Job DescriptionJob DescriptionJob SummaryLeads and manages team responsible for process improvement initiatives that result in operational efficiencies and/or increase customer satisfaction. Assists in development of enterprise process improvement methodologies and the implementation of business process improvement capabilities.
Job Duties• Oversees program development, implementations and process improvement initiatives.
• Assesses business and operational needs for opportunities to improve efficiency, productivity, effectiveness, and accuracy.
• Collaborates with senior leadership to develop and deploy an organizational strategies to optimize workflows.
• Uses Lean and Six-Sigma methodologies to create and maintain a culture of continuous improvement.
• Develops and conducts process improvement trainings.
• Conducts meetings and disseminates communications related to process improvement activities.
• Hires, trains, develops and manages team demonstrates accountability for team performance and achievement of quality/department-specific goals.
Job QualificationsREQUIRED QUALIFICATIONS:• At least 7 years of health care operations, process improvement and/or lean management experience, or equivalent combination of relevant education and experience.
• At least 1 year of management/leadership experience.
• Understanding of all areas of health plan operations including: claims processing, customer service/call center, provider contracting, benefit design and configuration, product development, membership accounting and enrollment, operational systems, provider contracting, authorizations/referrals, and utilization management.
• Experience with Medicare, Medicaid, and Marketplace plans.• Understands key revenue levers and cost drivers of business processes.
• Understanding of critical success factors for the industry.
• Experience designing and delivering solutions related to operational improvement functions.
• Ability to work cross-collaboratively across a highly matrixed organization and establish and maintain effective relationships with internal and external stakeholders.
• Strong organizational and time-management skills ability to manage simultaneous projects and tasks to meet internal deadlines.
• Strong verbal and written communication skills.
• Microsoft Office suite (including Excel), and applicable software programs proficiency.
Process Improvement & Operational Excellence
- Lead end-to-end process improvement initiatives, from problem identification through implementation and measurement
- Analyze current-state workflows and system behavior to identify inefficiencies, risks, and improvement opportunities
- Define future-state processes supported by data, clear metrics, and operational outcomes
- Establish KPIs and success measures to track adoption and performance improvements
Systems & Platform Expertise (Required)
- Serve as a subject-matter expert across core operational platforms, with a strong understanding of how system design and data impact business processes
- Understand upstream and downstream data flows and how system changes affect operational performance and reporting
- Partner closely with IT, Product, and Operations teams to support system enhancements, process changes, and analytics continuity
Analytics & Insights Enablement
- Translate system and operational data into actionable insights that inform process decisions
- Ensure accuracy, consistency, and usability of reporting tied to operational workflows
- Partner with analytics and reporting teams to ensure dashboards and metrics accurately reflect operational workflows
Stakeholder Partnership & Execution
- Act as a trusted partner to Sales, Agent Operations, and Member/Provider teams
- Communicate complex process and system insights clearly to both technical and non-technical stakeholders, including leadership
- Manage timelines, dependencies, and delivery commitments across multiple concurrent initiatives
Required Qualifications
- 4+ years of experience in process improvement, operational excellence, business intelligence, or analytics roles
- Required hands-on experience supporting operational processes and data management for the following platforms:
- Salesforce (CRM)
- Genesys (Telecom)
- Member, Provider and Broker
- Proven ability to translate complex, multi-system data into process improvements and operational insights
- Experience operating in integrated, enterprise system environments
- Strong communication, organization, and problem-solving skills
Preferred Qualifications
- Salesforce Administrator Certification
PREFERRED QUALIFICATIONS:• Lean certification and/or Lean Six Sigma black belt.
• Health care related process improvement experience with demonstrable successes in application of Lean/Six Sigma.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package.
