The Senior Process Improvement Professional understands the existing business process and develops sustainable, repeatable and quantifiable business process improvements within claims processing, systems support and quality audit processes. Determines how new information and technologies can support continued best business efforts to improve quality and minimize cost. May specialize or assist as needed in one or more of the following areas: benchmarking, business process analysis and re-engineering, change management and measurement, and/or process-driven systems requirements, claims processing, testing system updates and claims quality auditing. Provides support to department’s strategy to deliver optimum customer service. The Senior Process Improvement Professional will assist in design, implementation, and improve business processes across designated areas of responsibility to help enhance business outcomes that impact cost and quality. This includes making decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.
Proactively identifies improvement opportunities based on trends and analysis of current processes and barriers for claims, system support and quality
Ensure the appropriate identification of root causes through effective use of data analysis tools and techniques, analyze data to make informed decisions
Collect, validate, and disseminate detailed accurate information to key stakeholders (internal and external) to successfully implement changes and improve customer satisfaction
Provides and shares analysis for improvement efforts. Prepares plan for deployment
Assures process documentation meets current and future requirements and responsible for the successful implementation of projects
Map current processes, assess change required and implement accurately
Test and validate system changes to assure expected results are achieved
Meets established expectations and takes responsibility for achieving results; encourages others to do the same
Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and role essentials
Leads the design of innovative business processes that support Information Technology solutions, create sustainable competitive advantage and administrative efficiencies.
Provides assistance to less experienced analysts on process models to disseminate learning and promote the development of others
Extends professional knowledge and develops skills through departmental training and self-motivated opportunities
Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one’s actions
Bachelor’s degree or may substitute equivalent education and/or experience for degree
Advanced knowledge of Excel, Visio and SQL
Claims processing experience
Ability to learn a complex processing system
Ability to manage and prioritize multiple initiatives with little guidance.
Requires ability to understand policies and procedures for claims adjudication, system support and reporting
Requires a high level of problem-solving and analytical skills
Ability to read and interpret documents such as contracts, policy and operations manuals
Experience in process improvement projects
Strong communication and presentation skills.
Requires effective written and verbal communication skills and strong customer service skills
Our Department of Defense contract requires U.S. Citizenship
Successfully receive interim approval for government security clearance (eQIP – Electronic Questionnaire for Investigation Processing)
Workflow design and Business Process Optimization
Experience with TRICARE or Government field
Work Style: Remote/Work at Home
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire Text to enhance our hiring and decision-making ability. Modern Hire Text allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive a correspondence inviting you to participate in a Modern Hire Text interview. In this interview, you review a set of interview questions over your phone or computer and you will provide text responses to each question. You should anticipate this interview to take about 15 to 20 minutes. Your text message interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Scheduled Weekly Hours
Tagged as: 501+ Employees