Process Improvement Director

Anticipated End Date:

2025-08-06

Position Title:

Process Improvement Director

Job Description:

Process Improvement Director

Location: Ideal candidates will be able to report to our Pulse Point location at 21215 Burbank Blvd., Woodland Hills, CA 91367.

Work Hours: Monday to Friday, 8:00 am to 5:00 pm

The Process Improvement Director will be responsible for identifying opportunities for improvement, developing and implementing best practice and continuous improvement initiatives for a business unit.

How you will make an impact: 

• Generate process improvements that bring about measurable improvement in quality and/or efficiency.
• Contribute to achieving the department's objectives by serving as key contact for researching and implementing solutions and tools for new systems and other key operational improvements and providing guidance to leads, process experts, associates, and/or managers on process improvement issues.
• Represent the department on process improvement teams, special projects, and implementation of new process improvement initiatives such as Paper Claims Oversight Processes,
• Accumulate error reconciliation Processes, ServiceConnect Integration, and PG tracking and reporting.
• Conduct discovery and implement process improvement initiatives within the department. Interview leads within the team and identify process improvement opportunities.
• Establish the process improvement framework and provide pharmacy claims, Accums, and new client implementation business domain expertise to guide the team in implementing relevant initiatives.
• Lead the training of associates when new processes or procedures are implemented.
• Establish capacity models and dashboards to track efficiency of claims processing units.
• Develop regular cadence with vendor partners to ensure lessons learned are reviewed and incorporated for areas such as claims, member data transition, user access provisioning, data interfaces, and other claims business operation functions.
• Generate dashboard and reports for management on process improvements and tracking the savings established from the improvements.
• Manage and maintain SharePoint and MS Teams applications for the organization including workflow management.
• Develop and manage tableau reports for the department.
• Perform the role of the automation lead by developing business process automation initiatives for PBM (Pharmacy Benefit Management) Operations Functions.
• Collaborate with cross-functional teams in the identification, research, and implementation of process improvements.
• Lead projects of significant scope.
• Manage internal and external process improvement projects with team members who work across regional and enterprise-wide organizational structures and with external parties (providers and trade organizations) to formulate consensus on improvements and to implement internal and external systems, policies, and procedures.

Minimum Requirements: 

• Bachelor’s degree in Information Technology, Computer Science, Electronics Engineering, or a related field.
• Five (5) years of Information Technology (IT) experience, or related.
• Five (5) years of required IT, or related experience must include:
• Five (5) years of experience with integrating SQL scripts and SQL queries into Python for complex data analysis and process automation.
• Five (5) years of experience with designing user-friendly GUI tools and applications using Python to automate business processes.
• Five (5) years of experience with authoring business requirements and use cases.
• Five (5) years of experience with developing acceptance testing strategies and executing both manual and automated user acceptance testing.
• Five (5) years of experience with working with a suite of mainframe applications and developing automation tools within a mainframe environment.
• Four (4) years of experience with developing automation tools for web scraping and processing online forms, implementing complex business requirements with Python and Selenium.
• Three (3) years of experience performing advanced data analysis on pharmacy and medical claims, accumulators, and benefits data using Python-based data science tools.
• Two (2) years of experience with data visualization, creating charts, graphs, maps, dashboards, and narratives for business decision-making using Python and Tableau.

Salary:  $151,694 - $152,694 per year

Job Level:

Director Equivalent

Workshift:

Job Family:

BSP > Process Improvement

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.