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Recommends, develops, and implements quality improvement strategies for a Customer Service department. Responsible for planning, developing, coordinating, and implementing quality improvement initiatives stretching across business lines to various health plans and corporate units. Responsible for process mapping and process flows for the departments in which they support. Support process owners by identifying problems, finding root causes, and developing improvement strategies. Leads process and quality improvement team.
Responsibilities:
1. As a member of the process & quality improvement team for Customer Service initiatives, responsible for all process mapping and process flows.
2. Ensures timely completion of projects that support critical goals and customer satisfaction requirements.
3. Work with department head and Business Unit leaders to facilitate setting priorities, developing agendas, and designing objectives for projects.
4. Develop and communicate business case to support recommendations for change to current business practices and processes, and develop controls to monitor the progress associated with the implementation of recommended changes.
5. Serves as the corporate policies and procedures department key point of contact for department policies and policy (P&P) review and maintenance and maintains inventory of current P&Ps. Develops and maintains departmental P&P update, review and maintenance processes.
6. Engage proper resources to facilitate root cause analysis and identification of process or training deficiencies
7. Work with business leaders to coordinate improvement efforts across business lines.
8. Assist in the building and implementation of a process & quality improvement team / function.
9. Conduct effective presentations and act as a subject-matter expert / mentor on quality improvement activities.
10. Other duties as assigned.
Qualifications:
Education:
Required:
Bachelors degree
Preferred:
Masters degree in business administration, statistics, or healthcare related field, or equivalent work experience
Years and Type of Experience Required::
Required:
5 years relevant experience in the areas of process improvement and project management with at least 1 year of leadership/management experience.
Preferred:
Experience in call center operations and/or claims payment activities.
Experience in a HMO or managed care environment
Experience utilizing Six Sigma & Lean methodologies
Specific Technical Skills:
Required:
Proficient in MS Office (Work, Excel, Access, Powerpoint)
Preferred:
Visio and statistical software ' Microsoft Project
Certifications or Licensures:
Preferred:
Certified PMP
Certified Green Belt
Other:
Required:
Experience leading process improvement initiatives
Self-directed with strong organizational skills.
Excellent analytical skills
Excellent verbal and written communication skills.
Ability to foster inter and intradepartmental communication and team building.
Ability to influence others.
Ability to build collaboration by establishing, communicating and reinforcing shared values and norms.
Ability to prepare and deliver clear, well-organized presentations.
Attention to detail.
Multi-task oriented with ability to follow-up on numerous complex problems.
SCOPE INFORMATION
# Direct Reports: 0-3
PHYSICAL REQUIREMENTS:
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Must be able to operate general office equipment including but not limited to: computer, phones and related media and information devices.
Ability to communicate both in person and/or by telephone.
Must be able to travel as needed and adhere to AMERIGROUP travel policies and procedures