Process Improvement Lead, Medicaid

This is a fully remote position, open to applicants in South Carolina.

📋 Description

• Assess and evaluate the effectiveness of current business processes.

• Create sustainable, repeatable, and measurable improvements to business processes.

• Design and implement operational excellence initiatives.

• Identify areas of inefficiency, propose solutions, and facilitate the adoption of best practices.

• Investigate business practices to set team benchmarks.

• Review and optimize processes and procedures to enhance collaboration, efficiency, and compliance.

• Construct and implement new processes and practices.

• Act as the department's primary contact for compliance, audits, and quality assessments, including NCQA materials.

• Gather and analyze data, pinpoint gaps, and establish processes and procedures.

• Evaluate job aids, onboarding for new hires, and training procedures.

• Provide strategic advice to leadership on functional strategies.

• Report to the Director of Health Services and manage 1–2 direct reports.

⛳️ Requirements

• Bachelor's degree.

• A minimum of 5 years of experience in process improvement.

• At least 2 years of experience in project leadership.

• A minimum of 2 years of experience in case management and/or utilization management.

• Active Registered Nurse (RN) or Master of Social Work (MSW) license in the state of employment (preferred).

• Experience with Medicaid compliance (preferred).

• At least 2 years of experience with Medicaid.

• Certification in Lean, Six Sigma, or a similar process improvement methodology (preferred).

• Proven ability to lead multiple initiatives and implement change within a matrixed organization.

• Knowledge of project management tools and resources.

🏝️ Benefits

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Bonus incentive plan.