Medicaid Manager Process Improvement - Remote FL

Profile

Description

The Manager, Process Improvement analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Manager, Process Improvement works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.

Responsibilities

The Manager, Process Improvement:


Researches best business practices within and outside the organization to establish benchmark data.
Collects and analyzes process data to initiate, develop and recommend business practices and procedures that focus on enhanced safety, increased productivity and reduced cost.
Determines how new information technologies can support re-engineering business processes.
May specialize 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.
Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.
Requires cross departmental collaboration and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
Implement Performance Management operational resources and tools across clinical teams in Florida Medicaid market to assure efficiency in processes
Collaboratively develop Reporting requirements to assure operational oversight to identify inefficiencies
Responsible for management of Process Improvement team


Required Qualifications


Bachelor's Degree
2 or more years of management experience
4 years of Managed Care or health industry experience
2 or more years of consulting and/or process improvement experience
Strong business acumen balanced with analytical skills in order to see the big picture and draw out insights and observations
Demonstrated experience using process improvement methodologies and tools
Recent working knowledge and familiarity with NCQA and Medicaid policy guidelines
High emotional intelligence
Excellent interpersonal, organizational, communication and presentation skills
Problem solver with a proven ability to lead in a fast paced, highly complex organization
Demonstrated ability to effectively interact with and influence all levels of the organization, including senior/executive level leadership
Effectively leads through change
High level of proficiency with Microsoft applications (Word, Excel, Visio, PowerPoint)
Proactive and high level of accountability / ownership
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Must have accessibility to high speed DSL or cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems is 10M x 1M
A dedicated home office space, with a locked door, lacking ongoing interruptions to protect member PHI / HIPAA information


Preferred Qualifications


Licensed Registered Nurse (RN) in the state of FL or with compact state license
Previous Medicaid experience
Utilization Management or Case Management experience a plus
Clinical process improvement experience
Lean / Six Sigma Green and/or Black Belt certification (highly desired)


Additional Information


Benefit package that starts your 1st day of employment
Robust 401k plan through Charles Schwab.
Eligibility for associate wellness and rewards program
Opportunity to learn the industry and build professional career
Tuition Reimbursement & Student Loan Refinancing


PLEASE NOTE : As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in an SMS Text Messaging interview.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

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