Process Improvement Senior Manager, Medicare Risk Adjustment

Manages the delivery, execution, and sustainment of process improvement (PI) engagements including kaizen. Ensures consultation is provided to stakeholders and process owners by building partnerships between stakeholders and teams to drive process improvements. Develops strategic plans which ensure alignment of organizational objectives, business priorities, and process improvement initiatives. Serves as a lead advocate of continuous learning and professional development by defining, developing, and evaluating performance metrics, standards, and methods to establish process success. Manages change management activities associated with care delivery or clinical initiatives and manages team members in performing complex data analyses to drive care delivery or clinical initiatives.

• Creates and advocates for developmental opportunities for others; builds collaborative, cross-functional relationships. Solicits and acts on performance feedback; works with leaders and employees to set goals and provide open feedback and coaching to drive performance improvement. Pursues professional growth; hires, trains, and develops talent for growth opportunities; strategically evaluates talent for succession planning; sets performance management guidelines and expectations across teams / units. Oversees implementation, adapts, and stays up to date with organizational change, challenges, feedback, best practices, processes, and industry trends; shares best practices within and across teams. Fosters open dialogue amongst team members, engages, motivates, and promotes collaboration within and across teams; motivates teams to meet business objectives. Delegates tasks and decisions as appropriate; provides appropriate support, guidance and scope; encourages development and consideration of options in decision making; fosters access to stakeholders.


• Manages designated units or teams by translating business plans into tactical action items; oversees the completion of work assignments and identifies opportunities for improvement; ensures all policies and procedures are followed; partners with key stakeholders and business leaders to ensure products and / or services meet requirements and expectations while aligning with departmental strategies. Aligns team efforts; builds accountability for and measuring progress in achieving results; assumes responsibility for decision making; fosters direct reports to resolve escalated issues as appropriate. Communicates goals and objectives; incorporates resources, costs, and forecasts into team and unit plans; ensures matrixed resources are fulfilling service or performance requirements across reporting lines. Removes obstacles that impact performance; identifies and addresses improvement opportunities; guides performance and develops contingency plans accordingly; influences teams and units to operate in alignment with operational and business objectives.


• Manages the delivery, execution, and sustainment of process improvement (PI) engagements including kaizen by leveraging advanced methods and tools to ensure the development of stakeholder capabilities for process change and improvement; forecasting the deployment of new data-driven PI principles, tools, and problem-solving methods including Lean/Six Sigma concepts and techniques; fostering high performance team capabilities to harness collective intelligence and take quick action to test ideas and achieve real time business results; managing the design and development of process architecture and recommendation documents; sharing accountability for realization of results with process owners; and presenting results and recommendations to senior and/or management as appropriate.


• Ensures consultation is provided to stakeholders and process owners by building partnerships between stakeholders and teams to drive process improvements; leading the development of management systems to sustain process changes; empowering stakeholder process improvement leadership competencies; managing stakeholder training; and providing ongoing coaching to senior management in order to build a continuous improvement mindset and culture, and to build capabilities that drive results.


• Develops strategic plans which ensure alignment of organizational objectives, business priorities and process improvement initiatives by defining, developing, and evaluating performance metrics, standards, and methods to establish process success; partnering with senior and/or executive stakeholders, often with competing/conflicting objectives, to ensure cohesive and reachable metrics; refining strategic plans and performance metrics as appropriate to calculate future needs; and managing complex initiatives or portfolio to ensure delivery of measurable results and alignment with strategic objectives.


• Serves as a lead advocate of continuous learning and professional development by keeping abreast of industry practices, standards, and benchmarks; attending and presenting at roadshows, conferences, and speaking events; overseeing the ongoing enhancement and innovation of clinical consulting practices, standards, and methods across KP; and serving as an advocate to ensure continuous learning and improvement is championed as a people strategy.


• Manages change management activities associated with care delivery or clinical initiatives by engaging and influencing stakeholders to obtain support and buy in for changes; partnering with senior and/or executive management, project champions, and clinical owners to communicate and align improvement initiatives with strategic objectives; recommending and determining appropriate change management method and approach; and ensuring stakeholders embrace a change management mindset, understand intent and purpose, and foster a culture of change.


• Manages team members in performing complex data analyses to drive care delivery or clinical initiatives by recommending appropriate data analysis tools and approach to assess performance; empowering team members to utilize suitable data gathering and analysis methods (e.g., process observation, hard data, etc.); defining data requirements and obtaining customer agreements, including customer requirements as appropriate; and forecasting and alleviating risks through data-driven analysis.