Summary of Job

Direct and provide oversight for Operations process improvements; lead business initiatives/special projects, issue management and resolution that are specific to the success of EmblemHealth Operations. Liaise with Operational Leaders, IT, and other business stakeholders to develop action and/or project plans, derive and document business requirements and support the business throughout the process. Create, drive, and monitor progress of issue resolutions, initiatives, or projects; provide feedback and recommendations; compile and present results of analyses to appropriate parties; and develop and prepare meeting materials that monitor progress. Investigate shortfalls, issues, and complaints in current business processes. Ensure appropriate system and process changes are deployed as needed to ensure that the functionality delivered meets the intent of the business requirements. Evaluate and make sound recommendations to improve performance, including efficiencies that align with best practices. Analyze company processes and procedures; and recommend/develop process enhancement strategies in conjunction with Operations management. Directly support SVP of Operations on all initiatives and issue management, as required.

Principal Accountabilities 

Conduct research; gather data; use statistical and analytical techniques to identify potential issues and resolutions. Identify bottlenecks/obstructions to the completion of initiatives, projects/milestones; interface with business teams, IT leadership to remove barriers that slow or prevent the successful delivery of the project’s scope and objectives. Manage compilation, analysis and development of findings and recommendations with a particular emphasis on documenting issues (system, process, and people) and following through to complete resolution. Partner with Executive and line management to facilitate implementation of recommendations; facilitate follow-up. Drive development of business requirements and test planning and contribute as needed to document these requirements in alignment with other business stakeholders.  Facilitate end to end communications, ensuring alignment of Operations team. Identify and support standardization and automation of process and workflow across all business where possible.     Direct responsibility to track all efforts associated with assigned initiatives, including IT implementations/validations, workflow and process changes, training and effectiveness monitoring.   Work with IT and Operations to highlight opportunities for improvement and monitor corrective actions to completion to ensure complete and comprehensive delivery. Communicate and collaborate with internal stakeholders as needed to support Operations objectives.     

Qualifications 

BS or BA degree Project Management (PMI), Lean Six Sigma, or similar related certification preferred 5 – 8+ years of relevant, professional work experience Experience in Continuous Improvement Management for Operations Additional related specialized training/ experience/Project Management certification may be considered in lieu of Degree Energy, drive and passion for End-to-End excellence and customer experience improvement Excellent collaborative skills and the ability to influence management decisions Technical knowledge of health insurance claims/medical management/contact center/grievance and appeals systems Strong problem solving and analytical skills that be applied across all types of business problems Strong facilitation, oral and written communication, and presentation skills Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, etc.)
  
   Additional Information Requisition ID: 1000002531 Hiring Range: $77,760-$149,040