**Job Description** **Job Summary** Leads clinical systems, automation, integration, implementation and process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of MHI's business process improvement methodology and in the implementation of a business process improvement capability. Responsible for evaluating existing processes and configuring clinical systems to reduce cost and develop best practices within clinical programs. **Knowledge/Skills/Abilities** • Optimizes and improves clinical systems, business processes and productivity using understanding of key revenue levers, cost drivers and customer satisfaction impacts of business processes • Leads process improvement initiatives and implementation with defined objectives and measurable results • Works with business sponsors to develop clear definitions of business process improvement opportunities and establish measurable goals/objectives • Engages cross-functional areas & health plans (e.g. product, configuration, UM, Care Management, provider network, claims) for requirements planning • Makes recommendations on scope and priorities for improvement initiatives, assesses for opportunities for vendor solutions. • Develops and optimizes processes to achieve the output, quality, and cost goals of the organization. • Plans and executes process improvement initiatives, leading work streams of significant scope, typically requiring cross-functional integration • Focuses on improving operational fundamentals and effectiveness; uses expertise to make operating processes more nimble and sustainable • Ensures that on-going work following a system implementation or improvement initiative is identified, planned, assigned and successfully deployed • Researches and engages industry, evaluates, and provides industry insights, competitor best practices as applicable for adoption or use by Molina • Conducts or coordinates post-implementation initiative review to measure results and report to health plan partners, senior management & stakeholders • Provides summary analysis of clinical systems automation, implementation, integration and compliance based issues, to influence product revisions • Coaches and mentors other Molina leaders and staff in the system application of business process improvement, implementation and intergration • Manages a team of product owners, Program Managers and Subject Matter Experts responsible for implementation of approved initiatives • Responsible for coaching the team on Agile, Scrum, Quality Improvement methodologies for application on enterprise initiatives • Builds company specific systems and technology expertise across multiple infrastructure and development disciplines. • Responsible for areas of strategic planning for architecture standards, roadmaps, budgets, programs and projects. • Responsible for providing expertise of major industry trends such as cloud technologies, automation, agile methodologies, etc. • Ownership to provide cross-organization teamwork, collaboration, communication and leadership. • Provides constructive feedback on people, process and technology for continuous improvement. • Relationship building with IT leadership, technical engineers, program managers, support leads, and external vendors to understand and solve problems. Accountable for insuring compliance with contractual, accreditation and regulatory requirements • Partners with Compliance to ensure system features impacting regulatory requirements are addressed via a Corrective Action Plan in collaboration with IT.. **Job Qualifications** **Required Education** Bachelor's degree required in a related field (Business Administration, etc.) **Required Experience** • 10 years minimum experience in Healthcare. • Extensive management level experience or understanding of all areas of health plan operations: claims processing, customer service/call center, provider contracting, benefit design and configuration, product development, membership accounting and enrollment, operational systems, provider contracting, authorizations/referrals, utilization management. • Understands key revenue levers and cost drivers of business processes. • Understands critical success factors for the industry. • Experience designing and delivering solutions related to operational improvement functions. • Experience implementing new systems and systems processes • Strong leadership qualities and ability to get results. **Required License, Certification, Association** LEAN six sigma black belt **Preferred Education** Masters degree in Business Administration or a related field To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $186,201.39 - $363,093 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.