Process Improvement Project Manager

Summary

We are seeking a seasoned Project Manager to lead a Business Process Improvement Plan (BPIP) focused on optimizing workflows, data exchanges, and operational efficiencies within our Medicaid Interchange and related healthcare systems.

This role will play a critical part in aligning people, process, and technology to strengthen compliance, improve service delivery, and ensure seamless data exchange between state systems, providers, and internal delivery teams. The ideal candidate is highly organized, analytical, and skilled at driving process change within complex, regulated environments.

Your role in our mission

• Build & Maintain a list of business process improvements that is recommended from all key stakeholders.
• Lead the design and implementation of a comprehensive Business Process Improvement Plan to enhance Medicaid Interchange operations, claims processing accuracy, and cross-system data flow.
• Conduct end-to-end process mapping to identify inefficiencies across enrollment, eligibility, claims, financial reconciliation, and provider management workflows.
• Collaborate with Medicaid business owners, IT system managers, and PMO leads to document current-state processes, define measurable improvement goals, and establish future-state workflows.
• Develop and maintain a structured governance framework, including timelines, deliverables, KPI dashboards, and risk mitigation strategies.
• Partner with compliance and quality teams to ensure all process updates align with CMS and state Medicaid regulations.
• Drive implementation of standard operating procedures (SOPs) and process documentation that support audit readiness and knowledge retention.
• Facilitate cross-functional improvement workshops to gather input, resolve pain points, and secure buy-in from key stakeholders.
• Work with systems integration and analytics teams to automate manual handoffs, enhance data accuracy, and improve reporting capabilities across platforms.
• Monitor progress through key performance indicators and other tools including PowerBI (e.g., cycle time reduction, error rate improvement, service-level compliance) and communicate results to leadership.
• Support change management and training efforts to embed new processes and ensure sustainable adoption across teams.

What we're looking for

• 5+ years of experience in project management or process improvement within the healthcare or Medicaid domain.
• 3+ Years of business process improvement experience in a health care setting
• Strong understanding of Medicaid operations, MMIS/Interchange systems, and associated business functions (claims, eligibility, provider, finance).
• Demonstrated ability to manage cross-functional projects involving IT systems, business operations, and regulatory compliance.
• Experience with Lean, Six Sigma, or similar process improvement methodologies (certification preferred).
• Excellent stakeholder management, communication, and facilitation skills—capable of translating technical and operational requirements into actionable plans.
• Proficiency with process documentation, workflow modeling (Visio, Lucidchart), and data analysis tools (Excel, Power BI, Smartsheet).
• PMP, Lean Six Sigma, or similar certification preferred.

What you should expect in this role

• Remote position (US only)
• Opportunities to travel through your work (0-10%)
• Video cameras must be used during all interviews, as well as during the initial week of orientation
• The deadline to submit applications for this posting is 1/30/2026