Senior Specialist, Process improvement (SIU)
Core
Organize, scope, triage, investigate, and execute process improvements for the Special Investigations Unit (SIU) to resolve operational risks and adverse claim outcomes.
Role type
Senior Specialist, Process Improvement (SIU)
Builds
Actionable process improvements and technology-driven solutions for the SIU
Domain
Health Insurance / Claims Operations
Required skills
Root cause analysis, Data analysis, Process improvement, Stakeholder collaboration, Project management, Compliance monitoring, Workflow optimization, Technical requirements translation, Cost optimization, Documentation management
Preferred skills
SQL, Lean Six Sigma, Healthcare claims experience, Engineering/Data background, Knowledge management
Technologies
Excel, Databases, SQL
Responsibilities
Conduct SIU intake, triage, and tip research; Identify and resolve operational risks; Scope and deliver solutions based on stakeholder feedback; Produce quantitative insights from data analysis; Identify systemic areas for improvement; Maintain accurate records and documentation; Coordinate projects to meet SLAs; Implement cost optimization initiatives.
Seniority
Senior, hands-on IC