Senior Process Improvement Professional

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The Senior Process Improvement Professional analyzes, and measures the effectiveness of existing business processes and develops sustainable, repeatable and quantifiable business process improvements. The Senior Process Improvement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Process Improvement Professional will provide business ownership and leadership for strategic Medicaid enrollment and waiver modernization initiatives that support operational efficiency, regulatory compliance, and accurate member administration. These roles will partner across Enrollment, Clinical, Claims, Finance, and Technology teams to design, implement, and sustain enterprise solutions that reduce manual effort, improve data integrity, and mitigate operational risk.

The positions will be dedicated to advancing member movement capabilities and waiver administration enhancements that have significant downstream impacts across the organization.

Lead Enterprise Member Movement Enhancements

Serve as a business lead for initiatives that improve the organization's ability to execute large-scale member movement activities accurately and efficiently.

Partner with Information Technology and business stakeholders to define requirements, conduct testing, validate results, and support implementation activities.

Identify operational risks and develop solutions that improve responsiveness while minimizing impacts to clinical, claims, finance, and enrollment operations.

Monitor post-implementation performance to ensure expected business outcomes are achieved.

Lead Medicaid Waiver Modernization Efforts

Provide operational ownership and oversight for enhancements supporting the administration of multiple Medicaid waivers.

Manage and govern LTSS waiver-related processes, including oversight of waiver updates, validations, and issue resolution activities.

Assume responsibility for the LTSS mailbox and coordinate timely review, validation, and processing of waiver-related member information.

Develop and implement scalable processes that reduce manual intervention and improve waiver data accuracy.

Cross-Functional Leadership

Act as a liaison between business operations, technology, finance, claims, clinical, and enrollment teams.

Facilitate stakeholder alignment on priorities, business requirements, testing strategies, implementation plans, and operational readiness.

Communicate project progress, risks, dependencies, and recommendations to leadership.

Support training, change management, and adoption efforts for new processes and capabilities.

Continuous Improvement and Governance

Identify opportunities to automate manual processes and improve operational performance.

Establish monitoring, reporting, and governance practices to support compliance and operational excellence.

Analyze business processes and recommend enhancements that improve efficiency, scalability, and member experience.

Support enterprise transformation initiatives focused on Medicaid operations and enrollment modernization.

Number of Openings: 2 Senior Process Improvement Professionals. These positions will provide dedicated support for Medicaid member mass movement enhancements and multiple waiver administration initiatives while ensuring effective governance of LTSS waiver operations and related business processes.