Senior Process Improvement Professional
J
JobgetherHealthcare Operations
Must reside in Michigan or within a 40-mile radius of the Michigan border in Ohio or Indiana., 8:00 AM–5:00 PM Eastern TimeFull-TimeSenior
SalaryAnnual salary range of $78,400–$107,800
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Job Details
- Experience
- At least 3 years
- Required Skills
- Project ManagementData AnalysisMicrosoft ExcelPowerPointProcess improvement
Requirements
- Bachelor’s degree required.
- At least 3 years of experience in process improvement, healthcare operations, quality improvement, project management, or a related discipline.
- Professional experience within healthcare, managed care, Medicaid, LTSS, HCBS, or population health environments.
- Demonstrated ability to interpret operational and performance data and translate insights into effective business decisions.
- Proven experience analyzing business processes, identifying root causes, and implementing improvements that enhance performance, efficiency, and quality.
- Advanced proficiency with Microsoft Office applications, particularly Excel and PowerPoint.
- Excellent written and verbal communication skills.
- Strong project management, analytical, organizational, and problem-solving capabilities.
- Must reside in Michigan or within a 40-mile radius of the Michigan border in Ohio or Indiana.
- Master’s degree in healthcare administration, business administration, public health, or a related field is preferred.
- Lean, Six Sigma, PMP, or another relevant process improvement certification is preferred.
- Experience with Michigan Medicaid and LTSS programs is preferred.
Responsibilities
- Analyze LTSS operational workflows to identify opportunities to improve efficiency, quality, regulatory compliance, member outcomes, and contract performance.
- Partner with Care Management, Utilization Management, Quality, Reporting, Provider, Compliance, and other teams to redesign and implement effective operational processes.
- Develop standardized workflows, policies, procedures, audit tools, process documentation, and operational resources supporting LTSS programs.
- Monitor contract and regulatory requirements and coordinate operational changes needed to maintain compliance.
- Conduct root cause analyses of operational issues, performance gaps, audit findings, grievances, appeals, and quality concerns.
- Analyze reporting and performance data to identify trends, develop actionable recommendations, and measure the effectiveness of process improvements.
- Facilitate process mapping, workflow redesign, training, and change management initiatives across multiple business functions.
- Support state-directed initiatives, regulatory changes, EVV-related processes, assessment requirements, and other LTSS program enhancements.
- Develop KPIs, monitoring tools, and performance measures to evaluate operational effectiveness and process outcomes.
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