Job Description
Job Summary
Leads and manages team responsible for process improvement initiatives that result in operational efficiencies and/or increase customer satisfaction. Assists in development of enterprise process improvement methodologies and the implementation of business process improvement capabilities.
Job Duties
• Oversees program development, implementations and process improvement initiatives.
• Assesses business and operational needs for opportunities to improve efficiency, productivity, effectiveness, and accuracy.
• Collaborates with senior leadership to develop and deploy an organizational strategies to optimize workflows.
• Uses Lean and Six-Sigma methodologies to create and maintain a culture of continuous improvement.
• Develops and conducts process improvement trainings.
• Conducts meetings and disseminates communications related to process improvement activities.
• Hires, trains, develops and manages team demonstrates accountability for team performance and achievement of quality/department-specific goals.
Job Qualifications
REQUIRED QUALIFICATIONS:
• At least 7 years of health care operations, process improvement and/or lean management experience, or equivalent combination of relevant education and experience.
• At least 1 year of management/leadership experience.
• Understanding of all areas of health plan operations including: claims processing, customer service/call center, provider contracting, benefit design and configuration, product development, membership accounting and enrollment, operational systems, provider contracting, authorizations/referrals, and utilization management.
• Experience with Medicare, Medicaid, and Marketplace plans.• Understands key revenue levers and cost drivers of business processes.
• Understanding of critical success factors for the industry.
• Experience designing and delivering solutions related to operational improvement functions.
• Ability to work cross-collaboratively across a highly matrixed organization and establish and maintain effective relationships with internal and external stakeholders.
• Strong organizational and time-management skills ability to manage simultaneous projects and tasks to meet internal deadlines.
• Strong verbal and written communication skills.
• Microsoft Office suite (including Excel), and applicable software programs proficiency.
Process Improvement & Operational Excellence
Lead end‑to‑end process improvement initiatives, from problem identification through implementation and measurement
Analyze current‑state workflows and system behavior to identify inefficiencies, risks, and improvement opportunities
Define future‑state processes supported by data, clear metrics, and operational outcomes
Establish KPIs and success measures to track adoption and performance improvements
Systems & Platform Expertise (Required)
Serve as a subject‑matter expert across core operational platforms, with a strong understanding of how system design and data impact business processes
Understand upstream and downstream data flows and how system changes affect operational performance and reporting
Partner closely with IT, Product, and Operations teams to support system enhancements, process changes, and analytics continuity
Analytics & Insights Enablement
Translate system and operational data into actionable insights that inform process decisions
Ensure accuracy, consistency, and usability of reporting tied to operational workflows
Partner with analytics and reporting teams to ensure dashboards and metrics accurately reflect operational workflows
Stakeholder Partnership & Execution
Act as a trusted partner to Sales, Agent Operations, and Member/Provider teams
Communicate complex process and system insights clearly to both technical and non‑technical stakeholders, including leadership
Manage timelines, dependencies, and delivery commitments across multiple concurrent initiatives
Required Qualifications
4+ years of experience in process improvement, operational excellence, business intelligence, or analytics roles
Required hands‑on experience supporting operational processes and data management for the following platforms:
Salesforce (CRM)
Genesys (Telecom)
Member, Provider and Broker
Proven ability to translate complex, multi‑system data into process improvements and operational insights
Experience operating in integrated, enterprise system environments
Strong communication, organization, and problem‑solving skills
Preferred Qualifications
Salesforce Administrator Certification
PREFERRED QUALIFICATIONS:
• Lean certification and/or Lean Six Sigma black belt.
• Health care related process improvement experience with demonstrable successes in application of Lean/Six Sigma.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.