Medicare STARS Case Manager RN

5 - 7 years experience  •  Information Services

Salary depends on experience
Posted on 02/22/18
Jacksonville, FL
5 - 7 years experience
Information Services
Salary depends on experience
Posted on 02/22/18

The Process Improvement Senior Lead will work closely with leadership and operations to drive results at the strategic level: from initial strategy deployment through the tactical execution to achieve results.  Role builds controllership models in order to support organizational oversight and management of key activities. Advance knowledge in project management methodologies, statistical process controls, cost reduction techniques, and lean Six Sigma techniques.  Effectively work through complexities associated with coordination across multiple entities, conflicting efforts, and limited resources.  Manages multiple operational, financial, and compliance projects and assigned project team to achieve the scope, timing and objectives of each complex assignment. Utilize strong analytics, technical and communication skills as well as deep, broad understanding of the business to summarize key findings.   Key Responsibilities Program Management

  • Accountable for development and implementation of large scale business transformational programs.
  • Accountable for consultation to departmental heads and implementing solutions across functional areas (Delivery, IT, Sales, etc.) through interaction at all levels of the organization
  • Act as Program business lead for transformational initiatives for enterprise to support corporate strategic focuses on member experience and affordability.
  • Accountable for leading multiple projects and initiatives at once via hands on project management as well as through multiple other project managers.
  • Accountable for advising executives and upper leadership on the continuous improvement strategy and transformation
  • Responsible for design, development, implementation, and integration of people, processes, and technology needed for successful implementation of initiatives.
  • Accountable for integration of multiple projects within processes and functional areas of the company to ensure most effective implementation for assigned initiatives.
  • Accountable for the cost-benefit evaluation for all assigned projects to define potential financial, business, and industry impacts of initiatives.

  Process Improvements / Technical Skills

  • Strong qualitative and quantitative analytical ability to draw sound conclusions and make appropriate recommendations to management
  • Uses end-to-end mapping and analysis to identify opportunities for improvement that positively impact up-stream and down-stream business partners. 
  • Provides leadership and technical expertise for the planning, managing and implementation of enterprise-wide process improvement initiatives. 
  • May be accountable for the financial management of assigned initiatives, including integration opportunities and cost reductions.
  • Perform data manipulation and analysis (graphical and statistical) as required in support of performance metric reporting.

    Project Management

  • Manages projects by creating project plans, timelines, critical paths, and milestones.
  • Assigns tasks, responsibilities, and deadlines to initiative team members. 
  • Ongoing tracking of progress monitors and communicates project status at all levels. Identifies and resolves project barriers and/or risks. Builds and implements a sustainable control plan and develops controls for monitoring. 
  • Manages multiple project plans which may have many internal and external dependencies, are complex in scope, have divisional and/or organization-wide impact, have multiple integration points, a higher level or risk requiring mitigation plans and are worked within multiple teams of resources.
  • Oversees reporting, monitoring and evaluation activities of current projects and/or actions targeted to improve key metrics and customer insights.

  Change Leadership

  • Provides consultative support to senior management within context of overall strategic objective to initiate actions to improve the customer experience and gain process efficiencies.
  • Provides insight and guidance from a business perspective on the direction and continued utilization of continuous improvement methodologies.
  • Drives changes in the organizational measurement systems to effectively monitor key strategic focuses, shifting the organization to end-to-end process management beyond current functional focus.
  • Works with all levels (leaders, managers, and associates) of assigned areas to identify opportunities for improvement, structure efforts to achieve the targeted improvements and establish measurement systems to monitor performance.
  • Develops and maintains relationships that cross business sector and organizational boundaries to enable business objectives and issue resolution and program consistency.
  • Serves as key business advisor to Divisional Officers and Departmental Sr. Directors to drive deployment of Continuous Improvement and Process Management.

  Relationship Management

  • External facing continuous improvement consultant.  Consult with external leadership on member experience or affordability strategies.
  • May lead, coach, and develop a small staff.  

  Requirements ·   Bachelor degree or equivalent experience ·   3 or more years of experience in the health insurance industry or relevant business experience ·   6 or more years of experience leading continuous improvement initiatives and complex projects ·   2 or more years leadership experience within a functional area or project teams ·   Experience using algorithms and inferential statistics. ·   Experience data mining and building complex data relationships including writing related code ·   Strong facilitation and project management skills, confident communicator, both verbally and in writing with all levels of an organization and diverse audiences ·   Highly collaborative with a demonstrated ability to build strong, credible relationships and teams within all levels in the organization ·   Proven change agent and strong negotiation skills ·   Mastery of communicating highly complex information clearly and articulately for all levels and audiences ·   High critical thinking skills to evaluate alternatives and present solutions that are consistent with business objectives and strategy  

Preferred Criteria•Industrial Engineering or technical degree with emphasis on statistics•Lean/Six Sigma certification Green Belt/Black Belt•Project Management / Change Management experience (e.g. PMP)•Knowledge of Business Process Management       •Demonstrated ability to work with staff and management at all levels of the Company. 

9300

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