics.
Establish PI methodologies—including process mapping, gap analyses, root cause analyses, and improvement protocols—tailored to PBM operations and benefit administration.
Partner with cross-functional teams—Configuration, Clinical, Operations, Client Services, and IT—to ensure alignment on performance standards, improvement initiatives, and implementation timelines.
Develop and maintain PI policies, SOPs, and best practices to support consistent, repeatable, and auditable improvement processes.
Serve as the primary point of contact for Process improvement inquiries and initiatives across the organization.
Must have personally designed and implemented a centralized Process Improvement function or framework across multiple business units.
Demonstrated experience standardizing process governance, documentation, and performance measurement across an organization.
Hands-On Process Improvement Execution Conduct detailed operational reviews across key PBM functions, including claims processing, benefit configuration, formulary management, utilization management, and member/client services.
Identify performance gaps and inefficiencies through data analysis, audits, and stakeholder feedback, and develop targeted improvement plans.
Lead root cause analyses for operational failures, errors, or client escalations and partner with cross-functional teams to drive timely and sustainable resolution.
Build and maintain performance benchmarks, scorecards, and tracking tools to support ongoing improvement activities.
Monitor trend data to proactively surface opportunities for process optimization and automation.
Act as a working leader—balancing strategic direction with hands-on involvement in improvement initiatives.
Foster a culture of accountability, continuous improvement, and operational excellence across the organization.
Provide training and guidance to internal teams on PI methodologies, Process expectations, and best practices.
Performance Metrics & Reporting Define and track KPIs related to operational accuracy, efficiency, error rates, turnaround times, and client satisfaction.
Deliver clear, actionable reporting to leadership and key stakeholders on Process trends and improvement outcomes.
Recommend and implement enhancements based on data insights, client feedback, and industry best practices.