Process Excellence Role - Continuous Improvement + Transformation

1. Primary responsibilities (pl. provide a detailed description):

a. Customer related:

- Keep abreast with the process of claims processing/Rework/ G&A/ Payment Integrity/International Claims/ B&E, PB, PDM & Credentialing/ WCL, Coding & Clinical/ Pre registration..etc. in the healthcare industry

- Working with Healthcare client to drive transformation of their business through RPA, Intelligent Automation, OCR, AI/ML, Analytics, Data Mining, Process Mining, workflow solution and other Tech Led solutions

- Have a good understanding of the performance SLA's and meet the SLA's

- Understand all binding laws and regulations related to the project

- Developing in-depth knowledge base among the team members relating to domain and process

b. Financials related:

- Business strategist; plan and manage high ROI projects aligning business goals with technology solutions to drive process improvements, competitive advantage and bottom-line gains

- Responsible for driving transformation initiatives, among the teams aligned to them

- Identify opportunities to be implemented to derive tangible benefit for the organization

- Keep a track of transformation initiatives and adhere to project schedule, report out proactively the risk and failure points. Follow the escalation matrix

- Keep a track of Lean, WB, YB, GB and BB Project and monitor the adherence to the project timeline

- Collaborate with other BU s / Peer experts / Global teams to maximize benefit realization

- Plan & forecast resources for optimal utilization of manpower.

c. People related:

- Execute transformation business case, future state and implementation road map, guiding process documentation, setting up automation teams/practice and supporting in the implementation.

- Conduct individual performance reviews and propose the required action plan

- Strong communication skills with all levels of the organization, emphasis on oral presentation skills, exceptional classroom training techniques, facilitation, coaching and feedback

- Preferred experience in Mentoring team members through Blue Prism, Automation Anywhere, UiPath,, ABBYY Flex capture, UiPath Document Understanding, Analytics Dashboards etc. platform trainings - Providing advice and guidance on best practices and Development techniques.

- Ability to challenge current state and motivated to improve the business.

d. Process related:

- Metrics Management Conduct Opportunity Identification and prioritization workshops

- Execute transformation business case, future state and implementation road map, guiding process documentation, setting up automation teams/practice and supporting in the implementation

- Conduct process assessments / consulting assignments, assist in creating BRD / requirement document. Validate the Project benefit and present it to Internal and External customers

- Refining and controlling the Scope of the Project. Involved in Project Scoping / Assessments, Proposal & RFP / RFI evaluation and response, Costing, Sizing, Estimations, Project Planning, recruiting, reporting, resource management etc

- Facilitate all transformation initiatives including Automation, Analytics, Data science six sigma & lean projects in the organization

- Facilitate the requirements for the awards etc

- Capability to train and conduct workshops in Six Sigma, Kaizens, Lean training etc & certifications

- Coordinate with all the departments for the projects

- To drive quality culture in the team & make quality as a way of life,

- Data Analysis Identify & escalate issues/findings to the project leadership

- Provide support/coaching /mentoring to project lead or BU on data analysis and data interpretations

- Presenting data, sharing analysis and getting concurrence from stakeholders on actions (for assigned BU/processes)

- Value addition Effective running of the projects and recommending any process or other enhancements

- Identify & facilitate continuous operational improvement opportunities

- Identifying the high impact projects over and above client /BU expectations

- Creating or deploying additional CI ,Business Intelligence tools and deployment

- Reviews Review controls set for any projects

- Review controls set for any projects and Timely monitoring of Project Tollgates as per agreed timelines

- Conduct timely performance reviews as per HR guidelines

- Self-Improvement Build on competencies for the next level or another thread of the process

- Proactively approach to enroll self in trainings identified based on discussions and self evaluation/interests

- Have an in-depth understanding of all the quality tools, six sigma, kaizens etc

- Plan & forecast resources for optimal utilization of manpower.

- Manager in crisis management and administrative work and timely escalation of issues.

- Assisting training/refresher requirements for processing teams based on the error trends of individual teams

- Coordinating with the client on projects/programs related issues and updates.

- Effective participation in Con. Calls pertaining to Subject and process improvements.

- Addressing the technical queries raised by the team.

- Identify key people and build good leaders and motivating team members.

- Interacting with management, and put forth queries/concerns of the team.

- Identify and organize training programs

- Conducting team reviews, submitting progress reports of the team to the manager and conducting appraisals.

- Recommending benefits, bonus, incentives and promotions for the team to the Sr. Manager.

- Conducting regular team meetings, one on one coaching and feedback.

- Conduct periodic SWOT analysis and update the report to management.

- Meeting internal process metrics (GIS, PI, HL, and Appraisal etc.).

- Meeting attrition goals for their respective process.

- Supporting the management team on business development.

- Sharing management views with the team.

2. Secondary responsibilities (if any):

a. Customer related

b. Financial related

c. People related:

- Ability to work with a diverse population

- Ensure the process follows strict adherence to the process workflow and apt behavior is observed

- Ensure good leaders are developed

- Final point of Escalation of issues/concerns with the support groups i.e., HR, Admin, TSG, QAG and Finance

- Handling disciplinary issues and administrative issues of the project

d. Process related:

- Put forth queries/concerns of the BUH and address accordingly

- Counseling of team members on improving Quality & productivity

- Reviewing continuous quality improvements processes

Knowledge/Skills/Attitude/ Domain expertise (required to play this role) Knowledge:

- Knowledge in the healthcare industry required

- Team leadership skills (mandatory) including managing existing teams and growing new teams.

- Knowledge of Basis QC Tool, six sigma concepts of DMAIC (and all tools included therein)

- Experience of having done BPMS or trained on BPMS (Business Process Management System)

- Usage of Statistical tool like Minitab

Attitude:

- Have a positive attitude

- Flexibility and ability to assimilate new knowledge and standards quickly

- Courage to make difficult decisions and/or recommendations

Domain expertise, if any:

- Any healthcare BPO industry

Required Qualifications/ Experience/ Certifications Educational qualifications:

High school +2+3

Experience (years):

3+ years (healthcare industry knowledge preferred)

Min ~ 4 to 8 years' experience in a Lean/Six Sigma role

Certifications (Technical / Non-technical), if any:

Must be Certified Lean Six Sigma Black belt

Exposure to RPA projects would be an added advantage

Internal Customers, if any - Immediate reporting manager

- Employees reporting into the role of Sr. Manager

- Internal support functions Viz, HR, Admin, TSG.

- All vendors associated with the organization.

External Customers, if any - The client