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Sr Manager Continuous Process Improvement Master Black Belt Englewood, CO



Description

DESCRIPTION OF MARKET AREA
Working with the national claims administration team and regional leadership, the position will have significant engagement with Sr. leaders, line staff, analysts, and IT professionals through a variety of channels including formal meeting settings as well as impromptu touch points.


POSITION SUMMARY
The purpose of this position is to drive an increase in auto-adjudication for each regional instance of the Tapestry claims platforms through the identification of opportunities, monitor progress, and partner with others to resolve barriers to ensure the expected targets are realized/exceeded.
The work will engage a small team of experts, using proven methodologies, to identify types of claims that are causing holds to occur in the system preventing claims from automated timely processing. The manager will use in depth knowledge of both the system as well as the end to end claims adjudication workflow to make these improvements.

WORKING RELATIONSHIPS
NCA leaders and key subject matter experts
IT including production support, Application Build
Benefit Data Management
Provider Service Administration
Regional department leaders and staff

PRINCIPAL RESPONSIBILITIES
This position, reporting to the Executive Director, OPMI will have primary responsibility for:
1. Drive an increase in auto-adjudication for each region-s instance of Tapestry AP.

2. Meet or exceed targets outlined in the KPCC business case.

3. Lead a team of experts using proven methodologies to identify, analyze, measure and sustain positive results of automation.

4. Build relationships with key department leaders in region and NCA.

5. Partner with NCA department management and staff to drive solutions for problem areas impacting automation, create SBARs to drive decision-making, create documents and dashboards to ensure visibility for leadership.

6. Provide transparency to the NCA leaders re: issues and areas for improvement. Drive prioritization process of areas to address first and able to represent the data statistically to show the anticipated lift in AA. Document outcomes in a quantifiable manner.

7. Partner with others to resolve barriers to ensure the expected AA targets are realized/exceeded.

8. Ensure other teams are engaged to identify impacts to processes, documentation, training as well as platform build.

9. Leverage processes and successes from one region with the other

- Bachelor-s degree or equivalent experience required. Demonstrated experience is required in the following areas:

- Managing people, projects and processes.

- Strong analytical skills.

- Strong problem solving capabilities and the ability to teach others the skills.

- Industry knowledge of standard health plan operation processes and infrastructure, inclusive of claims hold/pend code strategies, coding practices and strategic approach for improving automation.

- Ability to see and understand end-to-end processes, cross boundary dependencies and -down-stream- effects.

- Familiar with project management and continuous process improvement methodologies, ( such as DMAIC, Lean Six Sigma, Scrum, etc.)

- Ability to present data in a user friendly actionable format.

- Ability to gain confidence and support of customers.

- Collaborative style with ability to engage multiple stakeholders with differing views.

- Ability to successfully work in a Labor-Management Partnership environment.





Qualifications:

Basic Qualifications:
Experience
- Minimum three (3) years of management experience.
- Minimum eight (8) years of process and/or project management, consulting, or related business experience.
Education
- Bachelor's degree OR four (4) years of experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- N/A


Additional Requirements:
- Must be able to work in a Labor/Management Partnership environment.


Preferred Qualifications:
- Knowledge of process management/improvement, methodologies preferred.
- Health plan management knowledge preferred.

- Graduate degree in a business or management discipline preferred.



Primary Location: Colorado,Englewood,Englewood MSSA 9800 S. Meridian Blvd.

Scheduled Hours (1-40): 40

Shift: Day

Working Days: Mon - Fri

Schedule: Full-time

Job Type: Standard

Employee Status: Regular

Employee Group: Salaried, Non-Union, Exempt

Job Level: Manager with Direct Reports

Job: Consulting Services / Project/Program Management (Non IT)

Public Department Name: NCA-Ops Performance Monitoring & Improvement


External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.

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